重庆市乡镇卫生人员培训现状分析及对策研究

发布时间：2019-05-29 13:03

【摘要】：目的：立足于重庆市乡镇卫生人员培训现状的现场调查情况，深入研究其素质状况、培训需求及满意度，分析需求和满意度差异及影响因素，为做好乡镇卫生人员培训工作，提升其医疗技术和综合素质，稳定农村卫生人才队伍、制定基层卫生政策和管理框架提供参考意见。方法： 1文献研究通过检索维普、万方、中国知网（CNKI）等数据库，查阅、整理与分析相关书籍、调查报告、政府文件等文献资料，了解乡镇卫生院卫生人员培训相关的概念及理论、观点及措施、以及研究进展和发展趋势。 2定量资料分析根据重庆市经济社会发展情况采取整群随机抽样方法，于2011年10月至2012年2月按重庆市都市发达经济圈D渝西经济走廊D三峡库区生态经济区D三大特色区域经济的科学划分分别抽取了渝北区、永川区以及丰都县，各个区县再分别随机抽取8所共计24所乡镇卫生院对当天卫生院里所有上班的卫生人员发放问卷进行现场调查。现场调查使用自行设计的调查问卷：重庆市乡镇卫生院卫生人员培训现状调查问卷D，问卷内容主要包括四方面：调查对象基本情况、培训需求情况、培训满意度情况、总体评价及建议。现场由经过培训的调查人员发放问卷、指导填写并当场回收，共发放850份问卷，回收828份(回收率为97.41%)，经审核，其中有效问卷819份(有效率为98.91%)。 3定性访谈根据本课题研究需要，明确访谈目的和所要获取的信息，自行设计半结构化访谈提纲，在征得调查对象同意后，进行个人深度访谈27人次，每人次访谈时间为15～20分钟，其中访谈各区县主管培训的卫生行政部门负责人3人次、乡镇卫生院领导12人次、乡镇卫生院职工12人次。访谈采取面对面、二对一的方式进行，其中一人访谈一人记录，访谈资料经过审核，在尊重原始信息的前提下整理、归类后提炼成主要观点和看法。 4统计分析数据处理采用EpiData3.1软件建立数据库进行录入、整理及逻辑检错，运用SPSS18.0进行统计描述、Cmh检验。运用Excel进行图表制作，综合运用管理学、人口学、社会心理学等相关知识进行分析和评价。 5质量控制正式调查前选取一所乡镇卫生院进行预调查，对问卷不合理条目进行了调整和补充，现场调查时问卷由经过统一培训的调查人员现场发放、指导填写并当场回收。问卷经审核整理后，由调查人员统一编码录入、分析处理。访谈过程采用一人访谈一人记录的方式，并且当天的访谈资料当天整理，避免隔天整理造成遗漏和遗忘，经过小组讨论、审核、验证和补充，最后形成主要观点和看法。结果：乡镇卫生人员综合素质不高，性别比和医护比失衡，学历和职称结构不合理。培训覆盖率不高（63.00%），培训时间以为期1～3个月的短期培训为主（57.98%），培训地点主要集中在区县医院（41.14%），培训次数分布呈中间小两头大的特征，培训1次（33.33%）和±5次(22.16%)较频繁，培训方式以医院技能进修为主（38.16%），培训内容以岗位技能培训为主（35.46%）。采用Likert5点量表评分法，培训总体满意度水平不高（3.29±1.034），介于一般D与较满意D之间，，且更偏向于一般D。三个区县满意度得分最高和最低的分别是永川区（3.34±1.017）和丰都县（3.20±0.996）。培训组织方式中，得分最高和最低的分别是培训地点（3.48±1.032）和培训内容（3.31±1.044）；培训支持条件中，得分最高和最低的分别是师资水平（3.59±0.989）和费用承担(2.93±1.128)；参训学员动机实现情况得分3.41±1.029。经Cmh检验，不同年龄组之间、不同文化程度之间、不同岗位之间、不同从业年限之间、不同人事关系之间满意度的差异均有统计学意义(p0.05)；不同人事关系之间满意度的差异有显著的统计学意义(p0.01)。88.40%的乡镇卫生院卫生人员对培训有不同程度的需求。经Cmh检验，不同年龄组之间需求的差异有统计学意义(p0.05)；不同岗位之间、不同从业年限之间、不同人事关系之间需求的差异均有显著的统计学意义(p0.01)。讨论与建议：乡镇卫生人员素质不高且结构欠佳，培训覆盖率和培训满意度偏低，培训需求非常强烈。政府必须增加财政投入，建立健全培训机制，加强宣传教育，完善配套政策和措施；乡镇卫生院领导及卫生人员自身有必要提高培训意识，创造培训条件，编制计划并精心组织落实；大型综合医院要进一步强化对口支援；医药高等院校须为乡镇卫生人力培训提供优质师资保障。
[Abstract]:Objective: To study the situation of health personnel training in the town of Chongqing, and to study the quality status, training demand and satisfaction, analyze the difference of demand and satisfaction, and to improve the medical technology and comprehensive quality of the health personnel in the town. To stabilize the rural health personnel and provide reference for the development of the grass-roots health policy and management framework. square Method:1 The paper studies the concepts and theories related to the training of health personnel in the township health center through the search of the databases such as the Weipu, Wanfang and CNKI, and the related books, investigation reports, government documents and so on. Points of view and measures, as well as the progress of research And the development trend. 2. The quantitative data analysis is based on the economic and social development of Chongqing By taking the cluster random sampling method, the regional economic scientific division of the three characteristics of the ecological economic zone D of the D-Chongqing Economic Corridor of the Three Gorges Reservoir of the City of Chongqing was taken from October,2011 to February,2012, respectively. In the Yongchuan district and the Fengdu county, the counties and counties of Fengdu County, respectively, respectively,8 total of 24 township health centers in the same day, and all the health personnel working in the health center of the day are sent. On-site survey was carried out on the questionnaire. The site investigation used a self-designed questionnaire: the questionnaire of the current status of health personnel training in the township health center of Chongqing. The content of the questionnaire mainly includes four aspects: the basic situation of the investigation object, the situation of training demand, and the satisfaction degree of the training. Status, overall evaluation and recommendations. The site was issued by trained investigators, instructed to complete and recovered on the spot, and 850 questionnaires were issued and 828 (97.41%) were recovered, and the effective questionnaire was 819 (effective). The rate is 98. 