江苏省基层全科医生人文关怀认知特征调查及相关调查量表构建

中华养生保健 ›› 2024, Vol. 42 ›› Issue (11): 78-82.

江苏省基层全科医生人文关怀认知特征调查及相关调查量表构建

周扬, 凌婷婷, 史卫红^*

江苏医药职业学院医学院,江苏盐城,224005

出版日期:2024-06-01 发布日期:2024-05-22
通讯作者: ^*史卫红,E-mail：shijsyy009@163.com。
作者简介:周扬（1991—）,男,汉族,籍贯：江苏省盐城市,博士研究生,讲师,研究方向：医学职业教育。
基金资助:
江苏基层卫生发展与全科医学教育研究中心开放课题（2020B07）

Survey on the Cognitive Characteristics of Humanistic Care of Grass Roots General Practitioners in Jiangsu Province and the Construction of Related Scales

ZHOU Yang, LING Ting-ting, SHI Wei-hong^*

School of Medicine, Jiangsu Medical Vocational College, Yancheng Jiangsu 224005, China

Online:2024-06-01 Published:2024-05-22

摘要/Abstract

摘要： 目的对江苏省基层全科医生人文关怀认知特征进行调查,并构建相关评价量表。方法采用整群抽样法,随机选取江苏省13个地级市的基层医疗卫生服务机构的部分全科医生为研究对象,进行问卷调查及统计分析。利用德尔菲专家咨询法,进行两轮专家咨询,确定“全科医生人文关怀应具素质调查表”最终的评估项目。结果职称、工作年限、雇用形式及月收入是影响基层全科医生对人文关怀重要性认知的关键因素,职称及月收入越高、工作年限越长、编制内人员认为“人文关怀非常重要”的比例显著较高。基层全科医生对人文关怀的核心理念理解较为一致,154人（89.0%）都认为人文关怀就是“呵护生命、敬畏生命”,149人（86.1%）认为人文关怀就是“在医疗过程中,提供热情、周到的服务”,但仅有69人（39.9%）表示,能在日常诊疗过程中对患者始终保持热情的态度。大多数全科医生的争议点集中于患者出院后的咨询工作,156人（90.2%）认为“做好出院后随访工作”是医疗过程的重要环节,106（61.3%）人认为应“做好出院后患者的咨询工作”。全科医生对人文关怀应具素质的理解主要集中于5个方面,包括“良好的沟通技巧”“强大的专业能力”“强烈的人文感情”“高尚的职业道德”“执着的科研能力”认同率分别为100%（173/173）、82.1%（142/173）、72.8%（126/173）、67.1%（116/173）、13.3%（23/173）。共进行了2轮德尔菲专家咨询,修改完成后形成了包括“奉献”“真诚”“同感”“信任”“耐心”5个纬度在内的共24个条目。结论本研究基于德尔菲法构建了“全科医生人文关怀应具素质调查表”,可为有效评估全科医师人文素质提供一定的参考。

关键词: 全科医生, 德尔菲, 人文素质

Abstract: Objective To investigate the cognitive characteristics of humanistic care of primary general practitioners in Jiangsu Province. Methods The general practitioners of primary medical and health service institutions in Jiangsu Province were randomly selected as the research objects. Questionnaire survey and data analysis were conducted. Delphi expert consultation method was used to determine the final evaluation items of the questionnaire. Results Professional title, working years, employment form and monthly income were the key factors influencing the cognition of the importance of humanistic care. 154 people (89.0%) thought that humanistic care was "caring for life and fearing life", 149 people (86.1%) thought that humanistic care was "providing warm and thoughtful service", but only 69 people (39.9%) said that they could always maintain a warm attitude towards patients in the process of daily diagnosis and treatment. 156 (90.2%) thought that "follow-up work after discharge" was an important part of the medical process, and 106 (61.3%) thought that "consultation work for patients after discharge" should be done well. General practitioners' understanding of humanistic care quality mainly focused on "good communication skills", "strong professional ability", "strong humanistic feelings", "noble professional ethics" and "persistent scientific research ability". After two rounds of Delphi expert consultation, a total of 24 items were formed, including five dimensions of "dedication", "sincerity", "Empathy", "trust" and "patience". Conclusion Based on the Delphi method, the questionnaire of humanistic care quality of general practitioners was constructed, which can provide reference for the effective evaluation of humanistic quality of general practitioners.

