大型综合医院组织文化测评量表研究

目的探索和完善医院文化评价指标与方法,了解医院文化的现状。方法运用课题组开发的医疗机构组织文化评价量表,从医院内部管理和外部服务2方面对北京市2家三甲综合医院医院文化进行评价。结果量表内部一致性信度为0.9475,内外文化各维度平均独自解释其变异程度分别为32.58%和42.74%;X医院在大部分内外文化维度上评分好于Y医院;不同工作岗位的员工对医院评分差异存在统计学意义。结论量表具有较好的信度和效度,能较好反映不同医疗机构的组织文化现状和差异。     

糖尿病患者生命质量量表研制及评价

目的对慢性病患者生命质量量表系列-糖尿病量表(QLICD-DM)测试版进行评价。方法收集2型糖尿病住院患者159例,采用自主研制的QLICD-DM测试版,于患者入院时、入院第2天和出院时进行量表测评,对量表的信度、效度、反应度进行评价。结果量表各维度的内部一致性α系数和分半系数均在0.7以上,重测信度相关系数均高于0.9;量表各条目与所属维度或维度的相关均大于该条目与其他维度或维度的相关;探索性因子分析结果显示,第1主成分主要涵盖心理状况各条目,方差贡献率达到33.919%;其次为第2主成分的糖尿病并发症条目,方差贡献率为12.006%;治疗前后患者的躯体功能、心理功能、社会功能、特异模块评分及量表总评分差异均有统计学意义(P<0.01),标准反应均数(SRM)分别为0.691、0.638、0.428、1.148、1.223。结论所研制的慢性病患者糖尿病生命质量量表具有较好信度、效度和反应度,可作为国内糖尿病患者生命质量测评工具。     

心血管疾病患者连续护理认知水平测评量表的构建

目的研制心血管疾病患者连续护理认知水平测评量表,并检验其信效度。方珐在参阅大量国内外文献的基础上．针对心血管疾病患者的连续护理需求．经咨询专家。编制了包括4个维度、62个条目的心血管疾病患者连续护理认知水平测评量表。请5位专家评阅,测算量表的效度;选取200名心血管疾病患者进行预试验调查,检验其信度。结果形成心血管疾病患者连续护理认知水平测评量表,量表内容效度系数为0．8418,所有条目均与其所属维度相关：各维度与总分的相关系数r=-0．873～0．968：各维度及总量表内部一致性信度Cranl）aeth’sa=0．9020～0．9838。结论该量表具有良好的可信度、稳定性和准确性．可作为心血管疾病患者连续性护理知识掌握程度的测评量表。     

住院医师导师考核评价量表的信度与效度研究△

目的：测评住院医师导师考核评价量表的信度和效度。方法：量表信度采用内部信度Cronbachα系数进行测量;效度检验采用内容效度进行测量。结果：信度分析三级指标的Cronbach系数均在0.6~0.8之间,内部信度较好;内容效度系数为 0.822。结论：住院医师导师考核评价量表具有良好的信度与效度,是研究住院医师导师遴选、培训、考核评价的重要工具。     

医患沟通质量量表设计及评价

目的：设计适合我国医院使用的医患沟通质量评价指标和评价工具。方法研究采用问卷调查的方法,通过对问卷的定量数据分析来检验量表的信度和效度。结果研究设计了有3个维度22个项目构成的《医患沟通质量评价量表》初稿,以随机抽样的方法选择了5家综合性医院,发放问卷1800份,回收有效问卷1400份,量表部分完整问卷559份,对559份问卷进行了探索性因子分析和验证性因子分析,探索性因子分析并没有验证设想的3个维度,而是将22个项目降维为5个维度：诊断信息、治疗信息、费用沟通、移情性和沟通结果。验证性因子分析 RMSEA、GFI、PGFI、IFI和 CFI 指标分别是0.066、0.895、0.704、0.916、0.915,显示5维度模型有较好的适配度。该量表 Cronbach α信度为0.924,5个维度的 Cronbach α信度和组合信度均在0.7以上,AVE 均接近或者超过0.5,维度间相关系数的平方值均接近或者小于相关维度的 AVE。结论实证分析结果显示量表具有较好的内部一致性、收敛效度和区别效度,模型适配较好。     

肠易激综合征患者生命质量测定量表研制及评价

目的 研制与评价慢性病患者生命质量测定量表体系之肠易激综合征量表(QLICD-IBS).方法 采用程序化决策方式,结合中国人群背景,进行量表开发和研制;对99例肠易激综合征患者住院治疗前后的生命质量进行测评,评价量表效度、信度、反应度.结果 肠易激综合征患者生命质量测定量表(QLICD-IBS)包括慢性病共性模块30个条目和肠易激综合征特异模块15个条目,量表各领域及维度的内部一致性信度(α)基本>0.6以上、重测信度(r)>0.9;各条目与所属维度及其领域的相关均大于与其他维度及领域的相关,相关系数(r)值大多>0.6;量表能够反映出患者治疗前后生命质量的变化.结论 量表(QLICD-IBS)具有较好的信度、效度、反应度和临床可行性,可作为适合中国人群的生命质量测评工具.     

