基于满意度调查的住院医师规范化培训存在问题与对策研究

发布时间：2018-04-17 02:00

本文选题：住院医师 + 规范化培训　；参考：《南京医科大学》2017年硕士论文

【摘要】：目的:住院医师规范化培训是医学生成长为合格临床医师的必经途径,是提高医疗服务质量和水平的治本之策,有利于培养均质化的优秀临床医学人才和促进医疗卫生事业的可持续发展。本研究通过调查了解参与规范化培训住院医师的满意度情况,探讨其存在的问题与影响因素,从多角度提出可行的优化策略与建议,为建立健全现有的住院医师规范化培训制度提供参考依据。方法:本研究选取了南京市3家医院的在培住院医师作为调查对象,调查问卷采用自行设计的《住院医师规范化培训满意度调查问卷》。问卷分为调查对象的基本情况和满意度情况两个部分。其中,满意度情况包括六个维度,共计33个条目,均采用Likert等级量表,实行5级记分法。问卷采用便利抽样调查的方法,共调查了 390名住院医师,回收有效问卷380份。调查数据使用Microsoft Excel 2003进行录入,并使用SPSS20.0进行相关的数据分析,包括一般的描述性分析(均数、标准差、构成比等)和统计推断(问卷的信效度分析、单因素方差分析、多元线性回归分析、相关分析),检验水准α=0.05,以P0.05为差异有统计学意义。结果:(1)满意度问卷的信度分析:所得Cronbach's α值为0.975,说明问卷具有较高的可信度。效度分析:所得KMO值为0.966,说明样本量充足,问卷结构效度较好。满意度各条目与总体满意度的相关性分析:相关系数r·值范围在0.506-0.722之间,均大于0.5,且P值均小于0.01,说明满意度各条目与总体满意度之间相关性较好。(2)住院医师满意度各条目得分的平均值在3.13-4.08之间,介于满意度水平的"一般"和"满意"之间。总体满意度得分为3.88±0.743,属于一般满意,位于满意度的中等水平。满意度各维度得分平均值在3.26-3.99之间,由高到低依次为培训效果、培训条件、工作环境、规范管理、职业发展和经济因素。(3)人口学特征对住院医师满意度各维度得分有影响,除性别、规培专业与住院医师满意度各维度得分之间差异无统计学意义,其他均有统计学意义。(4)住院医师总体满意度在学历、身份归属、参加规培时间、是否获得医师资格证这四个不同人口学特征上均存在统计学差异(P0.05)。其中,住院医师的身份归属可以解释总体满意度得分变异的4.7%,是影响住院医师总体满意度的重要人口学特征因素。结论:本研究通过对住院医师进行满意度问卷调查,发现:(1)住院医师的总体满意度一般;(2)住院医师对培训条件和培训效果的满意度较高;(3)住院医师对经济因素的满意度最低;(4)住院医师的满意度存在群体差异;(5)身份归属是人口学特征中影响最大的因素。并提出了一系列的优化策略与建议,包括:(1)建立物质激励机制,改善住院医师的薪酬待遇;(2)强化培训基地的工作环境建设,构建适合住院医师的精神激励机制;(3)优化整合资源,加强培训基地的软硬件建设;(4)加强动态管理,确保培训工作的制度化;(5)加强对住院医师的医学人文教育与科研能力培养;(6)培训基地发挥协同作用,帮助住院医师合理规划职业生涯;(7)政府部门加强顶层政策设计,建立与完善相关法律法规。
[Abstract]:Objective: the standardized training of residents is the necessary way for medical students to grow qualified clinicians, is a fundamental way to improve the quality and level of medical service, to cultivate excellent medical talents homogenization and promoting the sustainable development of medical and health undertakings. This study is to understand the satisfaction of participating in standardized training of resident physicians through investigation, study the existing problems and influence factors, puts forward strategies and suggestions to optimize the feasible from multiple perspectives, in order to establish and perfect the existing standardized residency training system reference. Methods: This study selected 3 hospitals of Nanjing city residents as the research object in the training, two parts of the basic circumstances and satisfaction questionnaire the self-designed < resident standardized training satisfaction questionnaire. The questionnaire for the survey. Among them, including satisfaction In six dimensions, a total of 33 entries, using Likert rating scale, the implementation of 5 scoring method. By using the method of questionnaire survey of a convenience sample, investigated a total of 390 residents, 380 valid questionnaires. The survey data using Microsoft 2003 Excel input, and analyze relevant data using SPSS20.0 analysis, including the general descriptive statistics (mean, standard deviation, percentage) and statistical inference (the reliability and validity of the questionnaire analysis, ANOVA, multiple linear regression analysis, correlation analysis), a =0.05 level test in P0.05, the difference was statistically significant. Results: (1) a reliability analysis of satisfaction questionnaire: the Cronbach's a value of 0.975, indicate that the questionnaire has high reliability. The validity analysis: the KMO value was 0.966, indicating a sufficient sample size, the questionnaire structure validity. Correlation analysis of each item and the overall satisfaction degree of satisfaction: the correlation coefficient of R And the value is in the range of 0.506-0.722, were more than 0.5, and the P values were less than 0.01, the satisfaction of each item and the overall satisfaction with good correlation. (2) the resident satisfaction of each item score average between 3.13-4.08, between the satisfaction level of the "general" and "satisfaction". The overall satisfaction score of 3.88. 0.743, belongs to the medium level in general satisfaction and satisfaction. Satisfaction scores in the average value of 3.26-3.99, from high to low in order for the training effect, training conditions, standardized management, work environment, occupation development and economic factors. (3) the demographic characteristics of the various dimensions of influence, inpatient physician satisfaction scores in gender. There was no significant difference between the training and professional resident satisfaction scores in each dimension, the other is statistically significant. (4) residents overall satisfaction in academic, identity, to participate in the training time, Whether there are statistically significant differences between the obtained doctor qualification certificate of the four different demographic characteristics (P0.05). Among them, the resident identity can explain the overall satisfaction score of 4.7% of variation, is an important demographic characteristics of residents overall satisfaction factors. Conclusion: This study was conducted on the residents' satisfaction survey found: (1) hospital physicians overall satisfaction in general; (2) residency training conditions and higher satisfaction of the training effect; (3) resident satisfaction of the minimum economic factors; (4) there are differences between groups in hospital physician satisfaction; (5) identity is the biggest factor affecting the demographic characteristics and put forward. The optimization strategies and recommendations, including a series of: (1) the establishment of material incentive mechanism, improve the residents' remuneration; (2) strengthen the training base construction work environment, suitable for the construction of hospital The division of the mechanism of spiritual motivation; (3) to optimize the integration of resources, strengthen the construction of hardware and software training base; (4) strengthen dynamic management, to ensure the system of training; (5) strengthen the training of medical humanities education and the scientific research ability of residents; (6) training base synergies, help residents reasonable occupation career planning; (7) the top policy designed to strengthen government departments, establish and improve relevant laws and regulations.

【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1

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