【摘要】：目的 基于計(jì)劃行為理論，參照臺(tái)灣版的《醫(yī)患溝通行為影響因素研究量表》，修訂形成本土化的《醫(yī)學(xué)生醫(yī)患溝通行為影響因素量表》，設(shè)計(jì)《醫(yī)學(xué)生醫(yī)患溝通行為影響因素問(wèn)卷調(diào)查表》并進(jìn)行現(xiàn)況調(diào)查，探討醫(yī)學(xué)生醫(yī)患溝通技能與其行為態(tài)度、主觀規(guī)范、認(rèn)知行為控制之間的相關(guān)性；分析醫(yī)學(xué)生醫(yī)患溝通行為的影響因素，為醫(yī)學(xué)教育與教學(xué)管理人員有針對(duì)性地制定提高醫(yī)學(xué)生醫(yī)患溝通技能的相關(guān)策略以及更好地提高臨床教學(xué)質(zhì)量提供科學(xué)依據(jù)。 方法 選取泰山醫(yī)學(xué)院臨床學(xué)院、人口與計(jì)劃生育學(xué)院210名本科五年級(jí)實(shí)習(xí)學(xué)生作為研究對(duì)象，采用基于計(jì)劃行為理論設(shè)計(jì)的《醫(yī)學(xué)生醫(yī)患溝通行為影響因素問(wèn)卷調(diào)查表》進(jìn)行橫斷面問(wèn)卷調(diào)查。資料懫用SPSS18.0和AMOS7.0軟件進(jìn)行信度和效度分析，描述性分析和結(jié)構(gòu)方程模式統(tǒng)計(jì)學(xué)處理。 結(jié)果 （1）基于計(jì)劃行為理論，形成了醫(yī)學(xué)生醫(yī)患溝通行為影響因素的理論框架及《醫(yī)學(xué)生醫(yī)患溝通行為影響因素量表》，，包括“你對(duì)醫(yī)生從事醫(yī)患關(guān)系的信念如何”等9個(gè)維度，共50個(gè)條目，并采用李克特（Likert）7分來(lái)測(cè)量記分，（2）基于《醫(yī)學(xué)生醫(yī)患溝通行為影響因素量表》，設(shè)計(jì)《醫(yī)學(xué)生醫(yī)患溝通行為影響因素問(wèn)卷調(diào)查表》并進(jìn)行現(xiàn)況調(diào)查，研究結(jié)果表明：醫(yī)學(xué)生醫(yī)患關(guān)系及醫(yī)生醫(yī)療行為保障對(duì)其醫(yī)患溝通態(tài)度具有顯著的正相關(guān)（標(biāo)準(zhǔn)化路徑系數(shù)分別是0.461、0.431）；醫(yī)學(xué)生同儕、上級(jí)（領(lǐng)導(dǎo)）的影響以及專業(yè)倫理認(rèn)知對(duì)其主觀規(guī)范具有顯著的正相關(guān)（標(biāo)準(zhǔn)化路徑系數(shù)分別是0.290、0.317、0.206）；醫(yī)學(xué)生醫(yī)患溝通態(tài)度、主觀規(guī)范以及知覺(jué)行為控制對(duì)其醫(yī)患溝通行為意圖具有顯著的正相關(guān)（標(biāo)準(zhǔn)化路徑系數(shù)分別是0.480、0.520、0.169）；醫(yī)學(xué)生知覺(jué)行為控制對(duì)其醫(yī)患溝通行為具有顯著的負(fù)相關(guān)（標(biāo)準(zhǔn)化路徑系數(shù)是-0.299）；醫(yī)學(xué)生醫(yī)患溝通行為意圖對(duì)其實(shí)際醫(yī)患溝通行為具有顯著的正相關(guān)（標(biāo)準(zhǔn)化路徑系數(shù)是0.248）。 結(jié)論 (1)基于計(jì)劃行為理論設(shè)計(jì)的本土化《醫(yī)學(xué)生醫(yī)患溝通行為影響因素問(wèn)卷調(diào)查表》，并具有良好的信效度，可用于醫(yī)學(xué)生醫(yī)患溝通行為影響因素的研究； （2）醫(yī)患關(guān)系及醫(yī)生醫(yī)療行為信念正向影響醫(yī)患溝通態(tài)度；同儕、上級(jí)、專業(yè)倫理認(rèn)知正向影響主觀規(guī)范；醫(yī)患溝通態(tài)度、主觀規(guī)范、知覺(jué)行為控制正向影響醫(yī)患溝通行為意圖；知覺(jué)行為控制負(fù)向影響醫(yī)患溝通行為；醫(yī)患溝通行為意圖正向影響醫(yī)患溝通行為。
[Abstract]:Objective based on the theory of planned behavior, referring to the Taiwan version of the scale of influencing factors of Doctor-patient Communication behavior, to revise the localized scale of influencing factors of Doctor-patient Communication behavior, to design the questionnaire of influencing factors of Medical students' Doctor-patient Communication behavior, and to explore the correlation between doctor-patient communication skills and their behavior attitude, subjective norms and cognitive behavior control. This paper analyzes the influencing factors of doctor-patient communication behavior of medical students, and provides scientific basis for medical education and teaching managers to formulate relevant strategies to improve doctor-patient communication skills and to improve the quality of clinical teaching. Methods 210 fifth grade interns from Taishan Medical College and School of population and Family Planning were selected as subjects. A cross-section questionnaire was designed based on planned behavior theory to investigate the influencing factors of doctor-patient communication behavior. Data SPSS18.0 and AMOS7.0 software were used for reliability and validity analysis, descriptive analysis and structural equation pattern statistics. Results (1) based on the theory of planned behavior, the theoretical framework of influencing factors of doctor-patient communication behavior of medical students and the scale of influencing factors of doctor-patient communication behavior were formed, including 9 dimensions, such as "how do you believe in doctor-patient relationship", with a total of 50 items, and the score was measured by Likert (Likert) 7 points. (2) based on the scale of influencing factors of Doctor-patient Communication behavior, A questionnaire on the influencing factors of doctor-patient communication behavior was designed and investigated. The results showed that there was a significant positive correlation between doctor-patient relationship and doctor-patient behavior security to their doctor-patient communication attitude (standardized path coefficients were 0.461 and 0.431, respectively). The influence of medical students' peers, superiors (leaders) and professional ethical cognition had significant positive correlation with their subjective norms (standardized path coefficients were 0.290, 0.317, 0.206, respectively), and doctor-patient communication attitudes, subjective norms and perceptual behavior control had significant positive correlation with their doctor-patient communication behavior intention (standardized path coefficients were 0.480, 0.520, 0.169, respectively). The perceived behavior control of medical students has a significant negative correlation with their doctor-patient communication behavior (standardized path coefficient is-0.299), and the intention of medical students' doctor-patient communication behavior has a significant positive correlation with their actual doctor-patient communication behavior (standardized path coefficient is 0.248). Conclusion (1) the localization questionnaire on the influencing factors of doctor-patient communication behavior based on planned behavior theory has good reliability and validity, which can be used to study the influencing factors of doctor-patient communication behavior. (2) the doctor-patient relationship and doctors' medical behavior belief positively affect the doctor-patient communication attitude, and the peer, superior and professional ethical cognition positively affects the subjective norms. Doctor-patient communication attitude, subjective norms and perceptual behavior control positively affect doctor-patient communication behavior intention; perceptual behavior control negatively affects doctor-patient communication behavior; doctor-patient communication behavior intention positively affects doctor-patient communication behavior.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R-4;G642

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