本文選題：精神病醫(yī)院　切入點：醫(yī)患關(guān)系　出處：《承德醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:應(yīng)用自編醫(yī)患關(guān)系調(diào)查問卷調(diào)查河北省精神病醫(yī)院醫(yī)患關(guān)系現(xiàn)況及影響因素,為臨床系統(tǒng)研究影響醫(yī)患關(guān)系的因素,改善醫(yī)患關(guān)系現(xiàn)狀,減少醫(yī)患糾紛的發(fā)生提供理論及實踐依據(jù)。方法:1.精神病醫(yī)院醫(yī)患關(guān)系調(diào)查問卷的編制:首先,在查閱大量相關(guān)文獻的基礎(chǔ)上,選取承德市某精神病醫(yī)院的8名醫(yī)護人員、4名患者及4名家屬進行半結(jié)構(gòu)式訪談,形成初始問卷,然后通過召開專家會議及預(yù)調(diào)查對問卷進行修訂完善,并檢驗其信效度。最終形成精神病醫(yī)院醫(yī)患關(guān)系現(xiàn)況及影響因素調(diào)查問卷。2.河北省精神病醫(yī)院醫(yī)患關(guān)系現(xiàn)況調(diào)查及影響因素分析:采用分層抽樣法,使用自編調(diào)查問卷在河北省精神病醫(yī)院選取醫(yī)護人員431例、患者438例進行調(diào)查。應(yīng)用統(tǒng)計描述、t檢驗等統(tǒng)計方法,了解河北省精神病醫(yī)院醫(yī)患關(guān)系現(xiàn)況及影響因素。結(jié)果:1.編制并形成精神病醫(yī)院醫(yī)患關(guān)系調(diào)查問卷:該問卷主要由三部分構(gòu)成:第一部分是一般資料問卷,包括醫(yī)護人員、患者的一般資料;第二部分是醫(yī)患關(guān)系現(xiàn)況調(diào)查問卷,包括5個條目;第三部分是醫(yī)患關(guān)系影響因素調(diào)查問卷,包括環(huán)境因素(9個條目)、醫(yī)護人員因素(12個條目)、患方因素(9個條目)3個維度,共30個條目。醫(yī)患關(guān)系調(diào)查問卷的Cronbach'sɑ系數(shù)為0.832,各維度的Cronbach'sα系數(shù)為0.801~0.843,重測信度值為0.889;醫(yī)患關(guān)系調(diào)查問卷的S-CVI值均為0.994,各維度的平均CVI值為0.983~1.000;探索性因子分析顯示,調(diào)查問卷提取3個因子,累積解釋變異量為55.351%,且各條目因子負(fù)荷均大于0.4。2.河北省精神病醫(yī)院醫(yī)患關(guān)系現(xiàn)況調(diào)查及影響因素分析:共發(fā)放問卷920份,其中醫(yī)護人員、患者各460份,回收有效問卷分別為431份和438份,有效回收率分別為93.7%和95.2%。調(diào)查結(jié)果顯示,醫(yī)護人員、患者在醫(yī)患關(guān)系現(xiàn)況認(rèn)知得分(條目均分)分別為(3.11±0.47),(3.51±0.55),醫(yī)護人員對醫(yī)患關(guān)系的態(tài)度不如患者樂觀(P0.01)。影響因素分析發(fā)現(xiàn),醫(yī)護人員的職業(yè)和人文素質(zhì)有待提高;精神病醫(yī)院資金、設(shè)備、人力不足;患者家屬經(jīng)濟負(fù)擔(dān)重;社會新聞或媒體的導(dǎo)向偏頗;社會急需對精神衛(wèi)生知識的宣傳及對精神病患者的尊重、理解和支持。結(jié)論:1.本研究編制了信效度較好的問卷,適用于精神病醫(yī)院醫(yī)患關(guān)系現(xiàn)況及影響因素的調(diào)查。2.河北省精神病醫(yī)院醫(yī)患關(guān)系總體現(xiàn)況尚可,但仍需改善。建議河北省精神病醫(yī)院應(yīng)加強醫(yī)護人員的再教育,提高醫(yī)護人員的職業(yè)和人文素質(zhì),增強對精神病患者的尊重、理解和支持;政府應(yīng)加大對精神病醫(yī)院的資金投入,完善醫(yī)療設(shè)備;健全醫(yī)療人力資源配置制度,緩解醫(yī)護人員短缺現(xiàn)象;政府應(yīng)加大醫(yī)療報銷比例,緩解患者看病貴的問題;新聞媒體應(yīng)客觀報道醫(yī)療環(huán)境,傳播正能量;社會應(yīng)加強對精神衛(wèi)生知識的宣傳,使公眾對精神科有更深入的了解。
[Abstract]:Objective: to investigate the relationship between doctors and patients and to improve the current situation of the relationship between doctors and patients in the clinical system by using the questionnaire survey of the relationship between doctors and patients in mental hospitals of Hebei province. To reduce the occurrence of doctor-patient disputes to provide theoretical and practical basis. Methods: 1.The compilation of the questionnaire on the doctor-patient relationship in psychiatric hospitals: firstly, on the basis of consulting a large number of relevant literature, Eight medical and nursing staff and four family members from a psychiatric hospital in Chengde City were selected to conduct semi-structured interviews to form the initial questionnaire, and then the questionnaire was revised and perfected by holding an expert meeting and a pre-investigation. And test its reliability and validity. Finally, form the questionnaire of the current status and influencing factors of doctor-patient relationship in mental hospitals. 