Physician personality characteristics and inquiry about mood symptoms in primary care.
Physician personality characteristics and inquiry about mood symptoms in primary care.
复制标题
初级保健中医生的性格特征和情绪症状询问。
DOI：
10.1007/s11606-008-0780-0
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发表时间：
2008
影响因子：
5.7
通讯作者：
Kravitz,RichardL
中科院分区：
文献类型：
--
作者：
Duberstein,PaulR;Chapman,BenjaminP;Epstein,RonaldM;McCollumn,KellyR;Kravitz,RichardL
研究背景抑郁症的治疗通常最初是从初级保健医生那里寻求的。目的探讨医生个性对抑郁症评估的影响。目的对随机对照试验中收集的数据进行二次分析。地点：纽约州罗切斯特的初级保健医生办公室。参与者：46名医生; 6名女性参与者。干预：86名未经宣布的标准化患者（SP）访视。医生们看了一个患有重性抑郁症的SP和一个患有适应障碍的SP。2测量者们听了录音带，并在访问后立即完成了一份关于医生行为和症状询问的表格。为了评估诊断文件，审查了SP的医疗记录。医生的个性进行了评估，通过项目从NEO-PI-R. SPECIFICATSPECIFICATIONS谁是更尽职尽责和更脆弱的更有可能记录抑郁症的诊断，那些谁是更尽职尽责也问了较少的问题，有关情绪symptoms.LIMITATIONRoles描绘的SP可能不反映一个典型的初级保健患者的经验。大多数PCP是白色男性。五氯苯酚样本仅限于一个地理位置。效应大小是moderate.CONCLUSIONSThe临床，教育，和翻译，研究表明，医生的人格特质可能会影响实践行为值得考虑的影响。目前在初级保健中治疗抑郁症的模式可以设计成适应医生个性的变化。鉴于没有单一的“正确”方式来询问情绪障碍或自杀，鼓励临床医生采用适合他们个人风格和偏好的方法。
BACKGROUNDDepression treatment is often initially sought from primary care physicians.OBJECTIVETo explore the influence of physician personality on depression assessments.DESIGNSecondary analysis of data collected in a randomized controlled trial.SETTINGOffices of primary care physicians in Rochester, NY.PARTICIPANTSForty-six physicians; six female actors.InterventionEighty-six unannounced standardized patient (SPs) visits; physicians saw one SP with major depression and one with adjustment disorder.MEASUREMENTSSPs listened to audiotapes and completed a form on doctoring behaviors and symptom inquiry immediately following the visit. For the assessment of diagnostic documentation, SPs’ medical records were reviewed. Physician personality was assessed via items from the NEO-PI-R.RESULTSPhysicians who are more dutiful and more vulnerable were more likely to document a diagnosis of depression; those who are more dutiful also asked fewer questions concerning mood symptoms.LIMITATIONRoles portrayed by the SPs may not reflect the experience of a typical primary care patient. Most of the PCPs were white men. The sample of PCPs was limited to a single geographic location. Effect sizes were modest.CONCLUSIONSThe clinical, educational, and translational, implications of research showing that physician personality traits could affect practice behaviors warrant consideration. Current models of treatment for depression in primary care could be engineered to accommodate the variability in physician personality. Given that there is no single “correct” way to ask about mood disorders or suicide, clinicians are encouraged to adopt an approach that fits their personal style and preferences.