1
|
Sebastián-Sánchez I, Gállego-Royo A, Marco-Gómez B, Pérez-Álvarez C, Urbano Gonzalo O, Delgado-Marroquín MT, Altisent-Trota R, Astier-Peña MP. Gender analysis of Spanish National Questionnaire on behaviours and attitudes of doctors towards their own illness (CAMAPE). J Healthc Qual Res 2022; 38:165-179. [PMID: 36549947 DOI: 10.1016/j.jhqr.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION AND OBJECTIVES Physicians' health is a key element for quality healthcare. Medical professionals have difficulty accepting their role as patients and it might be different among sexes. The aim was to describe behaviours and attitudes of doctors towards their own illness. MATERIALS AND METHODS An online survey was launched through the General Council of Medical Associations webpage for all Spanish registered doctors. A bivariate analysis by sex was performed for all the questionnaire variables using parametric and non-parametric tests. The significance level was p<0.05 (95% confidence interval). RESULTS A total of 4,308 registered doctors (1,858 men and 2,450 women) answered. Women were younger, single, and worked mainly in non-surgical specialities in the public sector. Men were older, married, and worked more frequently in public-private practice. Women had less chronic conditions, except for anxiety disorders (11.52% vs 15.18%). Both sexes, especially women, primarily self-treated (94.29% vs 95.02%), went to work while ill (88.16% vs 90.29%), visited their GP (56% vs 70%), and half of them underwent annual occupational health checks (40% vs 48%). Women self-prescribed more analgesics (93.43% vs 95.63%), more presenteeism (88% vs 90%) and felt more insecure when treating sick fellows (9.96% vs 20.12%) and requested training for it. More women agreed to make deontological recommendations about doctors' health (91.55% vs 96.16%) and considered revalidation may contribute to improve doctors' health (65.29% vs 66.16%). CONCLUSIONS Male and female doctors show illness-health behaviours and attitudes at work to improve. There are differences among male and female doctors. Regarding, medical feminization, ethical recommendations may be of benefit regarding doctors' health-illness issues and considering gender perspective.
Collapse
Affiliation(s)
- I Sebastián-Sánchez
- "Universitas" Health Center, Zaragoza, Spain; Public Health Service of Aragon, Spain; University of Zaragoza, GIBA-IIS-Aragón, Spain
| | - A Gállego-Royo
- Public Health Service of Aragon, Spain; University of Zaragoza, GIBA-IIS-Aragón, Spain; "Miguel Servet" University Hospital, Zaragoza, Spain
| | - B Marco-Gómez
- University of Zaragoza, GIBA-IIS-Aragón, Spain; Department of Psychiatry "Royo Villanova" Hospital, Zaragoza, Spain
| | - C Pérez-Álvarez
- University of Zaragoza, GIBA-IIS-Aragón, Spain; Department of Psychiatry "Royo Villanova" Hospital, Zaragoza, Spain
| | - O Urbano Gonzalo
- University of Zaragoza, GIBA-IIS-Aragón, Spain; Anaesthesiology and Resuscitation, "Miguel Servet" Hospital, Zaragoza, Spain
| | - M T Delgado-Marroquín
- Public Health Service of Aragon, Spain; University of Zaragoza, GIBA-IIS-Aragón, Spain; "Delicias Norte" Health Center, Zaragoza, Spain
| | | | - M P Astier-Peña
- University of Zaragoza, GIBA-IIS-Aragón, Spain; Territorial Quality Unit, Territorial Directorate of Camp de Tarragona, Catalan Institut of Health, Generalitat de Catalunya, Spain.
