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已发表论文
提升全科医生身心医学技能：来自生态系统理论的启示
Authors Zeng Z, Qian Y, Zhang W, Hu J, Jiang J, Zeng L, Chen Y , Huang L
Received 29 March 2025
Accepted for publication 17 August 2025
Published 17 September 2025 Volume 2025:18 Pages 5591—5603
DOI https://doi.org/10.2147/IJGM.S527054
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Redoy Ranjan
Zixuan Zeng,1,2,* Yingli Qian,3,* Wei Zhang,4,* Jia Hu,5 Jiahui Jiang,1 Lianhua Zeng,6 You Chen,5 Lei Huang2,7
1School of Medicine, Tongji University, Shanghai, 200331, People’s Republic of China; 2Department of Psychiatry, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People’s Republic of China; 3Department of General Medicine, Hengjing Health District, Suzhou, 215000, People’s Republic of China; 4Zhongshan Community Health Service Center, Songjiang District, Shanghai, 201600, People’s Republic of China; 5Shanghai Yangpu District Mental Health Center, Mental Health Center Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, 200093, People’s Republic of China; 6Fenglin Community Health Service Center, Shanghai, 200030, People’s Republic of China; 7Department of Medical Education, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People’s Republic of China
*These authors contributed equally to this work
Correspondence: You Chen, Shanghai Yangpu District Mental Health Center, Mental Health Center Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, 200093, People’s Republic of China, Email yangpucy@163.com Lei Huang, Department of Medical Education, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People’s Republic of China, Email huanglei@tongji.edu.cn
Purpose: Based on the Ecological Systems Theory, this study aims to identify multilevel factors that influence the psychosomatic medical service competency (PMSC) of general practitioners (GPs).
Methods: A cross-sectional survey was conducted among 699 community general practitioners in Shanghai from December 2022 to March 2023 using a stratified random cluster sampling method. GPs’ PMSC was assessed using a validated 27-item scale, covering knowledge, attitude and skills dimensions, with additional self-evaluative measures on perceived competency and training needs. Based on ecological systems theory, individual, institutional and systemic factors were examined. A three-stage hierarchical regression analysis was performed to identify multilevel determinants of PMSC.
Results: A total of 713 questionnaires were distributed, yielding 699 valid responses. The response rate was 98.04%. According to the multiple hierarchical regression analysis, higher educational attainment (p < 0.05) and greater empathy (β = 0.256, p < 0.001) were significantly associated with higher PMSC, explaining 7% of the variance (R² = 0.07, p < 0.001). While institutional factors (including psychological services, medication availability and referral pathways) were associated with PMSC in bivariable analysis (p < 0.01), they were not significant in multivariable models. PMSC training emerged as the strongest predictor of PMSC (R² = 0.263, p < 0.001), emphasizing its critical role in competency development.
Conclusion: Educational attainment, empathy, and training significantly influence general practitioners’ psychosomatic medical service competency, with training coverage being the strongest predictor. This study highlighted the urgent need for targeted training and policy reforms to enhance psychosomatic care in Chinese primary care settings.
Keywords: competency, empathy, general practitioners, primary care, psychosomatic medicine, training
1School of Medicine, Tongji University, Shanghai, 200331, People’s Republic of China; 2Department of Psychiatry, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People’s Republic of China; 3Department of General Medicine, Hengjing Health District, Suzhou, 215000, People’s Republic of China; 4Zhongshan Community Health Service Center, Songjiang District, Shanghai, 201600, People’s Republic of China; 5Shanghai Yangpu District Mental Health Center, Mental Health Center Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, 200093, People’s Republic of China; 6Fenglin Community Health Service Center, Shanghai, 200030, People’s Republic of China; 7Department of Medical Education, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People’s Republic of China
*These authors contributed equally to this work
Correspondence: You Chen, Shanghai Yangpu District Mental Health Center, Mental Health Center Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, 200093, People’s Republic of China, Email yangpucy@163.com Lei Huang, Department of Medical Education, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People’s Republic of China, Email huanglei@tongji.edu.cn
Purpose: Based on the Ecological Systems Theory, this study aims to identify multilevel factors that influence the psychosomatic medical service competency (PMSC) of general practitioners (GPs).
Methods: A cross-sectional survey was conducted among 699 community general practitioners in Shanghai from December 2022 to March 2023 using a stratified random cluster sampling method. GPs’ PMSC was assessed using a validated 27-item scale, covering knowledge, attitude and skills dimensions, with additional self-evaluative measures on perceived competency and training needs. Based on ecological systems theory, individual, institutional and systemic factors were examined. A three-stage hierarchical regression analysis was performed to identify multilevel determinants of PMSC.
Results: A total of 713 questionnaires were distributed, yielding 699 valid responses. The response rate was 98.04%. According to the multiple hierarchical regression analysis, higher educational attainment (p < 0.05) and greater empathy (β = 0.256, p < 0.001) were significantly associated with higher PMSC, explaining 7% of the variance (R² = 0.07, p < 0.001). While institutional factors (including psychological services, medication availability and referral pathways) were associated with PMSC in bivariable analysis (p < 0.01), they were not significant in multivariable models. PMSC training emerged as the strongest predictor of PMSC (R² = 0.263, p < 0.001), emphasizing its critical role in competency development.
Conclusion: Educational attainment, empathy, and training significantly influence general practitioners’ psychosomatic medical service competency, with training coverage being the strongest predictor. This study highlighted the urgent need for targeted training and policy reforms to enhance psychosomatic care in Chinese primary care settings.
Keywords: competency, empathy, general practitioners, primary care, psychosomatic medicine, training