Woolley D, Clements T
Department of Family and Community Medicine, University of Kansas School of Medicine, Wichita 67214-3199, USA.
Acad Med. 1997 Feb;72(2):155-7. doi: 10.1097/00001888-199702000-00027.
To assess how often family physicians question patient truthfulness, what factors influence them to do so, and how often resident physicians experience such doubts as compared with senior physicians.
In 1994-95, after half-day patient care sessions, 44 residents from the University of Kansas School of Medicine's three Wichita family practice residency programs and nine community family physicians associated with the programs recorded their impressions of each patient's truthfulness, what issues prompted concern about patient truthfulness, and their feelings about each encounter.
The residents doubted patients in 54 of 277 encounters (19.5%); the senior physicians doubted patients in 16 of 183 encounters (8.7%) (p = .003). Both groups had more negative than positive emotions toward such encounters, with no significant difference in feelings. The demographics of the resident and senior physician populations differed greatly.
Although preliminary, the present study suggests that family physicians question patient truthfulness fairly often, resident physicians more than senior physicians, and that these physicians have some negative feelings toward such situations. Because such feelings may contribute to inadequate patient care, the authors recommend that further research is warranted to understand contributing factors and to guide the development of resident and student education programs in this neglected area of the doctor-patient relationship.
评估家庭医生质疑患者真实性的频率、影响他们这样做的因素,以及与资深医生相比,住院医生经历此类怀疑的频率。
在1994 - 1995年,堪萨斯大学医学院威奇托分校的三个家庭医学住院医师培训项目的44名住院医生以及与这些项目相关的9名社区家庭医生,在半天的患者护理工作结束后,记录他们对每位患者真实性的印象、引发对患者真实性担忧的问题,以及他们对每次诊疗的感受。
住院医生在277次诊疗中有54次怀疑患者(19.5%);资深医生在183次诊疗中有16次怀疑患者(8.7%)(p = 0.003)。两组对这类诊疗的负面情绪都多于正面情绪,在感受方面无显著差异。住院医生和资深医生群体的人口统计学特征差异很大。
尽管本研究只是初步的,但它表明家庭医生相当频繁地质疑患者的真实性,住院医生比资深医生更频繁,而且这些医生对这种情况有一些负面感受。由于这些感受可能导致患者护理不足,作者建议有必要进行进一步研究,以了解促成因素,并指导在医患关系这个被忽视的领域开展住院医生和学生教育项目。