结核病防治新模式下的临床医生胜任度研究

发布时间：2018-01-19 22:27

本文关键词： 结核病防治新模式结核病防治临床医生胜任度　出处：《清华大学》2014年硕士论文　论文类型：学位论文

【摘要】：我国是结核病高负担国家，为有效应对结核病防治工作的新挑战，，我国的结核病防治模式也在逐步向新模式转型中。在结核病防治新模式下，定点医院成为结核病诊断和治疗的主要负责机构，这一机构定位的转型使得定点医院的结核病防治临床医生的主要职责产生了较大的变化。本研究试图了解在结核病防治新模式下，结核病防治临床医生所需具备的能力和素质要项以及现有结核病防治临床医生的胜任度水平及其影响因素，希望能为新模式下结核病防治临床医生人力资源的发展提供参考和借鉴。本研究通过对镇江、宜昌和汉中三个结核病防治新模式试点地区的结核病防治临床医生进行问卷调查和深度访谈，结合胜任素质模型的构建原理，构建了结核病防治临床医生的胜任素质模型，模型具体包括以下21项胜任素质要项：知识的扎实、可靠性、知识的应用性、特定知识的掌握程度、知识的针对性、识别病症、并发症的防治与其他传染病的鉴别、结核病与艾滋病的综合治疗方法的掌握情况、合理用药的知识与能力、自我发展、把握实时资讯、对区域传染性流行病知识的掌握程度、熟悉患者情况、医患关系、沟通能力、常规健康教育和行为干预、特殊人群的保护（妇女儿童）、并发其他传染病的特殊患者的健康教育和行为干预、直面压力、职业道德、职业使命感、价值认同。在此基础上，本研究运用构建出来的胜任素质模型，对镇江、宜昌和汉中的结核病防治临床医生进行了问卷调查。基于样本数据，本研究首先对结核病防治临床医生的胜任度进行了描述性统计分析。本研究发现，试点地区区县级综合医院和地市级专科医院的结核病防治临床医生的胜任度都处于所认知的合格标准附近，在部分要项上的胜任度有待提升。然后本研究又对教育背景和工作经验对结核病防治临床医生胜任度的影响进行了探究，结果发现对于地市级及以下定点医院的结核病防治临床医生来说，结核病防治临床工作经验的多寡可能是影响胜任度的重要因素，而学历可能不是胜任度的重要影响因素。针对调查和研究的结果，本研究提出了提高结核病防治新模式下临床医生胜任度的政策建议。第一，健全结核病防治临床医生的薪酬福利制度，提升岗位吸引力。第二，开展针对结核病防治临床医生的规范化培训，提升现有人员的能力和素质。
[Abstract]:China is a high-burden TB country. In order to effectively meet the new challenges of TB prevention and control, China's TB control model is also gradually changing to a new model, under the new TB control model. Designated hospitals have become the main agencies responsible for the diagnosis and treatment of tuberculosis. The transformation of this institutional orientation has made the major responsibilities of TB clinicians in designated hospitals have changed greatly. This study attempts to understand the new model of TB prevention and treatment. The ability and quality of TB clinicians and the competence level of existing TB clinicians and their influencing factors are also discussed. We hope to provide reference and reference for the development of human resources of TB clinicians under the new mode. This study through the three pilot areas of Zhenjiang, Yichang and Hanzhong tuberculosis prevention and control model pilot areas of tuberculosis control clinicians questionnaire survey and in-depth interviews, combined with the construction of competency model principles. The competency model of TB clinicians was constructed. The model includes the following 21 items: solid knowledge, reliability, application of knowledge and mastery of specific knowledge. Knowledge pertinence, identification of disease, prevention and treatment of complications and other infectious diseases, comprehensive treatment of tuberculosis and AIDS, knowledge and ability of rational use of drugs, self-development. Grasp real-time information, knowledge of regional infectious epidemic, familiar with patients, doctor-patient relations, communication skills, routine health education and behavioral intervention, protection of special groups (women and children). Health education and behavioral intervention of special patients with other infectious diseases, direct pressure, professional ethics, professional mission, value identity. On this basis, this study uses the competency model to investigate the tuberculosis clinicians in Zhenjiang, Yichang and Hanzhong, based on the sample data. In this study, first of all, the competency of TB clinicians was analyzed by descriptive statistics. The competence of TB clinicians in county level general hospitals and prefectural specialized hospitals in the pilot area is near the recognized eligibility criteria. Then the influence of educational background and working experience on the competence of TB clinicians was explored. The results showed that the number of clinical experience in TB prevention and treatment may be an important factor influencing the competence for the clinicians of TB prevention and treatment in the designated hospitals of prefectural and municipal level and below. Education may not be an important factor in competency. According to the results of the investigation and research, this study put forward some policy recommendations to improve the clinicians' competence under the new TB control model. First, improve the pay and welfare system of TB clinicians. Second, develop standardized training for TB clinicians to improve the ability and quality of existing staff.
【学位授予单位】：清华大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R52

【参考文献】