MEASURING PHYSICIANS TOLERANCE FOR AMBIGUITY AND ITS RELATIONSHIP TO THEIR REPORTED PRACTICES REGARDING GENETIC TESTING
MEASURING PHYSICIANS TOLERANCE FOR AMBIGUITY AND ITS RELATIONSHIP TO THEIR REPORTED PRACTICES REGARDING GENETIC TESTING
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DOI：
10.1097/00005650-199311000-00002
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发表时间：
1993-11-01
期刊：
影响因子：
3
通讯作者：
HOLTZMAN, NA
中科院分区：
文献类型：
--
作者：
GELLER, G;TAMBOR, ES;HOLTZMAN, NA
尽管医学存在不确定性，但研究医生对不确定性的容忍度的尝试很少，而且受现有测量仪器的限制。本文描述了改进的模糊耐受性（TFA）量表的发展，并将其与几个医生特征和报告的行为联系起来。18个TFA项目包括在一项关于医生对基因检测的知识和态度的全国调查中。在1759名产科医生、儿科医生、内科医生、家庭医生和精神科医生中，有65% （n = 1140）做出了回应。经过心理测量分析，量表减少到7个项目，显示出可接受的信度（Cronbach's alpha = .75）。在精神科医生中，TFA高于其他专业，在那些从医学院毕业时年龄较大的人中，在那些愿意提供一种新的低成本、准确的预测测试的人中，他们的同事都不愿意提供这种测试。在那些表示参加宗教仪式很重要的人中，在那些在产前诊断后建议患者终止妊娠的人中，以及在那些保留阴性基因检测结果的人中，TFA较低。未来的研究需要对量表本身进行研究，并评估影响TFA的因素，例如其对修改的易感性，以及其与其他医学领域临床实践的潜在关联，这些领域的特征是模糊的。
Despite uncertainties in medicine, attempts to study physicians tolerance for uncertainty have been few, and limited by the measurement instruments available. This paper describes development of a modified tolerance for ambiguity (TFA) scale, and correlates it with several physician characteristics and reported behaviors. Eighteen TFA items were included in a national survey of physicians' knowledge and attitudes about genetic testing. Sixty-five percent (n = 1,140) of 1,759 obstetricians, pediatricians, internists, family practitioners, and psychiatrists responded. After psychometric analyses, the scale was reduced to 7 items, demonstrating an acceptable reliability (Cronbach's alpha = .75). TFA was higher among psychiatrists than other specialties, among those who were older when they graduated from medical school, and among those willing to offer a new low-cost, accurate predictive test when none of their colleagues do. TFA was lower among those who indicated that attendance at religious services was important, among those who would make a recommendation to their patients regarding pregnancy termination after prenatal diagnosis, and among those who would withhold negative genetic test results. Future research is needed on the scale itself, and to assess factors affecting TFA, such as its susceptibility to modification, and its potential association with clinical practice in other areas of medicine that are characterized by ambiguity.