公立医疗机构医生工作满意度结构的验证性因素分析

目的通过探讨公立医疗机构医生工作满意度的潜在因素结构,评价测量工具的结构效度。方法自编医生工作满意度问卷(PJSQ-PMI),根据预调查探索性因素分析(EFA)结果提出假设模型,利用正式调查数据(N=1451)进行多样本、多阶层验证性因素分析(CFA)。结果由58个原始指标组成的五因素模型Model A、A'的拟合效果不佳,而经项目组合后的简化修饰模型Model B'(含13个指标)与实际数据的拟合状态理想(GFI、NFI、CFI、IFI>0.9,RMSEA=0.075,RMR=0.024),在不同地区的样本中都获得支持;进一步构建的二阶模型Model C同样达到拟合要求(RMSEA=0.086,RMR=0.025,γ≥0.64),与Model B'的拟合卡方值之差△CMIN=10.163,△DF=5,P>0.05,根据简效法则接受Model C为较佳模型。结论经EFA与CFA相结合的多样本交叉检验显示,公立医疗机构医生工作满意度的潜在结构为简化的五因素二阶模型,表明问卷总体上具有较好的结构效度和测量稳定性。     

城市公立医疗机构医生职业倦怠因素结构的探讨及恒等性检验

目的 探讨城市公立医疗机构医生职业倦怠的潜在结构,并进行测量恒等性检验.方法 自编医生职业倦怠问卷(POBQ-PMI)为工具,采用分层整群随机抽样共调查了湖北省三市1451名被试者,借助Amos 7.0软件对竞争性模型进行验证性因素分析及多样本比较.结果 调整后(允许同一因子内的误差相关)的三因素模型Model 3达到拟合标准(GFI、NFI、CFI均＞0.9,RMSEA =0.068,RMR=0.047),且在三个地区的样本人群中均得到支持,其因素载荷在不同地区的样本上满足测量恒等特性(⊿CMIN=25.941,⊿DF=16,P＞0.05).结论 城市公立医疗机构医生职业倦怠由情感耗竭、人格解体、成就感低落三个因素(11个条目)构成,因素结构与载荷参数具有跨样本稳定性,表明问卷内在信效度较高.     

上海市公立医疗机构门诊病人满意度及其影响因素分析

目的 :分析上海市公立医疗机构门诊病人满意率及其影响因素,为卫生行政部门和公立医院持续改善医疗服务质量提供决策依据。方法 :2016年7—8月,对上海市65所公立医疗机构及其门诊病人满意度进行了问卷调查。通过χ2检验比较不同类型和级别的公立医疗机构门诊病人满意率,运用多层logistic模型分析门诊病人满意率的影响因素。结果 :上海市公立医疗机构门诊病人总体满意率为92.73%,但对门诊诊疗等候时间的满意率最低(75.41%)。门诊病人在医院的逗留时间越长,总体满意率越低。结论 :上海市公立医疗机构门诊病人总体满意率较高,但需要进一步减少门诊病人逗留时间、提升社区卫生服务中心的医疗服务能力、加强公众宣传和公立医疗机构内部管理等,以提高病人满意度。     

医院门诊患者满意度评价模型构建及实证研究

目的 :探索构建市级医院门诊患者满意度测评量表及评价模型,优化门诊患者满意度绩效考核指标。方法 :基于顾客满意度模型和PZB服务品质模式编制门诊患者满意度量表,并对上海市6家三级甲等公立医疗机构共计758名门诊患者进行抽样调查。结果 :量表信度、效度及结构方程模型(SEM)各项拟合度良好,门诊患者总体满意度为83.52%。专科性医院总体满意度高于综合性医院。患者总体满意度与服务品质的各维度、医院形象、转换成本、忠诚度均有相关性(P0.01),其中医疗品质中的响应性(0.232)和保证性(0.201)的回归系数最大。"医生及时给与专业治疗和咨询"、"医务人员耐心解答疑惑"和"有效缓解患者对疾病的恐惧"是影响患者满意度的关键因素。结论 :本研究设计的门诊患者满意度测评量表具有实用价值,可在市级医疗机构推广使用。     

2022年和2021年上海市公立医疗机构门诊患者满意度分析

目的 分析2022年和2021年上海市公立医疗机构门诊患者满意度。方法 通过对2022年和2021年上海市公立医疗机构门诊患者的问卷调查，分析门诊患者对医疗服务的满意率和满意度评分，了解门诊患者希望得到改善的医疗服务，并采用多层广义线性混合模型比较了2022年与2021年的满意度评分。结果 2022年和2021年上海市公立医疗机构门诊患者的总体满意率分别为96.60%和95.30%，总体满意度分别为4.83分和4.76分，且多层广义线性混合模型显示在控制其他因素后，2022年门诊患者总体满意度和对医生服务满意度的评分均高于2021年。但是，被调查的门诊患者认为门诊等候时间、就医环境、医疗服务态度与沟通、适老化服务等方面还需要改善。结论 上海市公立医疗机构门诊患者满意度保持高水平，但还需根据患者的关切不断改善。     

