Personlighetstrekk ved leger

Transkript

1 Personlighetstrekk ved leger 10. januar 2013 Olaf Gjerløw Aasland

2 To forskjellige ting: Alle har personlighet Bare noen få har en personlighetsforstyrrelse

3 Big five: Måles med personlighetsinventorier (spørreskjema) Openness (inventive/curious vs. consistent/cautious) Conscientiousness (efficient/organized vs. easy-going/careless) Extraversion (outgoing/energetic vs. solitary/reserved) Agreeableness (friendly/compassionate vs. cold/unkind) Neuroticism (sensitive/nervous vs. secure/confident)

4 Utadvendt - Extraversion Høy Sosial, klarer å nyte livet, energisk Lav Innadvendt, stille når sammen med andre, trives alene Omgjengelig - Agreeable Høy Vennlig, godmodig, hjelpsom, tillitsfull Lav Kritisk, fiendtlig, aggressiv Pliktoppfyllende - Conscientousness Høy Lav Pålitelig, disiplinert, forsiktig Uorganisert, rotete, likegyldig Emosjonelt ustabil - Neuroticism Høy Lav Nervøs, anspent, usikker, bekymret Rolig, fattet Åpen for nye erfaringer - Openness Høy Lav Nyskapende, kreativ, nysgjerrig, tankemessig kompleks, liberal Konvensjonell, jordnær, konservativ

5 LEFO s to personlighetsinventorier BCI Basic Character Inventory (1966) Modifisert av den norske psykologen Svenn Torgersen Fire dimensjoner: Neuroticism - nevrotisisme Extraversion - utadvendt Conscientiousness - samvittighetsfull Reality weakness realitetssvak EPQ - Eysenck Personality Questionnaire (1947) Kortversjon utviklet bl.a. av den norske psykologen Kristian Tambs Fire dimensjoner Ekstrovert - introvert Sårbarhet/nevrotisisme Psykotisisme (reality weakness) Løgn

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8 To andre norske publikasjoner basert på legedata der BCI er benyttet: Røvik JO, Tyssen R, Gude T, Moum T, Ekeberg Ø, Vaglum P. Exploring the interplay between personality dimensions: A comparison of the typological and the dimensional approach in stress research. Personality and Individual Differences 2007;42: Conclusion: Neuroticism was most consistently associated with stress. Conscientiousness had a moderating role on stress, as those with high conscientiousness reported higher stress than those with low conscientiousness, for given constellations of levels of neuroticism and extraversion. Tyssen R, Dolatowski FC, Røvik JO, Thorkildsen RF, Ekeberg Ø, Hem E, Gude T, Grønvold NT, Vaglum P. Personality traits and types predict medical school stress: a nationwide longitudinal study. Medical Education 2007; 41: Conclusions: This is the first study to show that a specific combination of personality traits can predict medical school stress; in particular, the combination of high neuroticism and high conscientiousness is considered high risk.

9 130 Eysenck Introvert-ekstrovert (917 norske leger)

10 Eysenck Sårbarhet (956 norske leger)

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14 Sårbarhet

15 Ekstrovertintrovert

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17 Abstract: We did a questionnaire survey in the year 2000 on a representative sample of approx Norwegian doctors. The response variable was based on the question: Have you experienced serious patient injury in connection with medical treatment you have given? Middle aged male surgeons were most likely to give an affirmative answer to this question. There was a significant personality effect for doctors that scored high on extrovert and vulnerable (Eysenck). For doctors who worked in an atmosphere with openness around errors and misbehaviour, the impact of feeling responsible for an adverse event was milder.

18 Question posed to a representative sample of 1294 Norwegian doctors: Have you experienced serious patient injury in connection with medical treatment you have given? Never A few times Several times Not appliccable 878 (68 %) 354 (27 %) 14 (1 %) 48 (4 %)

19 partial for S Estimated partial effects of gender on the logit of the probability of having experienced serious patient imjury, controlled for age and specialty, with 95% confidence interval Mann Kvinne grand mean S

20 Estimated partial effects of age on the logit of the probability of having experienced serious patient injury, controlled for gender and specialty, with 95% confidence interval grand mean

21 Estimated partial effects of specialty on the logit of the probability of having experienced serious patient injury, controlled for age and gender, with 95% confidence interval grand mean

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23 The impact of personality on reporting serious patient injury can be illustrated by the following example: Estimated probability of reporting to have experienced an incident with serious patient injury for a male surgeon, anaesthesiologist or gynaecologist age 50 to 54 who scores 4 on extrovert and 0 on neuroticism is.67. However, if he, like one of the physicians in our sample, scores 8 on extroversion-introversion and 6 on neuroticism, this probability goes up to.89.

24 Hva skjer med legen?

25 Consequences of events with serious patient injury according to prevalence (percent) The incident was discussed at the workplace 83 I received good support from colleagues 69 I have spoken with the patient or the pationt's family about the incident 68 The incident was reported to the Board of Health 37 I was blamed by the patient or the patient's family 32 The incident had a negative impact on my private life 17 The incident was reported in the media 12 The incident has made it harder to work as a doctor 11 I have needed professional help 6

26 Å være åpen for kritikk

27 Frequency It is difficult to criticise my colleagues for their ethically unacceptable conduct (n = 1292) A good description A fair description A poor description 4. A wrong description Not appliccable Vanskelig å påtale etisk uakseptabel atferd Mean = 2,73 Std. Dev. = 1,239 N = 1 292

28 etisk, ordinal 4 Association between the acceptance of criticism pf ethically unacceptable behaviour and collegial support after serious patient injury (gamma =.272, p =.002) 3,5 3 2,5 2 1,5 R Sq Linear = 0, ,5 1 1,5 2 God støtte, ordinal

29 Frequency It is difficult to criticise my colleagues for their professionally unacceptable conduct (n = 1290) A good description A fair description A poor description A wrong description 5. Not appliccable Vanskelig å påtale faglig uakseptabel atferd Mean = 2,61 Std. Dev. = 1,214 N = 1 290

30 profesjonell, ordinal 4 3,5 Association between the acceptance of criticism pf professionally unacceptable behaviour and collegial support after serious patient injury(gamma =.292, P =.001) 3 2,5 2 1,5 R Sq Linear = 0, ,5 1 1,5 2 God støtte, ordinal

31 MM-meetings and support at home

32 MM (mortality and morbidity)-meetings, Norway : Anaesthesiology (41) Surgery (111) GYOB (40) Laboratory medicine (85) Family medicine (255) Internal medicine (277) Psychiatry (125) Public health (39) 0 % 20 % 40 % 60 % 80 % 100 % not applicable no no, but desireable has been decided,but not implemented yes

33 Table 2 Profession of spouses vs. gender of doctors. Percent, numbers in parentheses. Profession of spouse/partner Female doctors (124) Male doctors (234) All respondents (358) Doctor (90) Nurse (54) Other health profession (32) Other profession (124) No partner or spouse (58) All (358)

34 Table 3 Influence of professional secrecy, MM-meetings and partner/spouse s profession on doctors stress and lack of coping. Three logistic regression models. Model 1 Model 2 Model 3 beta p beta p beta p Male Age (years) Work in hospital Professional secrecy MM-meetings Profession of spouse/partner (ref. no partner) Doctor Nurse Other health worker Other Hosmer-Lemeshow chi square 4.7, df 8, p= , df 8, p= , df 8, p=