Musham C, Brock C D
Environmental Hazards Assessment Program, Medical University of South Carolina, Charleston.
Fam Med. 1994 Jun;26(6):382-6.
Balint groups are focused discussion groups that help students, residents, or physicians respond empathetically to their patients and recognize underlying psychosocial elements in patients' complaints. Approximately 40% to 60% of residents who start optional Balint group training show infrequent attendance. The primary objective of this study was to interview frequent and nonfrequent attenders to assess the value of Balint group training from the residents' perspective and to explain why many residents attend Balint group meetings infrequently or discontinue Balint training altogether.
Two methods were used to discern differences between frequent attenders and infrequent attenders: (1) evaluation of Myers-Briggs Type Indicator (MBTI) data collected at the beginning of the residency program, and (2) semi-structured personal interviews with both frequent and infrequent attenders.
MBTI data showed frequent attenders to have higher scores than infrequent attenders in the intuitive dimension. Interviews with Balint group attenders showed strong perception about the value of this training. The majority felt Balint training had improved their effectiveness as family physicians, specifically when dealing with troubling patients. Infrequent attenders mentioned scheduling problems and a variety of emotional/personality factors as reasons for not attending Balint seminars. Frequent attenders attributed nonattendance in others to lack of interest in the psychodynamics of the doctor-patient relationship and differences in personality type.
Residents who participated in Balint groups perceive this training as helpful in understanding themselves in relationships with their patients. However, the study results suggest that many residents choose not to attend optional Balint group seminars because of emotional or personality variables, such as anxiety about self-disclosure and introversion. While Balint groups are a valuable component of a family practice residency program, it is likely that not all residents will be motivated or capable of deriving benefits from this teaching approach.
巴林特小组是聚焦式讨论小组，旨在帮助学生、住院医师或医生对患者产生共情反应，并识别患者诉求中潜在的心理社会因素。开始参加巴林特小组选修培训的住院医师中，约40%至60%出席率较低。本研究的主要目的是访谈经常参加者和不经常参加者，从住院医师的角度评估巴林特小组培训的价值，并解释为何许多住院医师很少参加巴林特小组会议或完全停止巴林特培训。
采用两种方法来辨别经常参加者和不经常参加者之间的差异：（1）评估住院医师培训项目开始时收集的迈尔斯-布里格斯类型指标（MBTI）数据，以及（2）对经常参加者和不经常参加者进行半结构化个人访谈。
MBTI数据显示，经常参加者在直觉维度上的得分高于不经常参加者。对巴林特小组参加者的访谈表明，他们对这种培训的价值有强烈的认知。大多数人认为巴林特培训提高了他们作为家庭医生的效能，特别是在处理棘手患者时。不经常参加者提到日程安排问题以及各种情感/性格因素是不参加巴林特研讨会的原因。经常参加者将其他人不参加归因于对医患关系心理动力学缺乏兴趣以及性格类型差异。
参加巴林特小组的住院医师认为这种培训有助于他们理解自己与患者的关系。然而，研究结果表明，许多住院医师由于情感或性格变量，如对自我表露的焦虑和内向，选择不参加巴林特小组选修研讨会。虽然巴林特小组是家庭医学住院医师培训项目的一个有价值的组成部分，但并非所有住院医师都可能有动力或有能力从这种教学方法中受益。