| |
Collapse
|
2
|
Naehrig D, Glozier N, Klinner C, Acland L, Goodger B, Hickie IB, Milton A. Determinants of well-being and their interconnections in Australian general practitioners: a qualitative study. BMJ Open 2022; 12:e058616. [PMID: 35851015 PMCID: PMC9258487 DOI: 10.1136/bmjopen-2021-058616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The well-being of doctors is recognised as a major priority in healthcare, yet there is little research on how general practitioners (GPs) keep well. We aimed to address this gap by applying a positive psychology lens, and exploring what determines GPs' well-being, as opposed to burnout and mental ill health, in Australia. DESIGN Semi-structured qualitative interviews. From March to September 2021, we interviewed GPs working in numerous settings, using snowball and purposive sampling to expand recruitment across Australia. 20 GPs participated individually via Zoom. A semi-structured interview-guide provided a framework to explore well-being from a personal, organisational and systemic perspective. Recordings were transcribed verbatim, and inductive thematic analysis was performed. RESULTS Eleven female and nine male GPs with diverse experience, from urban and rural settings were interviewed (mean 32 min). Determinants of well-being were underpinned by GPs' sense of identity. This was strongly influenced by GPs seeing themselves as a distinct but often undervalued profession working in small organisations within a broader health system. Both personal finances, and funding structures emerged as important moderators of the interconnections between these themes. Enablers of well-being were mainly identified at a personal and practice level, whereas systemic determinants were consistently seen as barriers to well-being. A complex balancing act between all determinants of well-being was evidenced. CONCLUSIONS GPs were able to identify targets for individual and practice level interventions to improve well-being, many of which have not been evaluated. However, few systemic aspects were suggested as being able to promote well-being, but rather seen as barriers, limiting how to develop systemic interventions to enhance well-being. Finances need to be a major consideration to prioritise, promote and support GP well-being, and a sustainable primary care workforce.
Collapse
Affiliation(s)
- Diana Naehrig
- Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Nick Glozier
- Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Christiane Klinner
- Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Louise Acland
- ForHealth, Charlestown Medical & Dental Centre, Charlestown, New South Wales, Australia
- Expert committee - Standards for General Practices, RACGP, East Melbourne, Victoria, Australia
| | - Brendan Goodger
- Central and Eastern Sydney PHN, Mascot, New South Wales, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Alyssa Milton
- Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| |
Collapse
|
3
|
Benson J, Sexton R, Dowrick C, Gibson C, Lionis C, Ferreira Veloso Gomes J, Bakola M, AlKhathami A, Nazeer S, Igoumenaki A, Usta J, Arroll B, van Weel-Baumgarten E, Allen C. Staying psychologically safe as a doctor during the COVID-19 pandemic. Fam Med Community Health 2022; 10:fmch-2021-001553. [PMID: 35045988 PMCID: PMC8771807 DOI: 10.1136/fmch-2021-001553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 01/20/2023] Open
Affiliation(s)
- Jill Benson
- Discipline of General Practice, The University of Adelaide School of Medicine, Adelaide, South Australia, Australia .,Prideaux Centre for Health Professionals Education, Flinders University College of Medicine and Public Health, Bedford Park, South Australia, Australia
| | - Roger Sexton
- Doctors Health SA, Adelaide, South Australia, Australia
| | | | - Christine Gibson
- Department of Family Medicine and Psychiatry, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Christos Lionis
- Clinic of Social and Family Medicine, University of Crete School of Medicine, Heraklion, Greece
| | | | - Maria Bakola
- Research Unit for General Medicine and Primary Health Care, University of Ioannina Faculty of Medicine, Ioannina, Greece
| | - Abdullah AlKhathami
- Innovative Primary Mental Health Program, Eastern Province, Saudi Arabia Ministry of Health, Riyadh, Saudi Arabia
| | - Shimnaz Nazeer
- Family Medicine in Clinical Medicine Department, Weill Cornell Medical College in Qatar, Doha, Qatar
| | - Alkisti Igoumenaki
- University Clinic, University Hospital of Düsseldorf, Dusseldorf, Germany
| | - Jinan Usta
- Family Medicine Department, American University of Beirut, Beirut, Lebanon
| | - Bruce Arroll
- Department of General Practice and Primary Care, The University of Auckland, Auckland, New Zealand
| | - Evelyn van Weel-Baumgarten
- Department of Primary and Community Care, Radboud Institute for Health Sciences, University Nijmegen, Nijmegen, The Netherlands
| | - Claudia Allen
- Department of Family Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| |
Collapse
|
4
|
