Difficult Encounters Experienced by Family Physicians and the Coping Methods They Employ: A Cross-sectional Study

Abstract

Objective: The purpose of this study was to determine difficult encounters and the practice of medicine among family physicians (FPs). Methods: The research was conducted as a cross-sectional study using a questionnaire between 15 June and 15 July, 2019. The questionnaire included sociodemographic characteristics, difficult situations that may be encountered, and methods of coping with such situations. Three hundred twenty-five FPs took part in the study. Results: The FPs reported being most frequently troubled by “requests for unnecessary reports” and “patients requesting unindicated tests”. FPs described male gender, age 31-40, possession of a moderate income level, being married, and being a civil servant as the patient characteristics most frequently causing difficulties. The mean length of time spent with an ordinary patient was 7.4±0.1 minutes, but this rose to 12.6±0.3 in case of difficult patients. The coping method most frequently employed by FPs in the face of difficult encounters was empathy. Ninety-two percent of the FPs reported experiencing a communication problem with patients at least once a year. Only 22.5% of FPs reported having taken part in training regarding managing difficult situations. Conclusion: FPs frequently experience difficult encounters. The most frequent of these involve demanding, frequently presenting patients with numerous complaints. The principal reason for FPs experiencing difficult encounters was found to be problems in the health service. Although empathy was the most frequently employed coping method, a lack of training on the subject was also identified.

Keywords

• Delivery of Health Care
• Difficult Encounter
• Family Practice
• Physician-Patient Relations
• Primary Health Care

Aile Hekimlerinin Karşılaştığı Zor Durumlar ve Başa Çıkma Yöntemleri: Kesitsel Bir Çalışma

Abstract

Amaç: Bu çalışma ile aile hekimlerinin zor durumlarla karşılaşma durumlarının ve hekimlik pratiklerin saptanması amaçlanmıştır. Gereç ve Yöntem: Kesitsel tipteki bu çalışma 15 Haziran-15 Temmuz 2019 tarihleri arasında bir anket formu ile yürütülmüştür. Anket formunda sosyodemografik özellikler, karşılaşılabilecek zor durumlar ve zor durumlarla başa çıkabilme yöntemleri yer almaktadır. Çalışmaya toplam 325 aile hekimi katılmıştır. Bulgular: Aile hekimleri en sık “gereksiz yere rapor talepleri” ve “endikasyon olmadan tektik isteyen hastaların” kendilerini zorladığını belirtmektedir. Aile hekimlerini zorlayan hasta özellikleri erkek olma, 31-40 yaş arası olma, orta gelir düzeyinde olma, evliler ve devlet memurları olarak bildirilmiştir. Sıradan bir hasta görüşmesi ortalama 7,4±0,1 dakika iken, zor hastalarda 12,6±0,3 dakikaya çıktığı bildirilmiştir. Aile hekimleri zor durumlarla karşılaştıklarında en sık başa çıkma yöntemi olarak empati kurmaya çalıştığını belirtti. Aile hekimlerinin %92’si son 1 yılda en az bir kez hastalarla bir iletişim problemi yaşadıklarını belirtmiştir. Zor durum yönetimi ile ilgili sadece %22,5’i bir eğitime katıldığını belirtti. Sonuç: Aile hekimleri zor durumlar ile çok sık karşılaşmaktadır. Talepkar, sık başvuran, çok sayıda şikâyeti olanlar hastalar en sık karşılaşılan zor durumlardır. Aile hekimleri tarafından zor karşılaşmaların en önde gelen nedeni olarak sağlık sistemi sorunları gösterilmektedir. Empati kurma en sık kullanılan başa çıkma yöntemi olsa da bu konuda eğitim eksikliği olduğu saptanmıştır.

Keywords

• Sağlık hizmetleri sunumu
• Zor karşılaşma
• Aile hekimliği
• Hekim-hasta ilişkileri
• Birinci basamak sağlık hizmeti

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