巴林特小组在全科医师规范化培训中的实践应用

目的　探讨巴林特小组在全科医师规范化培训中的实践效果。方法　选取中南大学湘雅二医院2015级和2016级接受国家规范化培训的全部全科医师为研究对象,共54名,同时选取5名全科教学小组带教老师为巴林特小组长。于2016年11月—2018年1月,共开展了30次巴林特小组活动,每名全科医师均参加5~6次巴林特小组活动。活动结束后,采用自行设计的调查表对全科医师进行调查,内容包括全科医师的基本情况、对巴林特小组活动安排的满意度、参加巴林特小组活动的收获、继续参加巴林特小组活动的意愿。共发放问卷54份,回收有效问卷54份,问卷的有效回收率为100.0%。结果　54名全科医师中,对巴林特小组活动的活动时间、活动频率、小组人数、案例选择、小组长组织能力、小组氛围满意/非常满意者分别占94.4%（51/54）、88.9%（48/54）、100.0%（54/54）、96.3%（52/54）、88.9%（48/54）、100.0%（54/54）。54名全科医师中,认为巴林特小组活动在“提高沟通技巧,能够顺利与患者及家属进行沟通”“遇到突发事件时能够给予患者及家属理性的情感支持”“学会耐心倾听,能够自主识别和认知自身情绪问题”“理解自身角色对于患者及家属的重要性和责任”“释放职业压力,采取成熟的压力应对方式,正确地控制和表达情绪”“感受到理解和支持,提升职业认同感”“提升团队协作能力,更好地处理医患、医护关系”“帮助解决工作与个人生活交叉时出现的困惑”“有助于运用和谐医患关系,利于临床工作”9个方面比较有帮助/非常有帮助者分别占100.0%（54/54）、94.4%（51/54）、90.7%（49/54）、98.2%（53/54）、96.3%（52/54）、100.0%（54/54）、94.4%（51/54）、90.7%（49/54）、100.0%（54/54）。54名全科医师中,48名（88.9%）全科医师愿意继续参加巴林特小组活动。结论　全科医师对巴林特小组活动安排的满意度较高,参加巴林特小组活动后收获较多,且多数全科医师愿意继续参加巴林特小组活动。

Application of Balint Group Activities in the National Standardized Training of General Practitioners

Objective　To explore the effect of Balint group activities applied to the national standardized training of general practitioners（GPs）.Methods　We enrolled a total of 54 GPs with an experience of participating in the national standardized training of GPs conducted in 2015 or 2016 from The Second Xiangya Hospital of Central South University,and enrolled 5 GP training teachers as the group leaders of the Balint group activity.From November 2016 to January 2018,we carried out 30 Balint group activities in them,and each GP attended 5-6 activities.When the activities ended,we surveyed the GPs by using a self-developed questionnaire for collecting their general demographic data,level of satisfaction with the arrangement of Balint group activities,benefits of participating in such activities and intentions to participate in such activities later.The survey achieved a response rate of 100.0%.Results　The percentages of GPs who reported being "satisfied" and "very satisfied" with the timing,frequency of Balint group activities,number of participants in the activity,selection of cases,organizing ability of the group leader,and atmospheric conditions during the activity,were 94.4%（51/54）,88.9%（48/54）,100.0%（54/54）,96.3%（52/54）,88.9%（48/54）,and 100.0%（54/54）,respectively.The percentages of GPs who reported that Balint group activities were "helpful" and "very helpful" to them in terms of "ensure effective communication with patients and their family members by improving the communication skills" "offer rational emotional support to patients and their family members when an emergency occurs" "learn to listen to the patients and their family members patiently and be able to independently identify and recognize emotional problems of their own independently" "understand the importance of GPs' role to patients and their family members and GPs' responsibilities" "release the working pressure through managing stress via mature methods and controlling and expressing the emotions via appropriate ways" "perceive the understanding and support and improve the occupational identity" "enhance the level of team collaboration and improve the ability of handling physician-patient relationships and physician-nurse relationships" "solve the perplexities concerning imbalance between work and personal life" "promote the development of clinical practice via using the harmonious physician-patient relationship " were 100.0%（54/54）,94.4%（51/54）,90.7%（49/54）,98.2%（53/54）,96.3%（52/54）,100.0%（54/54）,94.4%（51/54）,90.7%（49/54）,100.0%（54/54）,respectively.48 GPs（88.9% of the total） intended to participate in the activities later.Conclusion　The GPs were highly satisfied with the arrangement of Balint group activities,and gained a lot from them.Moreover,most GPs were willing to participate in the activities later.