Key words: general practitioner, Delphi, humanistic quality

中图分类号:

R192.3

周扬, 凌婷婷, 史卫红. 江苏省基层全科医生人文关怀认知特征调查及相关调查量表构建[J]. 中华养生保健, 2024, 42(11): 78-82.

ZHOU Yang, LING Ting-ting, SHI Wei-hong. Survey on the Cognitive Characteristics of Humanistic Care of Grass Roots General Practitioners in Jiangsu Province and the Construction of Related Scales[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(11): 78-82.

参考文献

[1] KUNNEMAN M, GIONFRIDDO M R, TOLOZA F J K, et al. Humanistic communication in the evaluation of shared decision making: a systematic review[J]. Patient education and counseling, 2019, 102(3): 452-466.
[2] MWACHOFI A K, KHALIQ A A, CARRILLO E R, et al.Technology versus humanism: how patients perceive the use of electronic health records in physicians’ offices—a qualitative study[J]. Health communication, 2016, 31(3): 257-264.
[3] DA ROCHA A O, MAUÉS J L, CHIES G A F, et al. Assessing the impact of a ceremony in honor of the body donors in the development of ethical and humanistic attitudes among medical students[J]. Anatomical sciences education, 2020, 13(4): 467-474.
[4] RIDER E A, GILLIGAN M C, OSTERBERG L G, et al.Healthcare at the crossroads: the need to shape an organizational culture of humanistic teaching and practice[J]. Journal of general internal medicine, 2018, 33(7): 1092-1099.
[5] SWENDIMAN R A, MARCACCIO C L, Han J, et al.Attitudes and habits of highly humanistic surgeons: a single-institution, mixed-methods study[J]. Academic Medicine, 2019, 94(7): 1027-1032.
[6] 杨辉,韩建军,许岩丽.中国全科医生队伍建设的发展, 挑战与展望[J]. 中国全科医学, 2019, 22(19): 2267-2279.
[7] 刘红, 史卫红, 乔学斌. 江苏省基层全科医生岗位胜任力研究[J]. 中国全科医学, 2017, 20(25): 3088-3093.
[8] 魏东海,冯欣贤,张臣福,等.全科医生培养与使用相脱节的原因与对策研究[J]. 中国全科医学, 2018, 21(25): 3118-3122.
[9] BRANCH WT J R, FRANKEL R. Not all stories of professional identity formation are equal: An analysis of formation narratives of highly humanistic physicians[J]. Patient education and counseling, 2016, 99(8): 1394-1399.
[10] RIOS I C.The contemporary culture in medical school and its influence on training doctors in ethics and humanistic attitude to the clinical practice[J]. International Journal of Ethics Education, 2016, 1(2): 173-182.
[11] ADAMS S M, CASE T I, FITNESS J, et al.Dehumanizing but competent: The impact of gender, illness type, and emotional expressiveness on patient perceptions of doctors[J]. Journal of Applied Social Psychology, 2017, 47(5): 247-255.
[12] GLADSTONE T R G, TERRIZZI D A, PPULSON A, et al. Effect of internet-based cognitive behavioral humanistic and interpersonal training vs internet-based general health education on adolescent depression in primary care: a randomized clinical trial[J]. JAMA network open, 2018, 1(7): e184278.
[13] ALKUREISHI M A, LEE W W, LYONS M, et al.Impact of electronic medical record use on the patient-doctor relationship and communication: a systematic review[J]. Journal of general internal medicine, 2016, 31(5): 548-560.
[14] 董香书,Ariana P,肖翔.中国农村医生离职倾向研究——基于工作收入、医院管理与医患关系的实证分析[J]. 经济评论, 2013(2): 30-39.
[15] 董香书,Ariana P.为何农村医生工作不满意?——工作收入、医患关系和工作满意度的实证研究[J]. 管理世界, 2012(11): 77-88.