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目的 为提升医师职业精神评价指标体系的可操作性,尝试设计医师职业精神评价量表。方法 抽取来自上海8家三级医院的临床医师480名,采用自设问卷调研的形式,采用离散趋势法、区分度分析法、相关系数法、探索性因子分析法和克朗巴赫α系数法进行评价量表条目的筛选。结果 初步构建了含有41条评价量表条目的医师职业精神评价量表。结论 医师职业精神评价常模抽样需大样本量的支持。 相似文献
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Vase L Nørskov KN Petersen GL Price DD 《Philosophical transactions of the Royal Society of London. Series B, Biological sciences》2011,366(1572):1913-1921
Placebo analgesic effects appear to be related to patients' perception of the therapeutic intervention. In this paper, we review quantitative findings of how the relationship with the physician and the verbal suggestions given for relief may influence patients' perception of a treatment and how patients' expectations and emotional feelings may affect treatment outcome. We also present qualitative data from interviews with patients who have experienced pain relief following a placebo or an active treatment. A special focus is given to the temporal development of placebo analgesia at psychological and neurophysiological levels. Finally, we discuss the extent to which the quantitative and qualitative findings supplement or contrast with each other, and we touch upon possible implications of patients' direct experience as central for placebo analgesia. 相似文献
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Objective: Childhood obesity is one of the most challenging issues facing healthcare providers today. The aims of this study were to describe the ambulatory management of childhood obesity by pediatricians (PDs) and family physicians (FPs) and to evaluate knowledge of and adherence to published recommendations. Research Methods and Procedures: A 42‐item, self‐administered questionnaire was mailed to 1207 randomly selected primary care physicians (PDs = 700, FPs = 507) between September 2001 and January 2002. Results: Of 339 (28%) responses, 287 were eligible (PDs = 213, FPs = 74). Most respondents were in group or solo practice (87%) in a suburban or urban, non‐inner city location (67%). The average age was 48 years (range = 31 to 85 years), and the mean years in practice was 17 (range = 1 to 55 years). Nineteen percent of physicians were aware of national recommendations. Three percent of physicians reported adherence to all recommendations. Knowledge of recommendations was not associated with a greater likelihood of adherence. However, physicians who were aware of recommendations were more likely to have positive attitudes about personal counseling ability (odds ratio = 2.4, confidence interval = 1.3 to 4.4) and the overall efficacy of obesity counseling (odds ratio = 4.3, confidence interval = 1.7 to 10.8). Poor patient motivation, patient noncompliance, and treatment futility were perceived as the most frequently encountered barriers to obesity treatment. Discussion: Most physicians are not aware of or adherent to national recommendations regarding childhood obesity. Awareness of recommendations was associated with more positive attitudes about personal counseling ability and the effectiveness of obesity counseling in general. 相似文献
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医德医风与医院履责对医生履责的影响研究
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探讨医院医德医风和医生感知的医院责任履行状况对医生自身责任履行的影响。方法 运用自行设计的调查问卷对我国东、中、西3省、直辖市9个地区的128所公立医院医生进行调查。结果 回归分析显示,医德医风和医院履责对医生自身履责解释力均显著。在控制了个体变量与医院地区级别变量之后,医德医风对医生交易、发展、关系与理念责任的履行均具有显著正向影响(P<0.001),而医院履责对医生履责的影响有不同的对应性。结论 医院医德医风对医生自身责任的履行有积极促进作用。医院4类责任的履行状况与医生四类责任履行有紧密关联,但对应性略有不同。 相似文献
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Barlow SE Bobra SR Elliott MB Brownson RC Haire-Joshu D 《Obesity (Silver Spring, Md.)》2007,15(1):225-232
Objective: To assess, in diverse pediatric practices, the frequency of overweight/obesity (OW/OB) identification during health supervision visits and its association with BMI curve use. Research Methods and Procedures: Pediatricians in public and private practice in St. Louis, MO, participated in a study of the care of chronic conditions during health supervision visits. Requested information from 30 visits per pediatrician of children 6 to 17 years of age included the visit note, the growth chart, and a one‐page questionnaire about patient demographics and visit content. Pediatricians indicated the presence and discussion of common chronic conditions, including OW/OB. Identification was compared with patient BMI category, and associations between identification and patient and visit characteristics, including BMI curve use, were examined. Results: Twenty‐one (40%) of contacted pediatricians returned information from 557 visits. Pediatricians identified OW/OB in 27% of children with a BMI at the 85th to 94th percentile and 86% of children with a BMI at or above the 95th percentile. Identification was higher in adolescents but was not associated with patient sex or race, practice setting, insurance type, or visit length. Only 41% of growth charts were current, and 6.1% had BMI plotted. BMI plotting was associated with OW/OB identification when the BMI was at the 85th to 94th percentile but not when the BMI was at or above the 95th percentile. After controlling for BMI percentile, OW/OB identification was significantly associated with diet counseling (odds ratio, 7.46; 95% confidence interval, 3.42 to 16.24) and exercise counseling (odds ratio, 5.57; 95% confidence interval, 2.61 to 11.90). Discussion: Despite low BMI curve use, pediatricians recognized most overweight/obese children with a BMI at or above the 95th percentile. BMI plotting may increase recognition in mildly overweight children. 相似文献
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Objective: To examine the relationship between BMI and patient satisfaction with health care providers using a nationally representative survey. Research Methods and Procedures: This analysis examined the 9914 adult patients who completed the 2000 Medical Expenditure Panel Survey and had visited a health care provider within 12 months of the survey. Linear regression models were employed with patient satisfaction as the dependent variable. The patient satisfaction scale was based on ratings from five questions assessing the quality of provider interactions. The independent variable was BMI, with adjustments for the domains of demographics, social‐economic status, health attitudes and behavior, health status, and health care use. BMI (weight in kilograms/square of height in meters) was classified as normal weight (18.5 to 24.9), overweight (25.0 to 29.9), or obese (≥30.0). Hierarchical models were used to evaluate how each domain modified the BMI‐satisfaction association. Results: Obese patients reported significantly greater satisfaction with their health care providers than their normal‐weight counterparts did (p < 0.05). There were no significant differences in satisfaction between normal‐weight and overweight patients or between overweight and obese patients. The health status domain produced the largest modification in the BMI‐satisfaction relationship. Examination of interaction effects revealed that the association between BMI and satisfaction was confined to older persons. Discussion: In this nationally representative sample of individuals, obese persons were more satisfied than their normal‐weight counterparts. This finding counters those of previous studies. Incomplete adjustments for health care use and insurance status may have led to those conclusions. 相似文献