河北省精神病医院医患关系现况调查及影响因素分析

发布时间：2018-03-09 19:18

本文选题：精神病医院　切入点：医患关系　出处：《承德医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:应用自编医患关系调查问卷调查河北省精神病医院医患关系现况及影响因素,为临床系统研究影响医患关系的因素,改善医患关系现状,减少医患纠纷的发生提供理论及实践依据。方法:1.精神病医院医患关系调查问卷的编制:首先,在查阅大量相关文献的基础上,选取承德市某精神病医院的8名医护人员、4名患者及4名家属进行半结构式访谈,形成初始问卷,然后通过召开专家会议及预调查对问卷进行修订完善,并检验其信效度。最终形成精神病医院医患关系现况及影响因素调查问卷。2.河北省精神病医院医患关系现况调查及影响因素分析:采用分层抽样法,使用自编调查问卷在河北省精神病医院选取医护人员431例、患者438例进行调查。应用统计描述、t检验等统计方法,了解河北省精神病医院医患关系现况及影响因素。结果:1.编制并形成精神病医院医患关系调查问卷:该问卷主要由三部分构成:第一部分是一般资料问卷,包括医护人员、患者的一般资料;第二部分是医患关系现况调查问卷,包括5个条目;第三部分是医患关系影响因素调查问卷,包括环境因素(9个条目)、医护人员因素(12个条目)、患方因素(9个条目)3个维度,共30个条目。医患关系调查问卷的Cronbach'sɑ系数为0.832,各维度的Cronbach'sα系数为0.801~0.843,重测信度值为0.889;医患关系调查问卷的S-CVI值均为0.994,各维度的平均CVI值为0.983~1.000;探索性因子分析显示,调查问卷提取3个因子,累积解释变异量为55.351%,且各条目因子负荷均大于0.4。2.河北省精神病医院医患关系现况调查及影响因素分析:共发放问卷920份,其中医护人员、患者各460份,回收有效问卷分别为431份和438份,有效回收率分别为93.7%和95.2%。调查结果显示,医护人员、患者在医患关系现况认知得分(条目均分)分别为(3.11±0.47),(3.51±0.55),医护人员对医患关系的态度不如患者乐观(P0.01)。影响因素分析发现,医护人员的职业和人文素质有待提高;精神病医院资金、设备、人力不足;患者家属经济负担重;社会新闻或媒体的导向偏颇;社会急需对精神卫生知识的宣传及对精神病患者的尊重、理解和支持。结论:1.本研究编制了信效度较好的问卷,适用于精神病医院医患关系现况及影响因素的调查。2.河北省精神病医院医患关系总体现况尚可,但仍需改善。建议河北省精神病医院应加强医护人员的再教育,提高医护人员的职业和人文素质,增强对精神病患者的尊重、理解和支持;政府应加大对精神病医院的资金投入,完善医疗设备;健全医疗人力资源配置制度,缓解医护人员短缺现象;政府应加大医疗报销比例,缓解患者看病贵的问题;新闻媒体应客观报道医疗环境,传播正能量;社会应加强对精神卫生知识的宣传,使公众对精神科有更深入的了解。
[Abstract]:Objective: to investigate the relationship between doctors and patients and to improve the current situation of the relationship between doctors and patients in the clinical system by using the questionnaire survey of the relationship between doctors and patients in mental hospitals of Hebei province. To reduce the occurrence of doctor-patient disputes to provide theoretical and practical basis. Methods: 1.The compilation of the questionnaire on the doctor-patient relationship in psychiatric hospitals: firstly, on the basis of consulting a large number of relevant literature, Eight medical and nursing staff and four family members from a psychiatric hospital in Chengde City were selected to conduct semi-structured interviews to form the initial questionnaire, and then the questionnaire was revised and perfected by holding an expert meeting and a pre-investigation. And test its reliability and validity. Finally, form the questionnaire of the current status and influencing factors of doctor-patient relationship in mental hospitals. 2. Investigation of the current situation of doctor-patient relationship in mental hospitals in Hebei Province and analysis of influencing factors: stratified sampling method was used. A self-designed questionnaire was used to select 431 medical and nursing staff and 438 patients in Hebei Psychiatric Hospital. To understand the current situation and influencing factors of doctor-patient relationship in psychiatric hospitals in Hebei Province. Results: 1.The questionnaire on doctor-patient relationship in psychiatric hospitals was compiled and formed. The questionnaire consists of three parts: the first part is a general information questionnaire, including medical staff, The second part is the questionnaire of the current situation of the doctor-patient relationship, including five items; the third part is the questionnaire on the influencing factors of the doctor-patient relationship. Including environmental factors (9 items), medical staff factors (12 items), patient side factors (9 items), 3 dimensions, The Cronbach's coefficient of the questionnaire was 0.832, the Cronbach's 伪 coefficient of each dimension was 0.801 / 0.843, the reliability of retest was 0.889, the S-CVI value of the questionnaire was 0.994 and the average CVI value of each dimension was 0.9831.000.The exploratory factor analysis showed that, Three factors were extracted from the questionnaire, the cumulative interpretation variation was 55.351, and the load of each item was greater than 0.4.2.The present situation of the doctor-patient relationship and the analysis of influencing factors in the psychiatric hospital of Hebei province: 920 questionnaires were sent out, including 460 medical staff and 460 patients. The valid questionnaires were 431 and 438 respectively, and the effective recovery rates were 93.7% and 95.22.Results showed that, The scores of patients' cognition about the status of doctor-patient relationship were 3.11 卤0.47 and 3.51 卤0.55, respectively. The attitude of medical staff towards doctor-patient relationship was lower than that of patient optimism (P0.01). The analysis of influencing factors showed that the professional and humanistic quality of medical and nursing staff needed to be improved. Equipment, inadequate manpower, heavy financial burden on patients' family members, biased social news or media guidance, urgent need for publicity of mental health knowledge and respect for the mentally ill, Conclusion: 1. The questionnaire with good reliability and validity is suitable for the investigation of the relationship between doctors and patients in psychiatric hospitals. 2. The overall status of doctor-patient relationships in mental hospitals in Hebei Province is good. It is suggested that the hospital of Hebei Province should strengthen the re-education of the medical staff, improve the professional and humanistic quality of the medical staff, and enhance the respect, understanding and support for the patients with mental illness. The government should increase the investment in the psychiatric hospital, perfect the medical equipment, perfect the system of medical human resource allocation, alleviate the shortage of medical personnel, increase the proportion of medical reimbursement, and alleviate the problem of expensive medical treatment. The news media should objectively report the medical environment and spread positive energy, and the society should strengthen the publicity of mental health knowledge so that the public can have a better understanding of psychiatric departments.
【学位授予单位】：承德医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.5

【参考文献】