神经内科医生职业压力与医患关系现状分析
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摘要
[目的]探讨某市神经内科医师职业压力与医患关系现状及两者关系。[方法] 2018年3月,采用方便式抽样方法选取某市3家三甲医院神经内科科室的131名医生作为研究对象,分别采取《临床医生工作压力源量表》《困难医患关系量表》(DDPRQ-10)对其职业压力与医患关系分值进行调查。[结果]不同年龄、学历的神经内科医生的职业压力分值比较,差异有统计学意义(P <0.05),职业压力分值有随年龄增大而增大,随着学历升高而降低的趋势;不同年龄、学历、职称医生医患关系分值差异均无统计学意义(P> 0.05)。不同年龄医生在工作负荷上分值差异有统计学意义(P <0.05),其分值有随年龄增大而升高的趋势;但在其他分值上差异无统计学意义(P> 0.05)。不同学历医生在组织管理、职业兴趣、工作负荷、职业发展、人际关系、外部环境、医患沟通维度上的分值差异均有统计学意义(P <0.05)。神经内科医生医患关系分值与职业压力中的职业兴趣、医患沟通及职业压力总分间存在线性相关关系(r=0.532～0.825,P <0.01)。[结论]年龄、学历、职称对神经内科医师职业压力均可能存在影响。工作负荷过大是诱发职业压力的主要原因。职业压力与医患关系具有相关性。
[Objective] To observe the association between occupational stress and doctor-patient relationship among neurologists. [Methods] A total of 131 physicians in the neurology departments of top three hospitals were studied with the Scale for Occupational Stress of Clinician and the Difficult Doctor Patient Relationship Questionnaire(DDPRQ-10). [Results] The occupational stress scores varied among neurologists with different ages and education levels(P < 0.05). The occupational stress scores increased with age and decreased with the education level. There were no significant differences of doctor-patient relationship scores among neurologists with different ages,education levels and professional titles(P > 0.05). The workload difference of physicians in different ages was statistically significant(P < 0.05). There were no significant differences of organizational management,professional interest,career development,interpersonal relationship,external environment and doctorpatient communication among physicians in different ages(P > 0.05),while the differences of those aspects among physicians with different education levels were statistically significant(P < 0.05). The doctor-patient relationship scores were significantly related to the professional interest,doctor-patient communication and total occupational stress scores(r = 0.532-0.825,P <0.01). [Conclusion] Age,education,and professional title of neurologists may have an impact on their occupational stress.Excessive workload was the main cause of occupational stress. Occupational stress was related to the doctor-patient relationship.
[Objective] To observe the association between occupational stress and doctor-patient relationship among neurologists. [Methods] A total of 131 physicians in the neurology departments of top three hospitals were studied with the Scale for Occupational Stress of Clinician and the Difficult Doctor Patient Relationship Questionnaire(DDPRQ-10). [Results] The occupational stress scores varied among neurologists with different ages and education levels(P < 0.05). The occupational stress scores increased with age and decreased with the education level. There were no significant differences of doctor-patient relationship scores among neurologists with different ages,education levels and professional titles(P > 0.05). The workload difference of physicians in different ages was statistically significant(P < 0.05). There were no significant differences of organizational management,professional interest,career development,interpersonal relationship,external environment and doctorpatient communication among physicians in different ages(P > 0.05),while the differences of those aspects among physicians with different education levels were statistically significant(P < 0.05). The doctor-patient relationship scores were significantly related to the professional interest,doctor-patient communication and total occupational stress scores(r = 0.532-0.825,P <0.01). [Conclusion] Age,education,and professional title of neurologists may have an impact on their occupational stress.Excessive workload was the main cause of occupational stress. Occupational stress was related to the doctor-patient relationship.
引文
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[14]陆人杰,孙青,曹琪,等.医院青年医师职业压力现状[J].解放军医院管理杂志,2018,16(1):1-5.
[15]孙盼盼,夏云.医务人员视角下的医患关系影响因素研究[J].中国医院管理,2016,36(12):63-65.
