論文

Objective: This confirmatory survey aimed to verify the criterion-related validity and reliability of the final version of the Medical Doctors’ Work-Related Quality of Life Questionnaire (WQMD-9), following partial revision of its content. This study also explored the questionnaire’s structure and scoring methods. Method: From June to July 2022, the WQMD-9 was administered to 98 MDs selected to match the statistical distribution of MDs in Japan. Criterion-related validity was evaluated using a visual analogue scale (VAS) as the reference standard, and reliability was examined using inter-dimension correlations and Cronbach’s α. Results: The correlation coefficient between the VAS score and the simple sum of WQMD-9 dimensions scores was 0.7891, supporting criterion-related validity. Cronbach’s α was 0.87, indicating acceptable reliability. Conclusions: The profile-type WQMD-9 consists of nine dimensions—“Workload,” “Working time,” “Collaboration,” “Clinical practice,” “Working conditions,” “Working environment,” “Feelings of fatigue,” “Work-life balance,” and “Career”—with five levels. In the confirmatory survey population, the WQMD-9 demonstrated criterion-related validity and reliability, suggesting that it can be utilized with simple total scoring approach.

Background: With the ongoing development of game-changing technologies, assessing healthcare provider burden is desirable. This requires developing and evaluating subjective outcome measures, but there is no single scale that measures this burden. We developed a measure of quality of life (QOL) to address this, focusing on medical doctors (MDs). Methods: Based on Japan’s national statistical distribution of MDs in Japan, we qualitatively interviewed twenty MDs to identify factors that influenced their QOL and another eight MDs to verify the appropriateness and interpretability of the questions. Validity and reliability were evaluated and verified in a quantitative survey of 374 MDs to finalize the questionnaire. Results: Based on our initial research and interviews, we derived nine dimensions and developed the work-related QOL questionnaire for MDs (WQMD-9) accordingly. Correlation coefficients between questionnaire items were 0.3–0.7 and Cronbach’s α was 0.897, confirming the validity and reliability of the questionnaire. Conclusions: The WQMD-9 is an original profile-type scale with nine dimensions and five levels. We expect that as new technologies develop, evaluations of the associated medical treatment will involve measuring the QOL of not only patients but also MDs, and the WQMD-9 will facilitate this process.

Purpose: Remarkable progress in healthcare technology has recently been made alongside changes in concepts related to drugs and medical devices. It is speculated that this progress benefits not only patients but also healthcare professionals, such as medical doctors. We performed a systematic review of the characteristics of current data assessment tools to measure medical doctors’ work-related quality of life (QOL). Methods: A literature search was conducted through PubMed and Ichushi-Web in 2020. The related search terms used were ‘medical doctor,’ ‘quality of work life,’ and ‘questionnaire/interview.’ Two reviewers independently screened the studies, and the characteristics of the QOL assessment tools used in the identified studies were qualitatively reviewed and summarized. Results: In total, 5,443 and 760 articles were retrieved from PubMed and Ichushi-Web, respectively, of which 82 studies were included in this review. Sixty-five (79%) studies used structured questionnaires, and 17 (21%) studies used semistructured questionnaires. In terms of the study purpose, the identified studies mainly included four: mental health, the work or labor situation, satisfaction, and QOL. Components used to measure work-related QOL included satisfaction, burnout, QOL, the work environment, stress, mental health, work-life balance, and others. None of the studies used an originally developed QOL questionnaire to assess the work-related benefits of medical doctors. Conclusion: This systematic review found that there is a lack of studies directly assessing the work-related QOL of medical doctors and a lack of effective data collection tools to assess all work-related QOL components.

目的 2020年以降のコロナ禍で,医療従事者側の負担軽減も価値の要素として認識されるようになり,医療従事者の負担を可視化する観点から,「主観的」なアウトカム尺度の整備が望まれる。また,昨今の医療技術の開発においてもこれまでの概念が覆され享受できる価値を多面的に評価する取り組みが必要とされる。本研究では,医療従事者のうち患者や医療技術と直接に接する機会の多い医師に焦点をあて,仕事関連の価値を構成する指標としてQOLを直接測定できる尺度を開発することを目的とした。方法 QOL尺度の標準的な開発方法を参考に,医師を対象に4ステップで調査をした。まず,医師20名に対し影響因子を収集するために定性的なインタビューを実施し1stバージョン質問票を作成した。次に8名の医師にバリデーションインタビューを実施し2ndバージョン質問票として修正した。さらに374名の定量調査で妥当性および信頼性の検証を実施した。その結果をもとに3rdバージョン質問票として修正し,確認調査として,その信頼性と基準関連妥当性のための調査を実施した。また,QOL測定の専門家を交えた検討会を実施し,各種の妥当性を検討・実証しながら質問票を構築した。結果 医師の仕事関連のQOLの影響因子から,仕事量,仕事時間,協力,診療,労働条件,労働環境,心理面,ワークライフバランス,キャリアの9項目が導き出され,それぞれの項目ごとに質問を作成し検証した結果,Cronbach α係数は0.899であった。結論 開発された医師の仕事関連のQOLを測定するための質問票は,オリジナルのプロファイル型尺度で,9項目5段階で構成され,単純合計でスコア化して使用できるものとなった。(著者抄録)

2019年4月より費用対効果評価制度の導入により新規医療技術の価格調整が始まり,同時に慶應義塾大学医療経済評価人材育成プログラムも開始され4年目となった.本プログラム必修科目の医療経済評価特論における2021年度の報告に引き続き,すでに費用対効果評価結果が公表されているHI該当品目2品目について,2022年度も基本知識を学んだ主に修士1年生が参加し,企業側,当局側に分かれて模擬分析前協議のワークショップが行われた.模擬分析前協議では両者の視点で分析枠組みを議論し,模擬分析前協議の後に両者が合意した分析枠組みを決定した.最後に,その枠組みと公的分析が実施した分析枠組みとの違いについて議論や考察を行い,比較対照技術選択の難しさや,一律の指標で評価可能なのかなどの課題があげられた.また,受講後に執筆者らで制度全体にかかわる共通の課題や検討の必要性についての議論を行った.その内容も合わせて学生の視点から報告する.(著者抄録)