Bailie R, Sibthorpe B, Douglas B, Broom D, Attewell R, McGuiness C
National Centre for Epidemiology and Population Health, Australian National University, Canberra.
Fam Pract. 1998 Feb;15(1):58-66. doi: 10.1093/fampra/15.1.58.
Medical practitioners' satisfaction with their work impacts on quality of care for their patients and on their own sense of fulfillment. Reforms introduced in the early 1990s into Australian general practice have led to concerns over the morale of GPs. This study examines satisfaction and dissatisfaction of GPs with regard to the reform strategy.
GPs throughout Australia were approached via a popular GP magazine to express their views in a questionnaire comprising closed-end and open-ended questions enquiring about satisfaction with their current role and sources of satisfaction (and dissatisfaction) of working in general practice. Factor analysis was used to identify different sources of satisfaction (and dissatisfaction), which were intercorrelated and which together represented underlying factors. Logistic regression modelling was used to determine which sources were most strongly associated with being satisfied (or not satisfied), and to explore GP characteristics associated with satisfaction.
A total of 2186 questionnaires were returned, representing the opinions of 14-18% of Australian GPs. Two-thirds (68%) of respondents reported being satisfied, most frequently with the variety of work and establishing relationships with patients and their families. Six satisfaction factors were identified on factor analysis, the most important characterizing social and interpersonal roles. Leading sources of dissatisfaction related to perceived interference by the government. Six dissatisfaction factors were identified on factor analysis, the most important characterizing governmental issues. However, on logistic regression other sources of dissatisfaction (reflecting disillusionment) were most strongly associated with not being satisfied.
The main sources of satisfaction are those which typify the long-term caring role of the community GP. While the reform strategy aimed to address problems with the organization and financing of general practice, the resulting intervention is the focus of dissatisfaction. Among dissatisfied GPs these attitudes may arise primarily from a sense of disillusionment.
医生对其工作的满意度会影响患者的护理质量以及他们自身的成就感。20世纪90年代初澳大利亚普通医疗领域进行的改革引发了对全科医生士气的担忧。本研究调查了全科医生对改革策略的满意度和不满之处。
通过一本广受欢迎的全科医生杂志联系澳大利亚各地的全科医生，让他们在一份包含封闭式和开放式问题的问卷中表达自己的观点，这些问题询问他们对当前角色的满意度以及在普通医疗工作中的满意（和不满）来源。采用因子分析来确定不同的满意（和不满）来源，这些来源相互关联并共同代表潜在因素。使用逻辑回归模型来确定哪些来源与满意（或不满意）最密切相关，并探索与满意度相关的全科医生特征。
共收回2186份问卷，代表了14 - 18%的澳大利亚全科医生的意见。三分之二（68%）的受访者表示满意，最常见的是对工作的多样性以及与患者及其家人建立关系感到满意。通过因子分析确定了六个满意因素，其中最重要的是表征社会和人际关系角色的因素。主要的不满来源与认为政府的干预有关。通过因子分析确定了六个不满因素，其中最重要的是表征政府问题的因素。然而，在逻辑回归分析中，其他不满来源（反映幻想破灭）与不满意的关联最为强烈。
满意的主要来源是那些体现社区全科医生长期护理角色的方面。虽然改革策略旨在解决普通医疗的组织和资金问题，但由此产生的干预措施却是不满的焦点。在不满意的全科医生中，这些态度可能主要源于幻想破灭的感觉。
