本文關(guān)鍵詞：我國(guó)136家三級(jí)醫(yī)院醫(yī)生的職業(yè)認(rèn)同感及影響因素研究　出處：《北京協(xié)和醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：研究目的:醫(yī)務(wù)工作者是醫(yī)療衛(wèi)生行業(yè)的主力軍和醫(yī)院的主要人力資源財(cái)富,公立醫(yī)院醫(yī)務(wù)工作者的素質(zhì)、行為、能力和職業(yè)認(rèn)同感不僅直接影響患者的就醫(yī)體驗(yàn)和治療效果,而且也反映出他們所在醫(yī)院的文化和所在地區(qū)的社會(huì)文明程度。因此,了解醫(yī)務(wù)人員的從業(yè)現(xiàn)狀、他們對(duì)本職業(yè)的認(rèn)同感和影響因素并加以改進(jìn)提高是醫(yī)院管理的基本要素,是各級(jí)衛(wèi)生管理部門改善醫(yī)療服務(wù)質(zhì)量的前提條件,也是社會(huì)文明和穩(wěn)定的基本保障。本研究的目的是了解我國(guó)31個(gè)省的136家大型三級(jí)公立醫(yī)院醫(yī)生對(duì)職業(yè)認(rèn)同感的現(xiàn)狀,以及影響職業(yè)認(rèn)同感的基本信息因素,為提高醫(yī)生們的職業(yè)認(rèn)同感提出循證管理和政策建議。研究方法:本研究基于協(xié)和公共衛(wèi)生學(xué)院2016年底至2017年初對(duì)全國(guó)31個(gè)省的136家三級(jí)醫(yī)院的19,774位臨床醫(yī)生的問卷調(diào)查數(shù)據(jù),了解醫(yī)生們的基本情況(包括性別、年齡、學(xué)歷、婚姻狀況、子女情況、工作年限、醫(yī)院類型、醫(yī)院地域、科室、職稱、行政職務(wù)、月實(shí)際收入、月期望收入、是否有醫(yī)療責(zé)任險(xiǎn))以及這些因素對(duì)醫(yī)生們的職業(yè)認(rèn)同感之間的關(guān)系。職業(yè)認(rèn)同感由兩個(gè)指標(biāo)來衡量:“我所從事的職業(yè)得到社會(huì)認(rèn)同與尊重”和“我贊同或鼓勵(lì)我的子女從事醫(yī)務(wù)工作”,問卷采用李克特五級(jí)量表的形式,樣本醫(yī)生通過智能手機(jī)直接鏈接網(wǎng)上問卷并將答案直接上傳到衛(wèi)計(jì)委的“健康中國(guó)”公共數(shù)據(jù)平臺(tái)。數(shù)據(jù)分析采用SPSS21.0。我們對(duì)職業(yè)認(rèn)同感在不同基本信息變量之間的分布進(jìn)行描述性和相關(guān)分析(Spearman相關(guān)),單變量差異檢驗(yàn)采用秩和檢驗(yàn)。單因素和多因素分析采用二項(xiàng)Logistic回歸。當(dāng)P0.05時(shí),認(rèn)為具有統(tǒng)計(jì)學(xué)意義。研究結(jié)果:總體上,醫(yī)生們對(duì)“我所從事的職業(yè)得到社會(huì)認(rèn)同與尊重”的同意率(包括非常同意和同意)為33.82%,不同意率(包括非常不同意和不同意)為29.56%。針對(duì)“我贊同或鼓勵(lì)我的子女從事醫(yī)務(wù)工作”,醫(yī)生們的同意率為13.09%,不同意率為67.91%。多元統(tǒng)計(jì)分析結(jié)果:性別、子女情況、醫(yī)院類型、科室、在本院工作年限、職稱、行政職務(wù)、是否有醫(yī)療責(zé)任險(xiǎn)、實(shí)際收入、期望收入和薪酬差值(期望收入減實(shí)際收入)對(duì)職業(yè)認(rèn)同感有影響,最主要的影響該因素是薪酬待遇和醫(yī)療責(zé)任險(xiǎn)。在職業(yè)認(rèn)同感上,�？漆t(yī)院和中醫(yī)醫(yī)院相對(duì)于綜合醫(yī)院,外科醫(yī)生相對(duì)于內(nèi)科醫(yī)生,工作在5年以下的醫(yī)生相對(duì)于在本院工作5年以上的醫(yī)生,知道自己有醫(yī)療責(zé)任險(xiǎn)相對(duì)于沒有或者不知道有醫(yī)療責(zé)任保險(xiǎn)的醫(yī)生,月收入在1萬元以上相對(duì)于收入低于1萬元的醫(yī)生,職業(yè)認(rèn)同感更高。建議:提高醫(yī)生薪酬待遇,盡快做到醫(yī)療責(zé)任保險(xiǎn)全覆蓋,增加兒科醫(yī)生配置,降低工作負(fù)荷和強(qiáng)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.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R192.3

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