| 引用本文：刘雪娇, 张星星, 冯秒, 孙奕.医生职业风险认知对防御性医疗行为的影响[J].中国卫生政策研究,2018,11(3):15-19 |
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| 医生职业风险认知对防御性医疗行为的影响 |
| 投稿时间：2017-10-31 修订日期：2017-12-06 PDF全文浏览 HTML全文浏览 |
| 刘雪娇, 张星星, 冯秒, 孙奕 |
| 华中科技大学同济医学院公共卫生学院 湖北武汉 430030 |
| 摘要:以在职医生为调查对象，采用半结构式访谈法收集资料，用扎根理论方法分析医生职业风险认知与防御性医疗的关系。发现医生由于感知到各种职业风险会导致出现紧张、焦虑及抑郁，职业认同感降低等心理问题，同时在医疗工作中会出现不敢冒险与创新，工作积极性被打击，工作出错的概率增加等情况；为应对职业风险，医生在医疗决策时为自保会采取多开检查治疗项目，增加会诊，选择性收治病人，通过医疗知情同意以推卸责任等不利防御；感知到职业风险同时也会促使医生改善服务态度，更加谨慎小心，提升专业技能等方式来降低职业风险。医生职业风险认知是防御性医疗行为的主要动因，二者之间也可能互为因果。 |
| 关键词:医生职业风险 风险认知 防御性医疗行为 扎根理论 |
| 基金项目:国家社会科学基金项目（14BSH138） |
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| The effect of physicians' occupational risk cognition on defensive medical behavior in China |
| LIU Xue-jiao, ZHANG Xing-xing, FENG Miao, SUN Yi |
| School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei 430030, China |
| Abstract:Objective:The aim of this paper is to explore the influence of physician's occupational risk cognition on defensive medical behavior. Methods:Semi-structured interview was applied for data collection from in-service doctors. A grounded theory was used to analyze and develop the relationship between physicians' occupational risk cognition and defensive medical behavior. Results:This study shows that the cognition of various occupational risks may lead to a series of psychological effects on doctors, such as mental stress, anxiety and depression, professional identity decrease, fear of adventure and innovation, job enthusiasm decrease and probability of malpractice increase. Adverse defensive medical behaviors, such as ordering more tests, treatments and consultations, selective treatment of patients, shirking responsibility through informed consent, and favorable defensive medical behaviors, such as to improve service attitude, being more cautious during work and to improve professional skills, should be in response to occupational risks. Conclusions:Physicians' occupational risk cognition is the primary motivation of defensive medical behavior, and the relationship between physicians' occupational risk cognition and defensive medical behavior may also be mutually causal and effect. |
| Key words:Physicians' occupational risk Risk perception Defensive medical behavior Grounded theory |
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