Geuijen PM, Pars E, Kuppens JM, Schene AH, de Haan HA, de Jong CAJ, Atsma F, Schellekens AFA. Barriers and Facilitators to Seek Help for Substance Use Disorder among Dutch Physicians: A Qualitative Study. Eur Addict Res 2022; 28:23-32. [PMID: 34192705 DOI: 10.1159/000517043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/23/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Substance use disorders (SUDs) among physicians affect their health, quality of life, but potentially also their quality of care. Despite the availability of effective specific Physician Health Programs (PHPs), physicians with SUD often experience barriers when seeking professional help. Therefore, we studied barriers and facilitators when seeking help for SUD among physicians from a multiple perspective approach. METHODS A qualitative design was adopted for 2 sub-studies. First, answers of 2 open-ended questions (about anticipated barriers and facilitators) of an existing questionnaire were analyzed. This questionnaire was filled out by 1,685 general physicians (response rate = 47%). The answers of these open-ended questions were coded inductively. Second, 21 semi-structured interviews (about experienced barriers and facilitators) were performed with physician SUD-patients, significant others, and PHP employees. Themes identified in the first sub-study were used to deductively code the interview transcripts. Results were reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines. RESULTS Barriers were found at the level of the individual physician (negative feelings and lack of disease awareness), whereas facilitators were found at the level of social relationships (confrontation with SUD and social support) and health services (supportive approach, good accessibility, and positive image of services). The interviews emphasized the importance of nonjudgmental confrontation by social relationships in the process of seeking help for SUD. CONCLUSION Physicians with SUD face barriers when seeking help for SUD mostly at the level of the individual physician. Health services and people around physicians with SUD could facilitate the help-seeking process by offering confidential and nonpunitive support. Future studies should explore whether the barriers and facilitators identified in this study also hold for other mental health issues.
Collapse
Affiliation(s)
- Pauline M Geuijen
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, The Netherlands
| | - Esther Pars
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, The Netherlands
| | - Joanneke M Kuppens
- Physician Health Program ABS-Doctors, Royal Dutch Medical Association (RDMA), Utrecht, The Netherlands
| | - Aart H Schene
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hein A de Haan
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, The Netherlands.,Tactus Addiction Treatment, Deventer, The Netherlands
| | - Cornelis A J de Jong
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, The Netherlands.,Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Femke Atsma
- Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arnt F A Schellekens
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, The Netherlands
| |
Collapse
|
5
|
Doctors' experience of becoming patients and its influence on their medical practice: A literature review. Explore (NY) 2019; 16:145-151. [PMID: 31843394 DOI: 10.1016/j.explore.2019.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/14/2019] [Accepted: 10/20/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE Doctors' illness experiences can deeply influence not only their perceptions of illness and roles but also their medical practice. Researchers and doctors have sought to understand what happens when doctors become patients. However, currently, literature reviews focused exclusively on their illness experiences are lacking. This review examines academic literature and combines it with illness narratives (i.e., pathographies) written by doctors to elucidate the unknown about doctors' experiences and its subsequent influence on medical practice. METHODS An electronic search of the databases Academic Search Complete, Google Scholar, PubMed, ProQuest, and Ichushi-Web was conducted using relevant keywords. The literature reviewed included studies that described doctors' illness experiences or doctors' perspectives on their experiences of being patients. RESULTS Previous studies showed that doctors' disease prognoses are generally better than or similar to those of patients belonging to the general population. However, doctors' documented illness experiences are multi-dimensional and have several common themes. These include the concept of the 'medical self' (behaving as a doctor despite being a patient) and 'role reversal' (the doctor adjusting to the patient role). The other elements of their experiences include barriers to health care, self-treatment and self-doctoring, presenteeism, and 'wounded healers' (those who can heal others using the wisdom from their illness experiences). Most previous literature has omitted the sociocultural and historical dispositions of doctors and their biomedical perspectives of their own afflictions, even though these strongly impact their illness experiences. CONCLUSION Further research that re-contextualises the meaning of illness for doctors is necessary.
