Carter D, Lantos J, Hughes J
University of Chicago, Pritzker School of Medicine, Illinois, USA.
Acad Med. 1996 Nov;71(11):1250-2. doi: 10.1097/00001888-199611000-00024.
Past research has demonstrated that some physicians do not feel obligated to care for patients infected with the human immunodeficiency virus (HIV). This study sought to characterize the attitudes that affect medical students' willingness to treat HIV-infected patients and to determine which attitudes are most amenable to intervention.
All 414 matriculating medical students at three Chicago schools were surveyed in 1994. After reliability-testing the attitudinal scales, the authors created a predictive model by using multiple regression analysis.
A total of 297 (72%) of the matriculating students responded. Ninety-two percent of the students agreed that patients with HIV would be welcome in their medical practices. As in past studies, a strong sense of professional obligation was associated with willingness to treat, and fear of infection and homophobia were associated with decreased willingness to treat. The authors' measure of concern about social stigma was also associated with decreased willingness. Together, these factors accounted for 53% of the variance in the Willingness to Treat scale.
In addition to confirming the predictors found in previous studies, this study demonstrated that perceived social stigma is a measurable predictor of decreased willingness to treat (with the understanding that willingness to treat is influenced by both personal and social factors). A comprehensive approach, not only in curriculum design but also in admission and policy, might better prepare students to treat HIV-infected patients.
过去的研究表明,一些医生认为没有义务治疗感染人类免疫缺陷病毒(HIV)的患者。本研究旨在描述影响医学生治疗HIV感染患者意愿的态度,并确定哪些态度最适合干预。
1994年对芝加哥三所学校的414名入学医学生进行了调查。在对态度量表进行信度测试后,作者使用多元回归分析创建了一个预测模型。
共有297名(72%)入学学生做出了回应。92%的学生同意HIV患者在他们的医疗实践中会受到欢迎。与过去的研究一样,强烈的职业义务感与治疗意愿相关,而对感染的恐惧和恐同与治疗意愿降低相关。作者对社会耻辱感的衡量也与治疗意愿降低相关。这些因素共同解释了治疗意愿量表中53%的差异。
除了证实先前研究中发现的预测因素外,本研究还表明,感知到的社会耻辱感是治疗意愿降低的一个可衡量的预测因素(要理解治疗意愿受个人和社会因素的影响)。一种全面的方法,不仅在课程设计方面,而且在招生和政策方面,可能会更好地让学生为治疗HIV感染患者做好准备。