{"title":"初级保健中全科医生的风险态度、共情水平和倦怠状态与PSA检测的关系","authors":"A. Pedersen, A. H. Carlsen, P. Vedsted","doi":"10.3399/bjgp15X687649","DOIUrl":null,"url":null,"abstract":"Background Rates of prostate specific antigen (PSA) test ordering vary among GPs. Aim To examine whether GPs’ risk attitude, level of empathy, and burnout status are associated with PSA testing. Design and setting Register and questionnaire study including 129 solo GPs (active in the Central Denmark Region) and 76 672 of their adult male patients with no history of or current prostate cancer diagnosis. Method PSA tests from 2012 were retrieved from a register and classified as incident (that is, the first PSA test within 24 months), repeated normal, or repeated raised tests. This was merged with information on GPs’ risk attitudes, empathy, and burnout status from a 2012 survey. Results Patients registered with a GP with a high score on anxiety caused by uncertainty (odds ratio [OR] 1.03, 95% confidence interval [CI] = 1.00 to 1.06, P = 0.025) or concern about bad outcomes (OR 1.04; 95% CI = 1.00 to 1.08, P = 0.034) were more likely to have an incident PSA test, whereas those registered with a GP with increased tolerance for ambiguity were less likely (OR 0.98, 95% CI = 0.96 to 1.00, P = 0.025). Patients registered with a GP reporting high tolerance for ambiguity (OR 0.96, 95% CI = 0.94 to 0.99, P = 0.009) or high propensity to risk-taking (OR 0.97, 95% CI = 0.93 to 1.00, P = 0.047) were less likely to have a repeated normal PSA test. Conclusion Various aspects of GPs’ risk-taking attitudes were associated with patients’ probability of having an incident and a repeated normal PSA test. The probability of having a repeated raised PSA test was not influenced by any of the psychological factors. Burnout and empathy were not associated with PSA testing.","PeriodicalId":22333,"journal":{"name":"The British Journal of General Practice","volume":"34 1","pages":"e845 - e851"},"PeriodicalIF":0.0000,"publicationDate":"2015-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"20","resultStr":"{\"title\":\"Association of GPs’ risk attitudes, level of empathy, and burnout status with PSA testing in primary care\",\"authors\":\"A. Pedersen, A. H. Carlsen, P. Vedsted\",\"doi\":\"10.3399/bjgp15X687649\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background Rates of prostate specific antigen (PSA) test ordering vary among GPs. Aim To examine whether GPs’ risk attitude, level of empathy, and burnout status are associated with PSA testing. Design and setting Register and questionnaire study including 129 solo GPs (active in the Central Denmark Region) and 76 672 of their adult male patients with no history of or current prostate cancer diagnosis. Method PSA tests from 2012 were retrieved from a register and classified as incident (that is, the first PSA test within 24 months), repeated normal, or repeated raised tests. This was merged with information on GPs’ risk attitudes, empathy, and burnout status from a 2012 survey. Results Patients registered with a GP with a high score on anxiety caused by uncertainty (odds ratio [OR] 1.03, 95% confidence interval [CI] = 1.00 to 1.06, P = 0.025) or concern about bad outcomes (OR 1.04; 95% CI = 1.00 to 1.08, P = 0.034) were more likely to have an incident PSA test, whereas those registered with a GP with increased tolerance for ambiguity were less likely (OR 0.98, 95% CI = 0.96 to 1.00, P = 0.025). Patients registered with a GP reporting high tolerance for ambiguity (OR 0.96, 95% CI = 0.94 to 0.99, P = 0.009) or high propensity to risk-taking (OR 0.97, 95% CI = 0.93 to 1.00, P = 0.047) were less likely to have a repeated normal PSA test. Conclusion Various aspects of GPs’ risk-taking attitudes were associated with patients’ probability of having an incident and a repeated normal PSA test. The probability of having a repeated raised PSA test was not influenced by any of the psychological factors. Burnout and empathy were not associated with PSA testing.\",\"PeriodicalId\":22333,\"journal\":{\"name\":\"The British Journal of General Practice\",\"volume\":\"34 1\",\"pages\":\"e845 - e851\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-11-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"20\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The British Journal of General Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3399/bjgp15X687649\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The British Journal of General Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3399/bjgp15X687649","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 20
摘要
背景前列腺特异性抗原(PSA)检测顺序在全科医生中有所不同。目的探讨全科医生的风险态度、共情水平和职业倦怠状态是否与PSA检测相关。设计和设置登记和问卷研究包括129名全科医生(活跃在丹麦中部地区)和76 672名没有前列腺癌病史或目前诊断的成年男性患者。方法从注册表中检索2012年的PSA测试,并将其分类为事件(即24个月内的首次PSA测试)、重复正常测试或重复升高测试。这与2012年的一项调查中关于全科医生风险态度、同理心和倦怠状态的信息相结合。结果在全科医生处登记的患者因不确定性(优势比[OR] 1.03, 95%可信区间[CI] = 1.00 ~ 1.06, P = 0.025)或担心不良结局(OR 1.04;95% CI = 1.00至1.08,P = 0.034)更有可能进行偶发性PSA检测,而GP患者对模糊容忍度增加的可能性较小(OR 0.98, 95% CI = 0.96至1.00,P = 0.025)。注册的全科医生报告对模棱两可的高耐受性(OR 0.96, 95% CI = 0.94至0.99,P = 0.009)或高风险倾向(OR 0.97, 95% CI = 0.93至1.00,P = 0.047)的患者不太可能重复进行正常的PSA检测。结论全科医生的冒险态度的各个方面与患者发生事故和重复正常PSA测试的可能性有关。PSA反复升高的概率不受任何心理因素的影响。倦怠和同理心与PSA检测无关。
Association of GPs’ risk attitudes, level of empathy, and burnout status with PSA testing in primary care
Background Rates of prostate specific antigen (PSA) test ordering vary among GPs. Aim To examine whether GPs’ risk attitude, level of empathy, and burnout status are associated with PSA testing. Design and setting Register and questionnaire study including 129 solo GPs (active in the Central Denmark Region) and 76 672 of their adult male patients with no history of or current prostate cancer diagnosis. Method PSA tests from 2012 were retrieved from a register and classified as incident (that is, the first PSA test within 24 months), repeated normal, or repeated raised tests. This was merged with information on GPs’ risk attitudes, empathy, and burnout status from a 2012 survey. Results Patients registered with a GP with a high score on anxiety caused by uncertainty (odds ratio [OR] 1.03, 95% confidence interval [CI] = 1.00 to 1.06, P = 0.025) or concern about bad outcomes (OR 1.04; 95% CI = 1.00 to 1.08, P = 0.034) were more likely to have an incident PSA test, whereas those registered with a GP with increased tolerance for ambiguity were less likely (OR 0.98, 95% CI = 0.96 to 1.00, P = 0.025). Patients registered with a GP reporting high tolerance for ambiguity (OR 0.96, 95% CI = 0.94 to 0.99, P = 0.009) or high propensity to risk-taking (OR 0.97, 95% CI = 0.93 to 1.00, P = 0.047) were less likely to have a repeated normal PSA test. Conclusion Various aspects of GPs’ risk-taking attitudes were associated with patients’ probability of having an incident and a repeated normal PSA test. The probability of having a repeated raised PSA test was not influenced by any of the psychological factors. Burnout and empathy were not associated with PSA testing.