Collapse
|
6
|
Kay MP, Dawes V. Working together to ensure health care access for doctors. Med J Aust 2019; 211:497-498.e1. [DOI: 10.5694/mja2.50421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Margaret P Kay
- University of Queensland Brisbane QLD
- Queensland Doctors' Health Programme Brisbane QLD
| | | |
Collapse
|
7
|
Kemp S, Hu W, Bishop J, Forrest K, Hudson JN, Wilson I, Teodorczuk A, Rogers GD, Roberts C, Wearn A. Medical student wellbeing - a consensus statement from Australia and New Zealand. BMC MEDICAL EDUCATION 2019; 19:69. [PMID: 30832630 PMCID: PMC6399899 DOI: 10.1186/s12909-019-1505-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 02/22/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Medical student wellbeing - a consensus statement from Australia and New Zealand outlines recommendations for optimising medical student wellbeing within medical schools in our region. Worldwide, medical schools have responsibilities to respond to concerns about student psychological, social and physical wellbeing, but guidance for medical schools is limited. To address this gap, this statement clarifies key concepts and issues related to wellbeing and provides recommendations for educational program design to promote both learning and student wellbeing. The recommendations focus on student selection; learning, teaching and assessment; learning environment; and staff development. Examples of educational initiatives from the evidence-base are provided, emphasising proactive and preventive approaches to student wellbeing. MAIN RECOMMENDATIONS The consensus statement provides specific recommendations for medical schools to consider at all stages of program design and implementation. These are: Design curricula that promote peer support and progressive levels of challenge to students. Employ strategies to promote positive outcomes from stress and to help others in need. Design assessment tasks to foster wellbeing as well as learning. Provide mental health promotion and suicide prevention initiatives. Provide physical health promotion initiatives. Ensure safe and health-promoting cultures for learning in on-campus and clinical settings. Train staff on student wellbeing and how to manage wellbeing concerns. CONCLUSION A broad integrated approach to improving student wellbeing within medical school programs is recommended. Medical schools should work cooperatively with student and trainee groups, and partner with clinical services and other training bodies to foster safe practices and cultures. Initiatives should aim to assist students to develop adaptive responses to stressful situations so that graduates are prepared for the realities of the workplace. Multi-institutional, longitudinal collaborative research in Australia and New Zealand is needed to close critical gaps in the evidence needed by medical schools in our region.
Collapse
Affiliation(s)
- Sandra Kemp
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Western Australia
| | - Wendy Hu
- School of Medicine, Western Sydney University, Penrith, New South Wales Australia
| | - Jo Bishop
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland Australia
| | - Kirsty Forrest
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland Australia
| | - Judith N. Hudson
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia
| | - Ian Wilson
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales Australia
| | - Andrew Teodorczuk
- School of Medicine, Griffith University, Gold Coast, Queensland Australia
| | - Gary D. Rogers
- School of Medicine, Griffith University, Gold Coast, Queensland Australia
| | - Chris Roberts
- Northern Clinical and Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales Australia
| | - Andy Wearn
- Medical Programme Directorate, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| |
Collapse
|
8
|
Barriers, facilitators, and survival strategies for GPs seeking treatment for distress: a qualitative study. Br J Gen Pract 2017; 67:e700-e708. [PMID: 28893766 DOI: 10.3399/bjgp17x692573] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 07/13/2017] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND GPs are under increasing pressure due to a lack of resources, a diminishing workforce, and rising patient demand. As a result, they may feel stressed, burnt out, anxious, or depressed. AIM To establish what might help or hinder GPs experiencing mental distress as they consider seeking help for their symptoms, and to explore potential survival strategies. DESIGN AND SETTING The authors recruited 47 GP participants via e-mails to doctors attending a specialist service, adverts to local medical committees (LMCs) nationally and in GP publications, social media, and snowballing. Participants self-identified as either currently living with mental distress, returning to work following treatment, off sick or retired early as a result of mental distress, or without experience of mental distress. Interviews were conducted face to face or over the telephone. METHOD Transcripts were uploaded to NVivo 11 and analysed using thematic analysis. RESULTS Barriers and facilitators were related to work, stigma, and symptoms. Specifically, GPs discussed feeling a need to attend work, the stigma surrounding mental ill health, and issues around time, confidentiality, and privacy. Participants also reported difficulties accessing good-quality treatment. GPs also talked about cutting down or varying work content, or asserting boundaries to protect themselves. CONCLUSION Systemic changes, such as further information about specialist services designed to help GPs, are needed to support individual GPs and protect the profession from further damage.
