我国136家三级医院医生的职业认同感及影响因素研究

发布时间：2018-01-07 22:33

本文关键词：我国136家三级医院医生的职业认同感及影响因素研究　出处：《北京协和医学院》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的:医务工作者是医疗卫生行业的主力军和医院的主要人力资源财富,公立医院医务工作者的素质、行为、能力和职业认同感不仅直接影响患者的就医体验和治疗效果,而且也反映出他们所在医院的文化和所在地区的社会文明程度。因此,了解医务人员的从业现状、他们对本职业的认同感和影响因素并加以改进提高是医院管理的基本要素,是各级卫生管理部门改善医疗服务质量的前提条件,也是社会文明和稳定的基本保障。本研究的目的是了解我国31个省的136家大型三级公立医院医生对职业认同感的现状,以及影响职业认同感的基本信息因素,为提高医生们的职业认同感提出循证管理和政策建议。研究方法:本研究基于协和公共卫生学院2016年底至2017年初对全国31个省的136家三级医院的19,774位临床医生的问卷调查数据,了解医生们的基本情况(包括性别、年龄、学历、婚姻状况、子女情况、工作年限、医院类型、医院地域、科室、职称、行政职务、月实际收入、月期望收入、是否有医疗责任险)以及这些因素对医生们的职业认同感之间的关系。职业认同感由两个指标来衡量:“我所从事的职业得到社会认同与尊重”和“我赞同或鼓励我的子女从事医务工作”,问卷采用李克特五级量表的形式,样本医生通过智能手机直接链接网上问卷并将答案直接上传到卫计委的“健康中国”公共数据平台。数据分析采用SPSS21.0。我们对职业认同感在不同基本信息变量之间的分布进行描述性和相关分析(Spearman相关),单变量差异检验采用秩和检验。单因素和多因素分析采用二项Logistic回归。当P0.05时,认为具有统计学意义。研究结果:总体上,医生们对“我所从事的职业得到社会认同与尊重”的同意率(包括非常同意和同意)为33.82%,不同意率(包括非常不同意和不同意)为29.56%。针对“我赞同或鼓励我的子女从事医务工作”,医生们的同意率为13.09%,不同意率为67.91%。多元统计分析结果:性别、子女情况、医院类型、科室、在本院工作年限、职称、行政职务、是否有医疗责任险、实际收入、期望收入和薪酬差值(期望收入减实际收入)对职业认同感有影响,最主要的影响该因素是薪酬待遇和医疗责任险。在职业认同感上,专科医院和中医医院相对于综合医院,外科医生相对于内科医生,工作在5年以下的医生相对于在本院工作5年以上的医生,知道自己有医疗责任险相对于没有或者不知道有医疗责任保险的医生,月收入在1万元以上相对于收入低于1万元的医生,职业认同感更高。建议:提高医生薪酬待遇,尽快做到医疗责任保险全覆盖,增加儿科医生配置,降低工作负荷和强度。
[Abstract]:Objective: medical workers are the main force of the medical and health industry, the main human resources wealth of hospitals, the quality and behavior of medical workers in public hospitals. Ability and professional identity not only directly affect the patient's experience and effect of medical treatment, but also reflect the culture of their hospital and the degree of social civilization in the region. Therefore, understand the status quo of medical staff. Their sense of identity, influencing factors and improvement are the basic elements of hospital management and the precondition of improving the quality of medical service by health management departments at all levels. It is also the basic guarantee of social civilization and stability. The purpose of this study is to understand the status quo of professional identity among 136 large tertiary public hospitals in 31 provinces of China. And the basic information factors that affect the professional identity. Evidence-based management and policy recommendations for improving the professional identity of doctors. Research methodology:. This study is based on the Union Institute of Public Health from end of 2016 to early 2017 in 31 provinces of 136 tertiary hospitals 19. The survey data of 774 clinicians were collected to find out the basic information of the doctors (including sex, age, education, marital status, children, working years, hospital type, hospital area, department, title of title). Administrative position, actual monthly income, monthly expected income. Medical liability insurance available). And the relationship between these factors and doctors' professional identity. Professional identity is measured by two indicators: "the profession I am engaged in is socially recognized and respected" and "" I agree or encourage my children to work in the medical profession. " The questionnaire was in the form of Richter scale. Sample doctors directly link online questionnaires via smartphones and upload answers directly to the Health and Planning Commission's "healthy China" Public data platform. Data analysis using SPSS 21.0. We describe and correlate the distribution of professional identity among different basic information variables (. Spearman correlation). Univariate difference test using rank sum test. Univariate and multivariate analysis using binomial Logistic regression. When P0.05, considered to have statistical significance. Results: overall. Doctors' consent rate (including very consent and consent) to "the profession I am engaged in is socially recognized and respected" is 33.82%. The disapproval rate (including very disapproval and disapproval) is 29.56.The doctor's consent rate is 13.09% for "I approve or encourage my children to take up medical work." The disapproval rate is 67.91.The result of multivariate statistical analysis is: sex, child situation, hospital type, department, working years in our hospital, professional title, administrative position, whether there is medical liability insurance, actual income. The difference between expected income and salary (expected income less actual income) has an impact on professional identity, the most important factor affecting this factor is salary and medical liability insurance. Specialist hospitals and traditional Chinese medicine hospitals are relative to general hospitals, surgeons to physicians, doctors with less than five years of service compared to doctors who have worked in the hospital for more than five years. Know oneself to have medical treatment liability insurance is opposite to do not have or do not know to have medical treatment liability insurance doctor, monthly income is above 10,000 yuan relative to the doctor that income is lower than 10,000 yuan. Higher professional identity. Suggestions: improve the salary of doctors, achieve full coverage of medical liability insurance as soon as possible, increase the allocation of pediatricians, reduce the workload and intensity.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R192.3

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