Doctors' perceptions of the links between stress and lowered clinical care
Doctors' perceptions of the links between stress and lowered clinical care
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DOI：
10.1016/s0277-9536(96)00227-4
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发表时间：
1997-04-01
影响因子：
5.4
通讯作者：
Greenhalgh, J
中科院分区：
文献类型：
--
作者：
FirthCozens, J;Greenhalgh, J
我们从大量的工业研究中了解到，压力，特别是以疲劳和睡眠剥夺的形式出现的压力，对工作表现有不利影响，尽管医生的压力水平特别高，但在医生的研究中，这一点并不明确。这项研究探讨了医生对这一问题的看法，使用了来自225名医院医生和全科医生的匿名问卷，其中82人报告了最近发生的事件，他们认为压力症状对他们的病人护理产生了负面影响。他们给出的定性描述被编码为归因（压力症状的类型）及其影响。这些影响中有一半涉及降低护理标准; 40%是烦躁或愤怒的表达; 7%是严重的错误，但仍然避免直接导致死亡;两个导致患者死亡。这些原因主要是疲劳（57%）和过度工作的压力（28%），其次是抑郁或焦虑（8%）和酒精的影响（5%）。这些数据是根据医生的疲劳或工作压力与他们照顾病人的方式之间的联系进行讨论的。它假定这些事件以前没有报告过，并谈到这种保密对有关医生的情绪状态的影响。它为解决这个问题提供了前进的道路，这对专业人员、管理人员和专员都有好处。(C)1997年爱思唯尔科学有限公司
We know from numerous industrial studies that stress, particularly in the form of tiredness and sleep deprivation, has a detrimental effect upon work performance, though this is not so clear-cut in studies of doctors, despite their stress levels being particularly high. This study explores the doctors' views on this using anonymous questionnaires from a population of 225 hospital doctors and general practitioners, 82 of whom reported recent incidents where they considered that symptoms of stress had negatively affected their patient care. The qualitative accounts they gave were coded for the attribution (type of stress symptom) made, and the effect it had. Half of these effects concerned lowered standards of care; 40% were the expression of irritability or anger; 7% were serious mistakes which still avoided directly leading to death; and two resulted in patient death. The attributions given for these were largely to do with tiredness (57%) and the pressure of overwork (28%), followed by depression or anxiety (8%), and the effects of alcohol (5%). The data are discussed in terms of the links made by the doctors between their fatigue or work pressure and the way they care for patients. It presumes that these incidents had been previously unreported and talks about the effects this secrecy has on the emotional state of the doctors concerned. It offers ways forward for tackling the problem, of interest to the profession, managers and commissioners. (C) 1997 Elsevier Science Ltd.