背景:要有效地工作,医生需要照顾自己。他们经常因一系列原因而推迟寻求医疗护理。一旦他们做到了,有证据表明,治疗他们的医生(“治疗医生”)可能难以提供最佳护理。
目的:为了研究现有的文献,关于目前已知的治疗医生的经验,特别是全科医生,当他们的病人也是医生的时候。
方法:对英文文章的范围审查。
方法:使用JBI方法框架进行范围审查,五个数据库(MEDLINE,PsycINFO,CINAHL[护理和相关健康累积指数],谷歌学者,和Scopus)从数据库开始日期到2022年12月31日进行搜索。定性和定量研究报告治疗医生的经验,治疗医生的指南,专家意见文章,和社论都包括在内。考虑了灰色文献,搜索两个Google搜索的前10页。
结果:来自八个国家的48篇文章符合纳入标准,其中12项是研究性研究。主要关注领域如下:情感反应,其中包括被批评的焦虑,担心让医生-病人感到不安,以及对医生生病的承认的不适;关系因素,其中包括边界问题,过度认同医患关系,把他们当成同事而不是病人,和角色模糊;机密性,纳入了情感和关系方面;以及医学文化和社会化对治疗医生和医患之间动态的影响。这些发现已被提炼为治疗医生的关键建议清单。
结论:医生可以发现治疗医生患者会引起焦虑和挑战。这种不适的根源是多方面的,需要更多的实证研究来更好地理解和解决治疗医生和医患之间的复杂关系。
BACKGROUND: To work effectively, doctors need to look after themselves. They often delay seeking medical care for a range of reasons. Once they do, there is evidence that the doctors treating them (\'treating doctors\') can struggle to provide optimal care.
OBJECTIVE: To examine existing literature on what is currently known about experiences for treating doctors, in particular GPs, when their patient is also a doctor.
METHODS: A scoping review of articles written in English.
METHODS: Using the JBI methodological framework for scoping reviews, five databases (MEDLINE, PsycINFO, CINAHL [Cumulative Index to Nursing & Allied Health], Google Scholar, and Scopus) were searched from the database start date until 31 December 2022. Qualitative and quantitative studies reporting the treating doctor\'s experience, guidelines for treating doctors, expert opinion articles, and editorials were included. Grey literature was considered, searching the first 10 pages of two Google searches.
RESULTS: Forty-eight articles from eight countries met inclusion criteria, of which 12 were research studies. The main areas of focus were as follows: affective responses, which included anxiety about being criticised, concern about upsetting the doctor-patient, and discomfort regarding the acknowledgement that doctors get sick; relational factors, which included boundary issues, over-identifying with the doctor-patient, treating them as a colleague rather than a patient, and role ambiguity; confidentiality, which incorporated both affective and relational aspects; and influence of medical culture and socialisation on dynamics between treating doctor and doctor-patient. These findings have been distilled into a list of key suggestions for the treating doctor.
CONCLUSIONS: Doctors can find treating doctor-patients anxiety-provoking and challenging. The sources of this discomfort are multifaceted, and more empirical research is needed to better understand and address the complex relationship between treating doctor and doctor-patient.