Cognition ; Diagnostic Errors ; psychology ; Humans ; Physicians ; psychology ; Thinking

Cognition ; Diagnostic Errors ; psychology ; Humans ; Physicians ; psychology ; Thinking

Biomedical Research ; Career Choice ; Humans ; Motivation ; Physicians ; psychology ; Singapore

There are many reasons why doctors would not to be able to communicate with patients. First, medicine is science or humanity? Although object of medicine is human, modern medicine tends to regard human as broken machine. Second, gastroenterologists are overloaded by treatment of patients, providing education, attending academic conference, and writing papers. Above all things, it is much worse for gastroenterologists because of endoscopic procedures. The other problem is attitude of modern society about human suffering. Sufferings come from not only body but also mind or spirit. Although there are may difficult problems, if doctors listen to patients' history by their side, it will help to restore their faith. In addition, we need humanity education and improvement plans for medical service system.
Delivery of Health Care ; Education, Medical, Continuing ; Gastrointestinal Diseases/*psychology ; Humans ; Physician-Patient Relations ; Physicians/*psychology

Diagnostic errors can result in tangible harm to patients. Despite our advances in medicine, the mental processes required to make a diagnosis exhibits shortcomings, causing diagnostic errors. Cognitive factors are found to be an important cause of diagnostic errors. With new understanding from psychology and social sciences, clinical medicine is now beginning to appreciate that our clinical reasoning can take the form of analytical reasoning or heuristics. Different factors like cognitive biases and affective influences can also impel unwary clinicians to make diagnostic errors. Various strategies have been proposed to reduce the effect of cognitive biases and affective influences when clinicians make diagnoses; however evidence for the efficacy of these methods is still sparse. This paper aims to introduce the reader to the cognitive aspect of diagnostic errors, in the hope that clinicians can use this knowledge to improve diagnostic accuracy and patient outcomes.
Affect ; Attitude of Health Personnel ; Cognition ; Diagnosis, Differential ; Diagnostic Errors ; psychology ; Humans ; Physicians ; psychology ; Prejudice ; Thinking

OBJECTIVETo analyze the job burnout and mental health status of clinicians and the relationship of personality with job burnout and psychological stress, and to investigate the direct or indirect effects of personality on psychological stress.

METHODSMaslach Burnout Inventory-General Survey (MBI-GS), Eysenck Personality Questionnaire-Revised Short Scale (EPQ-RSC), and Kessler 10 Scale were administered to 775 clinicians.

RESULTSOf all clinicians, 29.5% had mild burnout, with a score of 22.7 ± 8.18 for psychological stress risk. The effect of personality on emotional exhaustion and cynicism was greater than that on personal accomplishment. Clinicians with a personality of introversion, neuroticism, and psychoticism suffered a higher risk of psychological stress. Personality had both direct and indirect effects on psychological stress. Neuroticism had the strongest effect on psychological stress, with an effect size of 0.55.

CONCLUSIONClinicians have a high level of both job burnout and mental psychological stress risk. Personality is significantly correlated with job burnout and psychological stress risk. Measures depending on personality should be taken for effective intervention.

Anxiety Disorders ; Burnout, Professional ; epidemiology ; psychology ; Fatigue ; Humans ; Neuroticism ; Personality ; Physicians ; psychology ; Risk ; Stress, Psychological ; epidemiology ; psychology ; Surveys and Questionnaires

OBJECTIVES: The purpose of this study was to assess the inter-rater reliability and intra-rater reliability of medical record review for the detection of hospital adverse events. METHODS: We conducted two stages retrospective medical records review of a random sample of 96 patients from one acute-care general hospital. The first stage was an explicit patient record review by two nurses to detect the presence of 41 screening criteria (SC). The second stage was an implicit structured review by two physicians to identify the occurrence of adverse events from the positive cases on the SC. The inter-rater reliability of two nurses and that of two physicians were assessed. The intra-rater reliability was also evaluated by using test-retest method at approximately two weeks later. RESULTS: In 84.2% of the patient medical records, the nurses agreed as to the necessity for the second stage review (kappa, 0.68; 95% confidence interval [CI], 0.54 to 0.83). In 93.0% of the patient medical records screened by nurses, the physicians agreed about the absence or presence of adverse events (kappa, 0.71; 95% CI, 0.44 to 0.97). When assessing intra-rater reliability, the kappa indices of two nurses were 0.54 (95% CI, 0.31 to 0.77) and 0.67 (95% CI, 0.47 to 0.87), whereas those of two physicians were 0.87 (95% CI, 0.62 to 1.00) and 0.37 (95% CI, -0.16 to 0.89). CONCLUSIONS: In this study, the medical record review for detecting adverse events showed intermediate to good level of inter-rater and intra-rater reliability. Well organized training program for reviewers and clearly defining SC are required to get more reliable results in the hospital adverse event study.
Drug-Related Side Effects and Adverse Reactions/classification/*pathology ; Hospitals, General ; Humans ; Medical Records ; Nurses/psychology ; Physicians/psychology ; Retrospective Studies