[16]UDOD S A,CUMMINGS G,CARE W D,et al. Impact of role stressors on the health of nurse managers:a western Canadian context[J]. J Nurs Admin,2017,47(3):159-164.
[17]ALLEN J L,SANDBERG S,CHHOA C Y,et al. Parent-dependent stressors and the onset of anxiety disorders in children:links with parental psychopathology[J]. Eur Child Adoles Psy,2018,27(2):221-231.
[18]吴起乐,赵存喜,任佰玲,等.关于医护人员和患者对医患纠纷及医师职业精神认知差异的研究[J].中国医学伦理学,2016,29(4):562-567.
[19]潘庆霞,梁立波,吴群红,等.公立医院医患关系紧张的原因及对策探讨——基于医患双方视角的分析[J].中国医院管理,2016,36(5):68-70.
[2]INOUE N,OTSUI K,YOSHIOKA T,et al. A simultaneous evaluation of occupational stress and depression in patients with lifestyle-related diseases[J]. Internal Med,2016,55(9):1071-1781.
[3]崔俐俊,季滨龙.急诊科医师职业压力源分析[J].解放军医院管理杂志,2016,23(11):1060-1061.
[4]金琳雅,尹梅.医师职业压力与医患关系现状分析——以神经内科医师的调研为例[J].中国医学伦理学,2016,29(6):948-951.
[5]陈建萍.临床医生工作压力源量表的编制与应用[D].上海:上海师范大学,2009.
[6]杨慧.中文版本PDRQ/DDPRQ量表研制与评价——医患关系量化研究[D].太原:山西医科大学,2011.
[7]CLOUGH B A,MARCH S,CHAN R J,et al. Psychosocial interventions for managing occupational stress and burnout among medical doctors:a systematic review[J]. Cochrane Db Syst Rev,2017,6(1):144-152.
[8]杨燕青,郑宏,王慧燕,等.医护人员压力源与应对策略现状分析[J].中华全科医学,2018,16(6):983-988.
[9]GU F,LI X F,XU J F,et al. Effect of nicotine dependence on quality of life and sleep quality in patients with lung cancer who continue to smoke after diagnosis[J]. J Thorac Dis,2018,10(5):2583-2589.
[10]陶伟,季国忠,刘虹.江苏省三甲医院医务人员情绪管理现状分析[J].中国医药导报,2016,13(35):165-168.
[11]SONG K W,CHOI W S,JEE H J,et al. Correlation of occupational stress with depression,anxiety,and sleep in Korean dentists:cross-sectional study[J]. BMC Psychiatry,2017,17(1):398-402.
[12]崔俐俊,季滨龙.急诊科医师职业压力源分析[J].解放军医院管理杂志,2016,23(11):1060-1061.
[13]Violanti J M,Fekedulegn D,Andrew M E,et al. The impact of perceived intensity and frequency of police work occupational stressors on the cortisol awakening response(CAR):Findings from the BCOPS study[J].Psychoneuroendocrinology,2017,75(2):124-131.
[14]陆人杰,孙青,曹琪,等.医院青年医师职业压力现状[J].解放军医院管理杂志,2018,16(1):1-5.
[15]孙盼盼,夏云.医务人员视角下的医患关系影响因素研究[J].中国医院管理,2016,36(12):63-65.
[16]UDOD S A,CUMMINGS G,CARE W D,et al. Impact of role stressors on the health of nurse managers:a western Canadian context[J]. J Nurs Admin,2017,47(3):159-164.
[17]ALLEN J L,SANDBERG S,CHHOA C Y,et al. Parent-dependent stressors and the onset of anxiety disorders in children:links with parental psychopathology[J]. Eur Child Adoles Psy,2018,27(2):221-231.
[18]吴起乐,赵存喜,任佰玲,等.关于医护人员和患者对医患纠纷及医师职业精神认知差异的研究[J].中国医学伦理学,2016,29(4):562-567.
[19]潘庆霞,梁立波,吴群红,等.公立医院医患关系紧张的原因及对策探讨——基于医患双方视角的分析[J].中国医院管理,2016,36(5):68-70.