医院管理者职业兴趣测评量表的构建

为提高医院管理者培养、选拔、任用和考核的科学性和准确性，构建了“医院管理者职业兴趣测评量表”。对测评量表题目分析采用因素分析法，对信度评定采用分半信度、重测信度和内部一致性信度指标，对效度也进行了初步评定。研究表明，本测评量表符合心理测量学要求。     

中国医院住院患者体验和满意监测量表的信效度评价

目的评价"中国医院住院患者体验和满意监测量表"的信度与效度,为改进量表、推广应用提供依据。方法采用邮寄方式对出院患者进行问卷调查,使用SPSS数据分析软件,分别对量表的内部一致性、折半信度、内容效度及结构效度进行评价。结果量表总体Cronbach’sα系数为0.956,所包含6个维度的Cronbach’sα系数均大于0.8。分半信度为0.971。各条目与量表总体的相关系数介于0.51~0.79之间。以所有条目为变量进行因子分析,共提取5个公因子,其累计贡献率为66.2%,各条目至少在其中一个公因子上负荷值大于0.4。结论量表具有良好的信度和效度,适用于中国医院住院患者满意度的测评。     

医院管理者职业能力倾向测评量表的构建

为提高医院管理者培养、选拔、任用及考核的科学性和准确性，构建了“医院管理者职业能力倾向测评量表”。对测评量表题目分析采用难度系数和区分度指数，对信度评定采用分半信度、重测信度和内部一致性信度指标，对效度也进行了初步评定。研究表明，本测评量表质量符合心理测量学要求。     

医院管理者职业人格测评量表的构建

为提高医院管理者培养、选拔、任用及考核的科学性和准确性，构建了“医院管理者职业人格测评量表”。对测评量表项目区分度的分析采用点二列相关法，对信度评定采用分半信度、重测信度和内部一致性信度指标，对效度也进行了初步评定。研究表明，本测评量表质量符合心理测量学要求。     

中国情境下非营利性医院市场导向量表编制构想

在分析市场导向内涵和量表编制必要性的基础上,评析了国内外学者在医院市场导向测量量表方面所取得的研究成果,指出现有研究的不足之处,提出编制适合我国情景的非营利性医院市场导向量表的思路,探讨了量表开发的意义和应用前景。     

北京市某三级综合医院员工市场导向观念的调查分析

[目的]了解医院内部员工市场导向的现状,为医院有针对性的开展管理和培训工作提供参考。[方法]采用市场导向量表（MKTOR）,对某三甲医院内部不同员工群体（高／中层管理者、医生、护士）的市场导向观念进行问卷调查,结合文献开口访谈进行系统分析。[结果]医院不同员工群体之间的市场导向观念存在显著差异,管理者和护士的市场导向观念最强,医生最弱。[结论]针对医院内部不同岗位的员工开展有针对性的措施,以文化建设为抓手,树立全员市场导向观念,通过改善组织支持系统来提高医院市场导向水平,改变员工的服务理念和行动。     

Market orientation in the hospital industry

Using the more recent methodological developments in the assessment of the unidemensionality, reliability, and validity, the authors developed and examined a scale of market orientation for the hospital industry. The scale is based on a clear definition of the content of the construct of market orientation in the hospital industry. To this end, a national random sample of 237 hospital administrators was used. In addition to the support for the reliability and validity, the scale promises parsimony, pragmatism, and wide-ranging applicability.     

利益相关者理论视野下公立医院的文化价值取向

公立医院的利益相关者主要包括政府、市场、患者和以医护人员为主体的医院员工,其相对应的利益相关者导向分别为政府导向、竞争者导向、顾客导向和员工导向。各种利益相关者客观存在并同时对物质、行为、制度和精神等4个层面的医院文化形成产生合力,在明确利益相关者导向定位之前,互相博弈和角力。深化公立医院体制机制改革的背景下,基于利益相关者理论,结合公立医院的利益相关者导向定位对医院文化建设发展的影响,公立医院文化应以坚持社会效益重于个体利益、转换医疗模式以健康为导向、定位于服务行业强调顾客导向为价值取向。     

护士文化智力与共享型领导及团队合作相关性分析

目的探讨跨文化情境下护士的文化智力、共享型领导与团队合作三者之间的关系。方法首先通过搜索国内外数据库,查阅大量相关文献并分析文化智力、共享型领导与团队合作水平三者之间关系,提出科学假设;其次通过方便抽样的方法对上海市某三甲医院282名护士进行问卷调查获取实证数据,调查工具包括一般资料调查表、文化智力量表、共享型领导测评量表、团队合作态度及认知量表;最后对所得临床数据进行整理,运用SPSS统计学软件进行Person相关分析、三步中介回归分析的方法对假设逐一进行验证。结果跨文化情境下护士共享型领导、文化智力与团队合作水平均呈显著正相关(P<0.001),其中共享型领导通过文化智力变量影响团队合作水平(P<0.001)。结论在多元文化冲击的现代医疗体系中,良好的文化智力、共享型领导能有效促进团队合作。护理管理者应关注护士人文素质的培养,加强对文化智力、共享型领导及团队合作的认知;同时可以通过对护士进行文化智力、共享型领导及团队合作水平的测量来选拔护理骨干,为进一步壮大护理管理队伍,打造一支高效合作的护士团队做准备。     

