摘要
目的了解全科住院医师规范化培训(住培)学员心身医学服务能力的现状和培训需求。方法本研究为横断面调查。采取整群抽样的方式,于2021年8—9月期间对同济大学4家附属医院参加住培的全科学员进行线上问卷调研。问卷内容包括全科住培学员的基本情况,心身医学相关知识自评和培训需求,以及社区患者的心身医学服务需求。结果共发放问卷159份,回收有效问卷140份(88.1%)。25.7%(36/140)全科住培学员认为临床工作中遇到躯体症状伴发情绪问题的患者比例高达50%及以上;29.3%(41/140)认为50%及以上的患者存在睡眠问题;但60.0%(84/140)能采取恰当的处理方式。全科住培学员对"心身医学核心知识和概念"了解的比例为47.5%(665/1400),对"常见心身疾病"判断的正确率为(64.6±23.4)%,自评对心身医学服务能力感到满意者仅占21.4%(30/140)。62.8%(88/140)认为目前全科住培方案对上述能力培训的涵盖率不足50%,66.4%(93/140)认为"有必要"强化训练,线上授课、工作坊、多学科诊疗和临床实践教学等形式的接受率为56.4%(79/140)~63.5%(89/140)。结论参与调研的全科住培学员认为患者有较大的心身医学服务需求,但自身能力和信心显著不足,建议在住培阶段强化心身医学服务能力的教学与培训。
Objective To investigate the current status of psychosomatic medical service competence and training needs among general practice resident physicians.Methods An online questionnaire survey was conducted from August to September 2021,among general practice resident physicians selected by cluster sampling from 4 affiliated hospitals of Tongji University.The questionnaire contained the basic information,the self-assessment and training needs of psychosomatic medical service competence of participants,and psychosomatic medical service requirements of patients in the community.Results A total of 159 questionnaires were distributed,and 140 were collected(88.1%).The survey showed that 25.7%(36/140)of participants believed that 50%or more patients had physical symptoms accompanied by emotional problems;29.3%(41/140)thought that 50%or more patients had sleep problems,but 60.0%(84/140)of them failed to provide appropriate treatment.The rate of"core knowledge and concepts of psychosomatic medicine"was 47.5%(665/1400)and the correct rate of"common psychosomatic diseases"was(64.6±23.4)%.Merely 21.4%(30/140)participants reported satisfaction with the psychosomatic medical service competence;62.8%(88/140)respondents believed that the coverage rate of the above-mentioned competence training in the current general practice residential training program was less than 50%,and 66.4%(93/140)supported that more psychosomatic training was"necessary".The acceptance rate of online training,workshops,MDT,and clinical practice ranged from 56.4%(79/140)to 63.4%(89/140).Conclusions The survey indicates that there are large needs for psychosomatic medical services among patients in community,but the competence and confidence of general practice resident physicians to provide the service are significantly insufficient.Therefore,it is suggested to strengthen the training of psychosomatic medical service competence in the general practice residency training program.
作者
黄蕾
张伟
曾子煊
王琛
高源
Huang Lei;Zhang Wei;Zeng Zixuan;Wang Chen;Gao Yuan(Department of Medical Education,Tongji Hospital,Tongji University,Shanghai 200065,China;School of Medicine,Tongji University,Shanghai 200092,China;Department of General Practice,Tongji Hospital,Tongji University,Shanghai 200065,China;President′s Office,Tongji Hospital,Tongji University,Shanghai 200065,China)
出处
《中华全科医师杂志》
2023年第5期486-491,共6页
Chinese Journal of General Practitioners
基金
全国教育科学“十三五”规划课题2019年度教育部重点项目(DIA190409)
2021年度上海市卫生健康委员会政策研究课题项目(2021HP47)
上海市浦江人才计划资助(2020PJC097)
2021年同济大学研究生医学教育管理专项项目(2021YXGL11)。
关键词
心身医学
全科医师
住院医师规范化培训
Psychosomatic medicine
General practitioners
Standardized residency training program
作者简介
通信作者:高源,Email:13601908332@163.com。
