A NEED ASSESSMENT OF ETHICS COURSE FOR PRIMARY CARE PHYSICIAN: PHYSICIANS' PERSPECTIVE IN YOGYAKARTA PROVINCE, INDONESIA

H. Nurrokhmanti,, Adi Heru, Hari Kusnanto Joseph
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Abstract

Background: Primary care physicians, as first-line doctors, deal with ethical cases that challenge them to make the best patient decisions. Helping primary care physicians to be more aware of ethical cases and the process of case decision-making will improve all stakeholder's needs. Physician standard opinion on the best decision for their patient will be the baseline of suited training for them.Methods: We conducted a mixed-method study to understand GP decisions regarding certain ethical cases. In the quantitative phase, we used and presented several standardized ethical cases with several "decisive" options followed by reason. For qualitative, in-depth guided interview was done with several physicians. The data was analyzed by close system coding. Results: We gained 36 responses from several physicians with 12 in-depth interviews. In the quantitative, we found that two questions related to communicating the mistake and the rural problem had the worst response, showed by highly unfavourable answers. The interview found that most physicians find it hard to decide on ethical cases, acknowledge religion as one aspect for making the decision, and expect a clear guideline that will help them make a firm decision regarding "difficult" dilemma cases. Conclusion: To avoid bad decision-making in ethical-related cases, the physician must take another training since low awareness of ethical cases will lead to unfavourable decisions regarding some dilemmas. Considering the methods and number of subjects in this research, the training should apply a specific strategy to all physicians.
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初级保健医生道德课程需求评估:印度尼西亚日惹省医生的观点
背景:作为一线医生,初级保健医生要处理的伦理案例挑战着他们为患者做出最佳决定。帮助初级保健医生提高对伦理病例和病例决策过程的认识,将改善所有利益相关者的需求。医生对患者最佳决定的标准意见将是他们接受合适培训的基线:我们开展了一项混合方法研究,以了解全科医生对某些伦理病例的决策。在定量研究阶段,我们使用并展示了几个标准化的伦理案例,其中包含几个 "决定性 "选项,并在选项后说明了理由。在定性阶段,我们对几位医生进行了深入的指导性访谈。我们通过严密的系统编码对数据进行了分析。结果:通过 12 次深入访谈,我们从几位医生那里获得了 36 个答复。在定量分析中,我们发现与沟通错误和农村问题有关的两个问题的回答最差,表现为非常不利的回答。访谈发现,大多数医生认为在道德问题上很难做出决定,承认宗教是做出决定的一个方面,并期望有一个明确的指导方针,帮助他们在 "困难 "的两难情况下做出坚定的决定。结论为了避免在与伦理相关的病例中做出错误决策,医生必须再接受一次培训,因为对伦理病例的认识不足会导致在某些两难病例中做出不利的决定。考虑到本研究的方法和研究对象的数量,培训应针对所有医生采用特定的策略。
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