The relationship between market orientation and performance in the hospital industry: A structural equations modeling approach

There is general consensus in the research literature that market orientation is related to organizational performance. This study examines this relationship in the hospital industry. One unique feature of this study is that both market orientation and performance are conceptualized as being multi-dimensional constructs. Hence the technique of Structural Equations Modeling (SEM) is used to examine the relationship. Analyses were based on market orientation and performance data obtained from 175 hospitals in a five-state region of the United States. The SEM results confirm the multi-dimensional nature of both market orientation and performance, and the strong relationship between the constructs. Interestingly, this relationship is found to be much stronger for smaller hospitals than for larger hospitals. Implications for the hospital industry are discussed. This revised version was published online in August 2006 with corrections to the Cover Date.     

Changing the Public Perception of Physiotherapeutic Treatment

Market research was undertaken to establish the public perception of physiotherapy. Using this market research strategic recommendations for the future marketing of physiotherapy. The market research involved a qualitative study of five focus groups of the general public and one focus group of physiotherapists. The responses from the focus groups were used to construct an appropriate questionnaire for the qualitative study. A random sample of 510 members of the general public were then surveyed. The market research results yielded the following key features: The best known conditions treated by physiotherapists are musculoskeletal. The least known are women and children; Client-centered care is sought. The importance of location gives portential for physiotherapists to capitalise on tailoring to clients in their area; Doctors are important for referral and communication about physiotherapy. Marketing should be used to inform doctors of what physiotherapy has to offer; A marketing orientation has begun within physiotherapy; however, it must 'fit' the culture initially to be successul. A marketing strategy should be developed on national, state, and individual levels based on a strategic intent. At the state level, strategies must be responsive to area or regional needs. Marketing needs to target identified market segments such as workers compensation organisations. Individual physiotherapists must promote themselves within their region, particularly to doctors and clients with the use of relationship markieting. Informal presentations to community groups and school students about physiotherapy will increase their profile.     

大学生自尊与孤独的相关研究

目的探讨大学生孤独与自我价值感之间的关系。方法采用自尊量表和状态与特质性孤独量表对330名大学生的自尊和孤独进行了测量,对测量结果进行统计分析。结果大学生自尊与状态性孤独和特质性孤独具有显著的负相关(状态性孤独r=0.416,特质性孤独r=0.423,p<0.01);特殊自我价值感和个人取向一般自我价值感对状态性孤独的回归效应显著(R=0.262);特殊自我价值感和社会取向一般自我价值感对特质性孤独的回归效应显著(R=0.283)。结论自尊量表各因子与状态、特质性孤独之间的关系存在差异。     

Medical curricula and students'' attitudes towards general and family practice in Mexico

In an exploratory study of the influence of different undergraduate curricula on students' attitudes towards general and family medicine, a questionnaire including a Likert attitude scale was administered to a sample of 1217 first- and fourth-year students at five medical schools with different curricula in Mexico City. The preliminary results suggest that the innovative educational programmes have not apparently had a significant impact on students' attitudes. It is hypothesized that students' perceptions of the job market are stronger in determining their attitudes than the orientation of the curriculum itself. It is also suggested that the differences found among the students of the five schools might have been due to differences in the populations entering them. The instrument developed during the study proved to be sufficiently reliable to warrant further use.     

Changing the public perception of physiotherapeutic treatment

Market research was undertaken to establish the public perception of physiotherapy. Using this market research strategic recommendations for the future marketing of physiotherapy are made within the professional context. Marketing will be used to contribute to changing the public perception of physiotherapy. The market research involved a qualitative study of five focus groups of the general public and one focus group of physiotherapists. The responses from the focus groups were used to construct an appropriate questionnaire for the qualitative study. A random sample of 510 members of the general public were then surveyed. The market research results yielded the following key features: The best known conditions treated by physiotherapists are musculoskeletal. The least known are women and children. Client-centered care is sought. The importance of location gives potential for physiotherapists to capitalise on tailoring to clients in their area. Doctors are important for referral and communication about physiotherapy. Marketing should be used to inform doctors of what physiotherapy has to offer. A marketing orientation has begun within physiotherapy; however, it must 'fit' the culture initially to be successful. A marketing strategy should be developed on national, state and individual levels based on a strategic intent. At the state level, strategies must be responsive to area or regional needs. Marketing needs to target identified market segments such as workers compensation organisations. Individual physiotherapists must promote themselves within their region, particularly to doctors and clients with the use of relationship marketing. Informal presentations to community groups and school students about physiotherapy will increase their profile.