变革型领导、心理授权对社区全科医生组织创新气氛的影响研究

目的　探讨社区卫生服务中心全科医生组织创新气氛状况，分析变革型领导、心理授权对全科医生组织创新气氛的影响。方法　于2016年9—10月，采用多阶段抽样方法，首先根据城区、郊区、城乡结合区域分层，按照约1∶1∶1的比例，从上海市浦东新区45所社区卫生服务中心中随机抽取10所；然后整群纳入各社区卫生服务中心中全部在岗注册的全科医生，共计380例为调查对象。采用自行设计的全科医生基本情况调查表、组织创新气氛量表、变革型领导量表、心理授权量表调查社区卫生服务中心全科医生的基本情况、组织创新气氛、变革型领导、心理授权水平。共发放问卷380份，回收有效问卷355份，问卷的有效回收率为93.4%。结果　355例全科医生组织创新气氛量表得分为（3.82±0.57）分，其中团队协力、上级支持维度得分较高，分别为（4.13±0.66）、（4.00±0.74）分，资源保障、激励机制的维度得分较低，分别为（3.14±0.88）、（2.89±0.60）分。变革型领导量表得分为（5.61±0.89）分；心理授权量表得分为（3.92±0.69）分。变革型领导量表得分、心理授权量表得分与组织创新气氛量表得分呈线性正相关（P<0.01）；除资源保障维度得分外，变革型领导量表得分、心理授权量表得分与组织创新气氛量表各维度（团队协力、上级支持、领导躬行、组织促进、自主工作、激励机制）得分呈线性正相关（P<0.01）。多元逐步回归分析结果显示，变革型领导、心理授权量表得分是组织创新气氛量表得分的影响因素（P<0.01）。结论　社区卫生服务中心全科医生组织创新气氛处于中等水平，变革型领导、心理授权与组织创新气氛呈线性正相关。管理者应以加强变革型领导和心理授权为切入点，充分发挥变革型领导行为作用，提升全科医生心理授权水平，营造组织创新气氛，从而高效高质地推进社区卫生工作。

Influence of Transformational Leadership and Psychological Empowerment on Organizational Innovation Climate of General Practitioners in Community Health Service Centers

Objective　To investigate the organizational innovation climate of general practitioners in community health service centers and to analyze the influence of transformational leadership and psychological empowerment on organizational innovation climate of general practitioners.Methods　According to the proportion of urban，suburban and urban-rural areas in ratio of approximately 1∶1∶1，multistage sampling method was applied to select randomly 10 community health service centers from 45 community health service centers in Pudong New Area of Shanghai from September to October in 2016，and then the whole group of all registered general practitioners in the selected community health service centers was included.A total of 380 registered general practitioners were investigated by the self-designed demographic data questionnaire，Organizational Innovation Climate Scale，Transformational Leadership Scale，and Psychology Empowerment Scale.A total of 380 questionnaires were distributed，and 355 valid questionnaires were collected.The effective recovery rate was 93.4%.Results　Among 355 general practitioners，the score of Organizational Innovation Climate Scale was （3.82±0.57），in which the scores of team cooperation （4.13±0.66） and superior support （4.00±0.74） were high，while the scores of resource guarantee（3.14±0.88） and incentive mechanism（2.89±0.60） were low.The score of Transformational Leadership Scale was （5.61±0.89），and the score of the Psychological Empowerment Scale was （3.92±0.69）.The score of Transformational Leadership Scale and the score of Psychological Empowerment Scale were positively related to the score of Organizational Innovation Climate Scale linearly（P<0.01）.Apart from the score of resource guarantee，the scores of other dimensions in Transformational Leadership Scale and Psychological Empowerment Scale were positively related to the scores of all dimensions in Organizational Innovation Climate Scale（team cooperation，superior support，leadership，organizational promotion，self-employment，and incentive mechanism） linearly（P<0.01）.The multivariate stepwise regression analysis showed that the scores of dimensions in Transformational Leadership Scale and Psychological Empowerment Scale were the influencing factors of the scores of dimensions in Organizational Innovation Climate Scale（P<0.01）.Conclusion　The organizational innovation climate in community health service centers was at a moderate level，and it is positively related to transformational leadership and psychological empowerment.Managers should strengthen transformational leadership and psychological empowerment as the breakthrough point，give full play to the role of transformational leadership，enhance the level of psychological empowerment among general practitioners，and create the new organizational innovation climate so as to promote community health services effectively and efficiently.