2. Investigation of the current situation of doctor-patient relationship in mental hospitals in Hebei Province and analysis of influencing factors: stratified sampling method was used. A self-designed questionnaire was used to select 431 medical and nursing staff and 438 patients in Hebei Psychiatric Hospital. To understand the current situation and influencing factors of doctor-patient relationship in psychiatric hospitals in Hebei Province. Results: 1.The questionnaire on doctor-patient relationship in psychiatric hospitals was compiled and formed. The questionnaire consists of three parts: the first part is a general information questionnaire, including medical staff, The second part is the questionnaire of the current situation of the doctor-patient relationship, including five items; the third part is the questionnaire on the influencing factors of the doctor-patient relationship. Including environmental factors (9 items), medical staff factors (12 items), patient side factors (9 items), 3 dimensions, The Cronbach's coefficient of the questionnaire was 0.832, the Cronbach's 偽 coefficient of each dimension was 0.801 / 0.843, the reliability of retest was 0.889, the S-CVI value of the questionnaire was 0.994 and the average CVI value of each dimension was 0.9831.000.The exploratory factor analysis showed that, Three factors were extracted from the questionnaire, the cumulative interpretation variation was 55.351, and the load of each item was greater than 0.4.2.The present situation of the doctor-patient relationship and the analysis of influencing factors in the psychiatric hospital of Hebei province: 920 questionnaires were sent out, including 460 medical staff and 460 patients. The valid questionnaires were 431 and 438 respectively, and the effective recovery rates were 93.7% and 95.22.Results showed that, The scores of patients' cognition about the status of doctor-patient relationship were 3.11 鹵0.47 and 3.51 鹵0.55, respectively. The attitude of medical staff towards doctor-patient relationship was lower than that of patient optimism (P0.01). The analysis of influencing factors showed that the professional and humanistic quality of medical and nursing staff needed to be improved. Equipment, inadequate manpower, heavy financial burden on patients' family members, biased social news or media guidance, urgent need for publicity of mental health knowledge and respect for the mentally ill, Conclusion: 1. The questionnaire with good reliability and validity is suitable for the investigation of the relationship between doctors and patients in psychiatric hospitals. 2. The overall status of doctor-patient relationships in mental hospitals in Hebei Province is good. It is suggested that the hospital of Hebei Province should strengthen the re-education of the medical staff, improve the professional and humanistic quality of the medical staff, and enhance the respect, understanding and support for the patients with mental illness. The government should increase the investment in the psychiatric hospital, perfect the medical equipment, perfect the system of medical human resource allocation, alleviate the shortage of medical personnel, increase the proportion of medical reimbursement, and alleviate the problem of expensive medical treatment. The news media should objectively report the medical environment and spread positive energy, and the society should strengthen the publicity of mental health knowledge so that the public can have a better understanding of psychiatric departments.
【學(xué)位授予單位】：承德醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.5

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