Physician Burnout and Patient Satisfaction with Consultation in Primary Health Care Settings: Evidence of Relationships from a one-with-many Design
Physician Burnout and Patient Satisfaction with Consultation in Primary Health Care Settings: Evidence of Relationships from a one-with-many Design
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DOI：
10.1007/s10880-011-9278-8
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发表时间：
2012-12-01
影响因子：
2.2
通讯作者：
Niakas, Dimitris
中科院分区：
文献类型：
--
作者：
Anagnostopoulos, Fotios;Liolios, Evangelos;Niakas, Dimitris
医生职业倦怠，作为对工作中慢性情绪和人际压力源的长期反应，与患者护理不佳和医患关系恶化有关。虽然先前的研究已经确定了一系列与患者满意度下降相关的因素，但大多数研究都是在三级医疗机构进行的，在医院单位层面检查了工作人员的职业倦怠。为了检查医生倦怠对初级保健机构咨询患者满意度的影响，在希腊西部进行了一项横断面调查。采用一对多的设计，30名医生和300名随机选择的病人对调查做出了回应。结果显示，患者满意度与医生情绪耗竭（r = - 0.636, p < 0.01）和医生人格解体（r = - 0.541, p < 0.01）显著相关。混合效应多水平模型显示，在调整患者特征后，34.4%的患者满意度总变化发生在医生层面。此外，在控制了患者和医生的特征后，医生的情绪耗竭和去人格化仍然是影响患者对会诊满意度的重要因素。与低疲惫和低去人格化的医生相比，高疲惫和高去人格化的医生的患者满意度得分显著低于低疲惫和低去人格化的医生。未来的研究需要探索医生职业倦怠影响患者满意度的机制。
Physician burnout, as a prolonged response to chronic emotional and interpersonal stressors on the job, has been associated with suboptimal patient care and deterioration in the patient-provider relationship. Although prior studies have identified a range of factors associated with decreased patient satisfaction, most have been conducted in tertiary care settings, with staff burnout examined at the hospital unit-level. To examine the impact of physician burnout on patient satisfaction from consultation in the primary care setting, a cross-sectional survey was conducted in Western Greece. Using a one-with-many design, 30 physicians and 300 of their patients, randomly selected, responded to the survey. Results showed that patient satisfaction correlated significantly with physician emotional exhaustion (r = -.636, p < .01) and physician depersonalization (r = -.541, p < .01). Mixed-effects multilevel models indicated that 34.4% of total variation in patients' satisfaction occurred at the physician level, after adjustment for patients' characteristics. Moreover, physician emotional exhaustion and depersonalization remained significant factors associated with patient satisfaction with consultation, after controlling for patient and physician characteristics. Patients of physicians with high-exhaustion and high-depersonalization had significantly lower satisfaction scores, compared with patients of physicians with low-exhaustion and low-depersonalization, respectively. Future studies need to explore the mechanisms by which physician burnout affects patient satisfaction.