DETERMINANTS OF PHYSICIAN AIDS-RELATED PRACTICE BEHAVIOR

这项研究旨在预测特征的影响， 的态度和经验的房子工作人员对他们的艾滋病相关的， 住院医师职业行为它建立在调查人员之前 研究，依靠纵向设计和采访医生 在他们的第六个研究生年，当他们进入实践。 拟议项目的目标是为以下方面提供经验基础： 采取有效措施，增加医生人数 致力于治疗HIV+和艾滋病患者。 要检验的假设已经被研究人员以前的研究所告知。 工作和重点是识别易受影响的预测因素， 改变，即，住院医师培训和个人态度的要素， 影响可以通过干预来调节。这些预测因素包括 住院医师计划的持续性（通过以下维度衡量， 容忍不同意见，民主决策， 学院的支持），教师对艾滋病治疗的看法， 对病人护理的愤世嫉俗，同性恋恐惧症和对药物的厌恶 瘾君子 根据前两波在关键节点收集的数据， 医生培训-医学院毕业后和 住院医师的第三年--调查人员先前的研究 对艾滋病的态度在不同年龄段之间波动很大， 医学院第四年（时间l）和完成第三年 住院医师培训（时间2），和居民的态度是显着的 与他们的艾滋病治疗实践计划有关。从这个 工作，很明显，居住，而不是医学院，是形成 确定与艾滋病有关的职业计划。对愿意 对待艾滋病的态度，即使是看似棘手的态度，如同性恋恐惧症， 在训练过程中，由于各种因素的变化， 目前的项目涉及住院医师培训与 艾滋病相关职业行为因此，它解决了以下方面的重大差距： 了解影响医生职业选择的因素，它承诺 制定具体战略，增加提供护理服务者的数量 对于PWA来说，它依赖于一个强大的设计来实现这些目标。

This study is designed to predict the impact of characteristics, attitudes, and experiences of house staff on their AIDS-related, post- residency, career behavior. It builds on the investigators' prior research, relying upon a longitudinal design and interviewing physicians during their sixth post-graduate year, when they are entering practice. The goal of the proposed project is to generate an empirical basis for undertaking effective interventions to increase the numbers of physicians who are committed to treating HIV+ and AIDS patients in their practices. Hypotheses to be tested have been informed by the researchers' previous work and focus on identification of predictors that are susceptible to change i.e., elements of residency training and individual attitudes whose effects can be mediated through intervention. Such predictors include supportiveness of the residency program (as measured by such dimensions as tolerance of diversity of opinions, democratic decision-making, and collegial support), perceptions of faculty outlook on AIDS treatment, cynicism concerning patient care, homophobia, and revulsion toward drug addicts. Based upon two prior waves of data collected at critical junctures in the training of physicians --upon graduation from medical school and during the third year of residency -- the investigators' prior research has established that attitudes toward AIDS fluctuate significantly between the fourth year of medical school (time l) and completion of the third year of residency training (time 2), and residents' attitudes are significantly related to their practice plans with regard to AIDS treatment. From this work, it is clear that residency, not medical school, is the formative period determining AIDS-related career plans. The impact on willingness to treat AIDS of even seemingly intractable attitudes, such as homophobia, was muted and exacerbated by factors which are changeable during training. The current project addresses the linkage between residency training and AIDS-related career behavior. As such, it addresses a significant gap in knowledge of factors affecting physicians' career choices, it promises to yield concrete strategies for enhancing the supply of providers who care for PWAs, and it relies upon a powerful design for achieving these ends.