Journal of the Korean Academy of Family Medicine 1987;8(12):1-16.
Published online December 1, 1987.

질병치료에 관련된 사회심리적 문제들과 의사개입정도에 관한 연구

김기형 오미경 윤방부

연세대학교의과대학 가정의학교실

Abstract

In most of medical problems, psychosocial factors closely relate to the autonomic nervous system, the neuroendocrine, and the immune system and give various influence on natural process of illness. While psychosocial factors are important to the family physician as well as the organic etiology of disease, family physician cannot solve the vast majority of psychosocial problems in reality. Therefore, this study is to determine the cost-effective ways of physician intervention to the psychosocial problems by comparing priorities of patients, family practice residents, and family medicine practitioners. The results for the analysis of the data obtained from the interview questionnaire survey on 336 outpatients from 4 hospitals and from the mail questionnaire survey on 98 family practice residents, and 40 family medicine practitioners are as follows:
1. The order of importance of physician intervention to the psychosocial problems for patients, family practice residents, and family medicine practitioners is the subjects on health and disease, the subjects on marriage, and the subjects on occupation.
2. The extent of physician intervention requested by the patients is in between ideal and actual degree of intervention perceived by both family practice residents and family medicine practitioners. The least different subjects between the patients request and the family physicians opinion on the extent of physician intervention are health and disease, whereas the most different subjects are occupation.
3. The patients request on the extent of physicians intervention differs according to sex, education, age, medical insurance, occupation, and religion. The outpatient practice experience is a factor that influences the actual degree of intervention for family practice residents and the degree of intervention between ideal and actual is higher for the female than male among residents while there is no difference among family medicine practitioners.
4. The proportions of those who feel the difference between ideal and actual are 87.8% for family practice residents and 75.0% for family medicine practitioners, respectively. They point out the lack of education during training period as a primary reason for the difference.
5. The favoritely used methods to manage psychosocial problems in actual practice by both family practice residents and family medicine practitioners are formation of a good patient relation, care of somatic complaints, and administration of antipsychotic agents.
As a result, the important subjects of all of the patients the family practice residents, and the family medicine practitioners are the subjects on health and disease, the physical complaints, and the health education. The extent of physician intervention requested by the patients is in between ideal and actual degree of intervention perceived by family physicians. The majority of family practice residents and family medicine practitioners feel the difference between ideal and actual and point out the strengthening of education during training period as the problem solving approach.