ABSTRACT

Numerous reports advocate improving doctors’ working conditions as an important part of initiatives to enhance the quality of patient care. However, the research literature is not clear on this underlying relationship. This systematic review examines the evidence on the relationship between the working conditions perceived by doctors and the quality of patient care. Seven electronic databases were searched, with 21 studies from six countries included in the review. The findings highlight questions on how quality of care is constructed and measured, as the presence of these relationships varied by the outcome measure used. A greater number of significant relationships were observed for clinical excellence and patient safety than patient experience. The reviewed literature reflects a lack of theoretical underpinning and consideration of the mechanisms underlying pathways between doctors’ perceived working conditions and quality of care. It also does not capture the complexities within the healthcare sector, nor the wider theoretical and empirical developments in the field. Therefore, a definitive relationship between doctors’ perceived working conditions and the quality of patient care should be considered with caution. Future research should account for the observed methodological and theoretical limitations to better understand the nuances within this complex, but important relationship.

摘要

许多报告主张改善医生的工作条件，这是提高患者护理质量的举措的重要组成部分。但是，有关这种潜在关系的研究文献尚不清楚。这项系统的审查检查了医生认为的工作条件与患者护理质量之间关系的证据。检索了七个电子数据库，其中包括来自六个国家的21项研究。这些发现凸显了有关如何构建和衡量护理质量的问题，因为这些关系的存在会因所使用的结果指标而异。与患者经验相比，在临床卓越性和患者安全性方面观察到更多的重要关系。回顾的文献反映出缺乏理论基础和对医生感知的工作条件与护理质量之间的潜在通路机制的考虑。它也没有抓住医疗保健部门的复杂性，也没有抓住该领域更广泛的理论和经验发展。因此，应谨慎考虑医生的感知工作条件与患者护理质量之间的明确关系。未来的研究应考虑所观察到的方法和理论局限性，以更好地理解这种复杂但重要的关系中的细微差别。也没有该领域更广泛的理论和经验发展。因此，应谨慎考虑医生的感知工作条件与患者护理质量之间的明确关系。未来的研究应考虑到所观察到的方法和理论局限性，以更好地理解这一复杂但重要的关系中的细微差别。也没有该领域更广泛的理论和经验发展。因此，应谨慎考虑医生的感知工作条件与患者护理质量之间的明确关系。未来的研究应考虑所观察到的方法和理论局限性，以更好地理解这种复杂但重要的关系中的细微差别。