OBJECTIVES: This study was conducted to investigate the levels of psychosocial stress, job stress and their related factors among medical doctors practicing at local clinics. METHODS: A survey using a self administered questionnaire was administered to 1,456 doctors practicing at private clinics via post for 2 months (2006. 1 - 2006. 3). Psychosocial stress, job stress,demographic factors, job related factors and health related behaviors were investigated. Among the eligible study population, the respondents were 428 doctors (29.4%). RESULTS: The average scores of psychosocial stress and job stress were 2.19 and 3.13, respectively. The levels of psychosocial stress and job stress were statistically lower in older respondents, those who worked shorter or who were more satisfied with their job, and those with higher socioeconomic status. The level of psychosocial stress was related with smoking status, drinking status and exercise. The level of job stress was related with smoking status and exercise. In multiple linear regression analysis using psychosocial stress as a dependent variable, age, working hours per day, job satisfaction and perception on socioeconomic status were significant independent variables. In analysis using job stress as a dependent variable, age, working hours per day and job satisfaction were significant independent variables. CONCLUSIONS: Stress affects the doctor-patient relationship, productivity and overall health level of people. Therefore, it is important to manage and relieve the stress of doctors. It is suggested that more advanced studies on stress level and related factors and ways to improve the stress and health related behaviors of medical doctors should be conducted.
*Stress, Psychological ; Questionnaires ; Psychology ; Physicians/*psychology ; Occupational Exposure ; Middle Aged ; Male ; Korea ; Humans ; Female ; *Ambulatory Care Facilities ; Adult

PURPOSE: Community health practitioners (CHP) in Korea have a responsibility for delivering primary health care to remote or isolated communities. The aim of this paper is to analyze CHPs' level of depression and impacts of their Ego state and interpersonal attitude in transactional analysis on depression. This paper gives fundamental data for developing a the program for mental health promotion of CHPs. METHOD: The subjects of this study consisted of 459 Korean CHP who were conveniently selected from the target population. The data was collected through interviews using self-administered questionnaires, including the Korean Ego gram and life position inventory and depression scale. RESULTS: The CHP's Ego gram showed the N type with the top point of NP. The type of interpersonal attitude was I'M OK - YOU'RE OK (I+U++). The level of depression was 35.4, normal range. There was a significant difference in depression according to the duration of the career. There was a significant negative correlation among NP, A, FC ego states, interpersonal OK and depression, and a significant positive correlation between interpersonal Not-OK and depression. The NP, A, FC ego states and interpersonal Not-OK were significant predictors (47.1%) of depression. CONCLUSION: This study showed that a program for CHPs to should include increasing the function of ego states and positive interpersonal attitude.
Adult ; Attitude of Health Personnel ; Community Health Centers ; Depression/epidemiology/*psychology ; *Ego ; Humans ; Middle Aged ; Physicians/*psychology ; *Professional-Patient Relations

OBJECTIVETo investigate the status of job burnout in traditional Chinese medicine (TCM) doctors and explore the effect of occupational commitment on job burnout.

METHODSA test of occupational commitment and job burnout was carried out in 507 TCM doctors with occupational commitment questionnaire and Maslach Burnout Inventory-Human Services Survey (MBI-HSS).

RESULTSThe age group of < 30 years scored lowest (2.352 +/- 0.660) in personal accomplishment compared with 30 years old group and 40 years old group [(2.136 +/- 0.704) and (2.127 +/- 0.628) respectively] (P < 0.01). The score of emotional exhaustion and depersonalization increased with educational levels. There was significantly negative correlation between job burnout and occupational commitment (P < 0.01). Occupational commitment had significant effect on job burnout (P < 0.01). Occupational trouble commitment was a major predictor for emotional exhaustion (P < 0.01). Professional self-efficacy commitment was a major predictor for depersonalization (P < 0.01). Affective commitment was a major predictor for personal accomplishment (P < 0.01).

CONCLUSIONOccupational commitment is a good predictor for job burnout. Improving occupational commitment is an important measure to prevent job burnout.

Adult ; Burnout, Professional ; psychology ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Physicians ; psychology ; Surveys and Questionnaires ; Young Adult