Lin Yifei, Yin Senlin, Lai Sike, Tang Ji, Huang Jin, Du Liang
Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China West China School of Medicine, Sichuan University, Chengdu, Sichuan, PR China Global Services, NewYork-Presbyterian Hospital, New York, NY, U.S.A West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.
Medicine (Baltimore). 2016 Oct;95(43):e5128. doi: 10.1097/MD.0000000000005128.
As the relationship between physicians and patients deteriorated in China recently, medical conflicts occurred more frequently now. Physicians, to a certain extent, also take some responsibilities. Awareness of medical professionalism and its influence factors can be helpful to take targeted measures and alleviate the contradiction. Through a combination of physicians' self-assessment and patients' assessment in ambulatory care clinics in Chengdu, this research aims to evaluate the importance of medical professionalism in hospitals and explore the influence factors, hoping to provide decision-making references to improve this grim situation. From February to March, 2013, a cross-sectional study was conducted in 2 tier 3 hospitals, 5 tier 2 hospitals, and 10 community hospitals through a stratified-random sampling method on physicians and patients, at a ratio of 1/5. Questionnaires are adopted from a pilot study. A total of 382 physicians and 1910 patients were matched and surveyed. Regarding the medical professionalism, the scores of the self-assessment for physicians were 85.18 ± 7.267 out of 100 and the scores of patient-assessment were 57.66 ± 7.043 out of 70. The influence factors of self-assessment were physicians' working years (P = 0.003) and patients' complaints (P = 0.006), whereas the influence factors of patient-assessment were patients' ages (P = 0.001) and their physicians' working years (P < 0.01) and satisfaction on the payment mode (P = 0.006). Higher self-assessment on the medical professionalism was in accordance with physicians of more working years and no complaint history. Higher patient-assessment was in line with elder patients, the physicians' more working years, and higher satisfaction on the payment mode. Elder patients, encountering with physicians who worked more years in health care services or with higher satisfaction on the payment mode, contribute to higher scores in patient assessment part. The government should strengthen the medical professionalism for young physicians and improve the payment mode.
近年来,随着中国医患关系的恶化,医疗冲突愈发频繁。在一定程度上,医生也负有一定责任。了解医学职业精神及其影响因素有助于采取针对性措施并缓解矛盾。本研究通过成都门诊中医生自评与患者评价相结合的方式,旨在评估医院中医学职业精神的重要性并探究影响因素,希望为改善这一严峻形势提供决策参考。2013年2月至3月,通过分层随机抽样方法,在2家三级医院、5家二级医院和10家社区医院,按1/5的比例对医生和患者进行了横断面研究。问卷采用一项预试验中的问卷。共匹配并调查了382名医生和1910名患者。关于医学职业精神,医生自评得分在满分100分中为85.18±7.267分,患者评价得分在满分70分中为57.66±7.043分。自评的影响因素是医生的工作年限(P = 0.003)和患者投诉(P = 0.006),而患者评价的影响因素是患者年龄(P = 0.001)、医生的工作年限(P<0.01)以及对支付方式的满意度(P = 0.006)。对医学职业精神自评较高的是工作年限较长且无投诉史的医生。患者评价较高的是老年患者、医生工作年限较长以及对支付方式满意度较高的情况。老年患者遇到在医疗服务中工作年限较长或对支付方式满意度较高的医生时,会使患者评价部分得分更高。政府应加强对年轻医生的医学职业精神培养并改善支付方式。