Collapse
|
9
|
Sturman N, Tan Z, Turner J. "A steep learning curve": junior doctor perspectives on the transition from medical student to the health-care workplace. BMC MEDICAL EDUCATION 2017; 17:92. [PMID: 28549459 PMCID: PMC5446747 DOI: 10.1186/s12909-017-0931-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 05/18/2017] [Indexed: 05/09/2023]
Abstract
BACKGROUND The transition from medical student to hospital-based first year junior doctor (termed "intern" in Australia) is known to be challenging, and recent changes in clinical learning environments may reduce graduate preparedness for the intern workplace. Although manageable challenges and transitions are a stimulus to learning, levels of burnout in junior medical colleagues are concerning. In order to prepare and support medical graduates, educators need to understand contemporary junior doctor perspectives on this transition. METHODS Final-year University of Queensland medical students recruited junior doctors working in diverse hospital settings, and videorecorded individual semi-structured interviews about their transition from medical student to working as a junior doctor. Two clinical academics (NS and JT) and an intern (ZT) independently conducted a descriptive analysis of interview transcripts, and identified preliminary emerging concepts and themes, before reaching agreement by consensus on the major overarching themes. RESULTS Three key themes emerged from the analysis of 15 interviews: internship as a "steep learning curve"; relationships and team; and seeking help. Participants described the intern transition as physically, mentally and emotionally exhausting. They learned to manage long days, administrative and clinical tasks, frequent interruptions and time pressures; identify priorities; deal with criticism without compromising key relationships; communicate succinctly; understand team roles (including their own status within hospital hierarchies); and negotiate conflict. Participants reported a drop in self-confidence, and difficulty maintaining self-care and social relationships. Although participants emphasised the importance of escalating concerns and seeking help to manage patients, they appeared more reluctant to seek help for personal issues and reported a number of barriers to doing so. CONCLUSION Findings may assist educators in refining their intern preparation and intern training curricula, and ensuring that medical school and intern preparation priorities are not seen as competing. Insights from non-medical disciplines into the organisational and relational challenges facing junior doctors and their health-care teams may enhance inter-professional learning opportunities. Workplace support and teaching, especially from junior colleagues, is highly valued during the demanding intern transition.
Collapse
Affiliation(s)
- Nancy Sturman
- Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Zachary Tan
- Princess Alexandra Hospital and Faculty of Medicine, University of Queensland, Brisbane, Queensland Australia
| | - Jane Turner
- Discipline of Psychiatry, Faculty of Medicine, University of Queensland, Brisbane, Australia
| |
Collapse
|
10
|
McMichael LC, Zambrano SC, Crawford GB. The physician as patient in palliative care: A retrospective case-note audit. Palliat Med 2016; 30:889-92. [PMID: 27013531 DOI: 10.1177/0269216316639774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dying physicians may present unique challenges to palliative care teams. Studies of dying physicians are scarce, but those that exist suggest a potential absence of a coordinating clinician, prolongation of curative treatments, resistance to palliative care input and barriers to discussing psychosocial needs. AIM The aim was to describe and examine the care provided to physician-patients referred to an Australian palliative care service, and to identify issues faced by the physician-patient and by the treating team. DESIGN AND PARTICIPANTS A retrospective case-note audit of the case notes of medical practitioners referred for palliative care and dying between January 2007 and April 2013 was conducted. RESULTS There was evidence of medically qualified friends or family members initiating referrals and directing treatment decisions. There was some evidence of increased consultant-led decision-making and bypassing of usual referral pathways and systems for providing after-hours advice and calling consultants directly. There also appeared to be some reluctance by junior doctors to make decisions, because of the patient's desire for consultant-level advice only. CONCLUSION This study adds to the growing body of literature that identifies the potential difficulties associated with caring for medical practitioners. By understanding some of the complexity of this particular doctor-patient relationship, clinicians can approach the management of physician-patients facing the end of their lives with a more sound understanding of their particular care needs.
Collapse
Affiliation(s)
| | - Sofia C Zambrano
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Gregory B Crawford
- Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia Northern Adelaide Palliative Service, Northern Adelaide Local Health Network, Modbury, SA, Australia
| |
Collapse
|
11
|
Zhang L, Wang F, Cheng Y, Zhang P, Liang Y. Work characteristics and psychological symptoms among GPs and community nurses: a preliminary investigation in China. Int J Qual Health Care 2016; 28:709-714. [DOI: 10.1093/intqhc/mzw098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 07/19/2016] [Indexed: 11/13/2022] Open
|