Griffith C H, Rich E C, Wilson J F
Department of Internal Medicine, University of Kentucky College of Medicine, Lexington 40536-0284.
Acad Med. 1995 Jan;70(1):64-6. doi: 10.1097/00001888-199501000-00016.
To assess the extent to which house officers know the social histories of their hospital patients, and to examine the factors that influence social history knowledge.
In October-November 1992, all 31 internal medicine housestaff rotating on the hospital inpatient services at the University of Kentucky A. B. Chandler Medical Center completed questionnaires regarding the social histories of up to three of their patients. Responses were analyzed using simultaneous multiple linear regression analysis.
Standard questions about social history were answered correctly only 29% of the time (two of seven items). The overall knowledge of patients' social histories was significantly less for supervising residents than for interns (p = .03) and, independently, for housestaff with greater patient loads (p = .04). Knowledge of a patient's social history was not related to the particular inpatient service, time the patient was admitted, or other characteristics of the patients or residents.
The internal medicine residents' knowledge of their hospital patients' social histories was limited, particularly when the residents had relatively heavy patient loads or supervisory roles in patient care. The data suggest that patients' social histories may have been underemphasized during the residents' training.
评估住院医师了解其医院患者社会史的程度,并探讨影响社会史知识的因素。
1992年10月至11月,在肯塔基大学A.B.钱德勒医疗中心医院内科病房轮转的所有31名住院医师完成了关于其最多三名患者社会史的问卷调查。使用同步多元线性回归分析对回答进行分析。
关于社会史的标准问题只有29%的回答正确(七个问题中的两个)。带教住院医师对患者社会史的总体了解明显少于实习医师(p = 0.03),并且独立来看,患者负荷较大的住院医师了解程度也较低(p = 0.04)。对患者社会史的了解与特定的住院科室、患者入院时间或患者及住院医师的其他特征无关。
内科住院医师对其医院患者社会史的了解有限,尤其是当住院医师患者负荷相对较重或在患者护理中担任带教角色时。数据表明,在住院医师培训期间,患者的社会史可能未得到足够重视。