A Study On The Relationship Between Physicians’ Occupational Risk Perception And Defensive Medicine

Objective:Firstly,to explore what professional risk would physicians encounter? What impact of doctors’ occupational risk perception on the doctor’s work and psychology? What measures should be taken to response occupational risks with qualitative method.Secondly,to quantitatively analyze the inter-relationship between doctors’ professional risk perception and defensive medical behavior.Methods:(1)The subjects of the study were in-service physicians.(2)Methods: qualitative study: Semi-structured interviews were carried out to collect data of the impact of occupational risk on doctors and physicians’ risk response measures with convenience sampling.Grounded theory method was applied to analyze the interview data.Based on this,occupational risk response questionnaire was designed.Quantitative study: research subjects were chosen with convenience sampling.A self-administered anonymous questionnaire survey was conducted in several hospitals in Hubei Province with occupational risk response questionnaire,combined with physicians’ occupational risk perception scale designed in former stage.(3)Descriptive statistics was applied to analyze the subjects’ basic information and item scores of occupational risk response questionnaire and physicians’ occupational risk perception scale.The occupational risk response items were classified with exploratory factor.(4)To explore the inter-relationship between doctors’ occupational risk perception and defensive medical behavior by applying Structure Equation Model.Results:1.71 valid interviews were included among 121 interviews.Adverse effect on physicians and their work included tension,anxiety,and depression,professional identity decrease,dare to take risks and innovate,enthusiasm for work decrease,probability of malpractice increase.Response measures which doctors agree included ordering more check,treatment items and consultations,refuse treatment of critical patients,improving service attitudes,being more prudence,greater communication with patients and enhancing professional skills.2.In physicians’ occupational risk perception possibility conceptual model,patient safety has the greatest effect(FL=0.80),followed by occupational exposure(0.79),workload(0.79)and personal development(0.78),disputes and conflicts(FL=0.71)had the least effect.In physicians’ occupational risk perception severity conceptual model,Patient safety has the greatest role(FL=0.78),followed by occupational exposure(0.77),workload(0.76)and personal development(0.70),dispute and conflict(0.57)had the least effect.There is relation between patient safety and disputes and conflicts.The correlation coefficients are 0.41 and 0.28 respectively.3.Occupational risk perception has positive impact on social support,active defense medicine,and negative defense medicine.The impact of risk perception probability on social support,active defense medicine,and negative defense medicine was 0.53,0.41,and 0.15 respectively.The impact of risk perception severity on social support,active defense medicine,and negative defense medicine was 0.57,0.39,and 0.28 respectively.There is a close connection between social support and active defense medicine.The correlation coefficients are 0.73 and 0.74 respectively.Conclusions: When doctors have perceived occupational risk,they hope to gain social support.Doctors’ occupational risk perception has a greater impact on positive defensive medical and less influence on negative defensive medical.Social support is closely related to positive defensive behavior.Social support may promote doctors to practice positive defensive medical behaviors in a certain extent.