91%). The qualitative interview is based on the research needs of the subject, the purpose of the interview and the information to be obtained, and the outline of the semi-structured interview is designed by a self-designed semi-structured interview outline. After the consent of the investigation object is obtained, the individual depth interview is conducted for 27 persons, each of which The time of the interview is 15-20 minutes, among which,3 people in charge of the health administration department of the district and county competent training are interviewed, and 12 people in the township health center The interview was conducted in a face-to-face and two-to-one way, one of which was interviewed by one person, the interview data was reviewed and the original information was respected on the premise of respecting the original information. post-classification it is the main point of view and view. The statistical analysis data processing uses the Epidata 3.1 software to set up the database for entry, sorting and logical error detection, using the SPS "S18.0 carries out statistical description and Cmh test. The chart is made by using Excel, and management and demography are applied in a comprehensive way." social psychology 5. Before the formal investigation of quality control, a township health center is selected to carry out the pre-investigation, and the unreasonable entry of the questionnaire is adjusted and supplemented, and the questionnaire on site investigation is unified The survey personnel of the training shall issue, guide and recover the questionnaire on the spot. The questionnaire shall be submitted for approval. After the core is finished, the survey personnel will be used for unified code entry and analysis. The interview process adopts one person to interview one person to record the same day, and the interview data of the same day is arranged on the same day, so as to avoid the omission and forgetting caused by the other day, and the panel discussion will be conducted. , Review And finally to form a main point of view and view. The training coverage is not high (63.00%), and the training time is based on short-term training for 1-3 months (57.98%). The training site is mainly concentrated in the district and county hospital (41.14%). The training frequency is distributed in the middle and small two-end features and training. 1 (33.33%) and 5 (22.16%) were more frequent, and the training method was mainly based on the hospital skills (38.1). 6%). The training content is mainly based on post skill training (35.46%). The quality of the training is not high (3.29% 1.034), which is between the general D and the better D, and is more inclined to the general D. The highest and lowest satisfaction score of the three districts is the Yongchuan area (3). 34 (1.017) and Fengdu (3.20, 0.996). In the training organization mode, the highest and lowest scores are the training sites (3.48-1.032) and the training content (3.31-1.044); in the training support conditions, the highest and the lowest of the scores are the level of teachers (3.5 9 (0.989) and cost (2.93. 1.12 8). The achievement score of the trainees' motivation is 3.41-1.029. After the Cmh test, there are no differences among the age groups, between different positions, among different positions, among different working years, different people There was a significant difference in the degree of satisfaction between the relationships (p0.05), and there was a significant difference in the degree of satisfaction between different personnel relationships (p0.01). 40% of the health personnel of the township health center have a different degree of demand for the training. The difference of the needs between different age groups is statistically significant through the Cmh test (p0.05); among the different positions, the different people are concerned with the different working years. inter-system There is a significant difference in the difference (p0.01). The discussion and suggestion: the quality of the health personnel in the township is not The government must increase the financial input, establish and improve the training mechanism, strengthen the publicity and education, and improve the supporting policies and measures; the leaders of the township health center and the health personnel It is necessary to improve the awareness of the training, to create the training conditions, to prepare the plan and to elaborate the implementation of the plan, and to further strengthen the large-scale comprehensive hospital
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R197.6

【参考文献】