The article “Attitudes to doctors and medicine: the effect of setting and doctor-patient relationship” is dedicated to the problem of attitudes to doctors and medicine. There are very few studies regarded this problem, in spite of the fact that it is of great importance. Because the doctor – patient relationship to a great degree defines the success of medical assistance. That’s why these relations should be based on complete confidence; the doctor and his patient should collaborate, share their doubts and tell each other real truth.

The importance of this research article is defined by the fact that the patient entrusted to the doctor the most valuable he has: his life, his health. Patient’s trust can be conditioned by his expectation that the doctor has abilities, desires and means of helping the patient in proper way. So such articles as this one give us very important information demonstrating typical attitudes to doctors and medicine and revealing problem to be solved.

It is stressed in the article that patient attitudes to the doctors can differ according to the different health care systems. The authors emphasize the importance of the setting and context of doctor – patient relationship. The first aspect concerns type of the practice: general and antenatal ones, the second includes specific doctors or doctors in general.

The article contains some analysis of previous researches of this topic and its own research with detailed description of the procedure and discussion of the results.

The brief characteristic of the research.

Object of the research.

The object is to investigate the influence on patients’ attitudes of setting (general practice vs. antenatal) and context (specific doctors vs. doctors in general).

Tasks of the research.

1. To examine the attitudes to doctors and to medicine itself.

2. To compare attitudes of antenatal attenders and general practice ones.

3. To investigate attitudes to doctors in general, to the person’s family doctor and to the doctors at the antenatal clinics.

Hypotheses.

1). There would be a strong distinction between attitudes to doctors in general and to the person’s family doctor.

2). There would be more positive attitudes to antenatal care than to family doctors.

Examinees.

167 women attending a maternity hospital for antenatal care

and 113 women general practice attenders.

Method of the research.

Interview survey with the use of the extended questionnaire of the Attitudes to Doctors and Medicine Scale. The author of the method is Marteau (1990). It contains 19 items. There were proposed four types of response – disagree strongly, disagree, agree and agree strongly. The method consisted of two parts: section of general information about the examinees and section of statements.

Researchers.

The researches are high – qualified specialists in the field of medicine, they are also competent in the sphere of psychological medicine. They represent Royal College of Surgeons in Ireland, Department of General Practice and Department of Psychology. They formed a great research team and displayed excellent knowledge of the topic of the research.

The procedure of the research.

The examinees were interviewed in the hospitals while they were waiting to see the doctor. They were proposed to answer 19 items according to the response categories and to give necessary personal information of the second section of the questionnaire.

The assumptions and main ideas of the research.

The authors suppose that there are certain stereotypes concerning doctors, their profession and medicine itself.

They directed their research at the investigation of patients’ attitudes attending different health care systems.

The researchers point out that there should be a strong distinction between attitudes to doctors and medicine, they should not coincide.

They also assumed that the attitudes of antenatal attenders would be quite different from those of general practice attenders.

The authors suppose that women attending antenatal clinics are more likely to believe and trust the doctor. Their relationship with doctors are based on the necessity of forming confident relations. But speaking of general practice patients, the authors state that they usually have some problems with health, different diseases. And this fact can worsen their relationship with doctor and increase the level of their anxiety.

The researchers also assume that there will be more confidence and positive attribution to person’s family doctor than to doctors in general. From the authors’ point of view attenders will express more confidence in family doctors’ effectiveness and competence.

The research methodology.

The method used in the research is the questionnaire. This method is a way of investigating distinctions between people concerning some models of behavior, reactions, needs, attitudes and many other aspects.

As any method has its strong and weak points, method of questionnaire has also some advantages and disadvantages. In order to define whether the research was effective or not, we should regard all strong and weak sides of this research method.

Advantages of the research method.

First of all, the researchers with the help of questionnaire received substantial data on the problem. It did not take much time, as this method presupposed quick procedure and simple interpretation of results.

The implementation of this method allows the researchers to generalize received data on other doctor attenders and assume that their attitudes are similar. So after interviewing certain amount of people the researchers could integrate the results and find constructive solutions of the problem of patient – doctor relationship.

The method of this research was strongly standardized; the procedure and the assessment of results were the same for all examinees. That’s why the data received from different people were quite comparable.

Disadvantages of the method.

It is well known that there should be preliminary preparation before the interviewing; there should be no unforeseen circumstances. The situation of the testing should be invariable. But this research was conducted while examinees were waiting to see the doctor. They were a bit anxious and nervous, as the interviewing could be interrupted any time. This fact could increase examinees’ anxiety and influence improperly the validity of results.

The data presented in the research is limited, because there are some unknown effects of the research setting. There are many factors that can influence doctor – patient relationships, such as type of disease, kind of the treatment, medicines taken by patient and others. And these factors are not taken into account in this research. That’s why only this method does not allow to form precise picture of the problem, there is a necessity of broadening spectrum of research to receive all-embracing information.

Ethical considerations about the research.

The ethical aspect of research work includes different requirements. There were no ethical violations in the research described in the article.

Firstly, ethical code presupposes that the researchers conducted the investigation were well-informed about the researched field to make justified conclusions about the results. As it was mentioned before, the researchers of the investigation are high – qualified specialists. So they can assess properly such characteristics as norm, validity and reliance of the testing.

Secondly, the questionnaire was completely voluntary; there was no interference into the private life of examinees.

The interviewing was anonymous and confidential, that’s why the examinees could be sincere and free answering questions. Their rights were not broken, and there was no access to the received data by strangers.

The quality and significance of received data.

The quality of the received data is quite appropriate to make certain conclusions. The investigation of the attitudes of antenatal attenders and of general practice ones, demonstrates more positive attitudes of antenatal patients and their stronger belief in the effectiveness of the doctors’ work. Even notwithstanding the fact that this distinction is not very strong (summary score of items is 0,57 for antenatal attenders and 0,52 for general practice group), these results should be taken into account.

There were received evident data concerning attitudes to doctors in general, to family doctors and doctors in clinics. These three criteria have such alpha value as 602, 812 and 720 correspondingly. These date entirely prove the authors’ hypothesis that family doctors enjoy more patients’ confidence than others.

The third part of the research was dedicated to the comparison of UK antenatal and Irish antenatal groups. There are some common features in these groups (approximately 65% of the items). But the UK antenatal sample differs from that of the Irish one. It is quite obvious that these data is appropriate. Because it is well known that there are different stereotypes, opinions in different nations. And the attitudes to doctors and medicine are not the exception.

Generally speaking, received data can be considered to be appropriate and of good quality. In spite of the fact that the distinctions between researched groups are not very strong, it allows to make certain valuable conclusions.

Conclusion.

To my way of thinking, the article is a great contribution to the research of the problem of doctor – patient relationship. High – qualified specialists in the field conducted this research; there was used effective research method and there were received quite appropriate data.

The article shows us the most usual attitudes to doctors and medicine. According to received data we can judge about how people make use of medical services nowadays.

There are some main conclusions that should be made according to the received data. Only 40% of people feel that all doctors are good ones. 85% of examinees think that their family doctors are good. And almost 100% of women credit completely their doctors and consider them to be very effective and good.

The researchers managed to prove all their assumptions and to confirm some of the results of other researchers investigated the problem of doctor-patient relationship.