新型冠状病毒感染疫情期间医务人员心理健康状况、工作满意度调查及其影响因素分析

目的 分析新型冠状病毒感染疫情期间隔离场所医务人员抑郁、焦虑心理健康情况和工作满意度情况及其影响因素。方法 选取2022年3-9月在广东省广州市入境隔离酒店、健康驿站等集中隔离场所工作的223名公立医疗机构医务人员为调查对象,作为闭环组;以同属公立医疗机构的455名未到过隔离场所的医务人员作为对照组。对两组进行问卷调查,调查一般情况;采用美国精神病学会出版《精神障碍诊断统计手册》抑郁症筛查量表(PHQ-9)和广泛性焦虑障碍筛查量表(GAD-7)评估调查对象抑郁、焦虑状况;采用明尼苏达满意度短式量表(MSQ)调查问卷调查医务人员的工作满意度。采用多元logistics回归分析工作满意度影响因素。结果 不同年龄闭环人员中重度及以上抑郁发生率比较差异有统计学意义(χ²=8.736,P<0.05),不同年龄、职称的中重度焦虑发生率比较差异有统计学意义(χ²值分别为19.598、13.636,P<0.05)。与对照组比较,闭环组PHQ-9、GAD-7评分高(t值分别为3.887、5.919,P<0.05)。不同闭环工作时长PHQ-9评...     

新医改后乌鲁木齐市医务人员 工作满意度调查分析*

目的调查乌鲁木齐地区新医改后医务人员工作满意度的总体状况及影响因素,为新医改可持续发展提供参考。方法依据人均国内生产总值(GDP)与不同医疗机构,采用分层整群随机抽样方法,对700名医务人员进行满意度问卷调查。结果影响因素的单因素秩和检验结果显示:调查机构、从业时间、学历、职称和用工形式等与医务人员满意度程度差异均有统计学意义;多因素有序logistics回归分析显示:医疗机构级别越高满意度越低,学历高者满意程度较低,职称低者满意程度较低。结论医务人员满意度水平需进一步提高,应关注满意度的影响因素,促进医改工作的可持续发展。     

西藏地区农村医务工作者职业满意度影响因素的结构方程模型分析

目的探讨影响西藏地区农村医务工作者职业满意度的因素。方法对西藏拉萨周边农村地区医疗机构医务人员进行抽样调查,就职业满意度、薪酬待遇、职业认同、职业规划等相关方面进行问卷。对以上因素构建结构方程模型并分析影响职业满意度的相关因素。结果结构方程模型以职业规划作为中介变量,职业认同度、薪酬待遇满意度为外生潜变量影响,职业满意度为内生潜变量。模型配适度指标符合要求,拟合度较好(CMIN/DF=2.509,RMSEA=0.076,CFI=0.78)。模型构建的回归路径系数均具有统计学意义(P0.05)。其中职业认同度的标准化回归系数为0.629,占职业满意度可解释方差的40%。结论职业认同度不仅对职业满意度产生直接效应,并通过职业规划对职业满意度产生间接影响。     

四川省医务人员工作满意度及影响因素分析

摘要:目的 分析四川省医务人员工作满意度及其影响因素。方法 利用第五次全国卫生服务调查四川省调查数据,描述四川省医务人员的工作满意度现状,采用单因素分析、logistic回归以及结构方程模型研究工作满意度的影响因素并进行模型拟合和评估。结果 四川省医务人员工作满意度总体得分为4.15±0.94;主要影响因素有学历、职称和行政业务管理职务;结构方程模型结果显示医务人员工作投入对工作满意度有直接(正向)效应(β=0.50,P<0.01),工作-家庭冲突对工作满意度有直接(负向)效应(β=-0.20,P<0.01),工作投入还可通过工作-家庭冲突间接影响工作满意度。结论 结构方程模型可以较好地分析医务人员工作满意度与其他潜在变量之间的关系。四川省医务人员工作满意度总体处于一般水平,应根据影响满意度的具体因素完善相应的激励制度。     

云南省龙陵县新型农村合作医疗定点医疗机构服务质量评价

目的:探讨不同人群对新型农村合作医疗定点医疗机构服务质量的评价情况,确保新型农村合作医疗制度的顺利推行。方法:采用流行病学现场调查方法。结果:全体调查对象对各定点医疗机构服务条件的评价分布差异分别都有统计学意义(P<0.001)。参合农民与医务人员对各定点医疗机构的服务态度、总体满意度和选择就诊的评价分布差异分别都有统计学意义(P<0.01)。经非条件Logistic回归分析表明,参合农民选择村卫生室就诊的主要原因是医生服务态度好、可信度高和就医方便等。医务人员选择县医院就诊的主要原因是医疗设备较好、总体满意度较高等。结论:各级定点医疗机构服务质量一般。建议有关卫生主管部门努力改善乡村卫生机构的服务条件,改善县级医疗机构的服务态度,严格控制农村医药费用的不合理增长。     

Job satisfaction and trust in Health Insurance Review Agency among Korean physicians

OBJECTIVES: To measure Korean physicians' job satisfaction and to examine the relationship between trust in Health Insurance Review Agency (HIRA) and job satisfaction. METHODS: Stratified sampling was used. The sample was representative of Korean office-based physicians; 1593 office-based physicians in Korea were surveyed by mail over a 4-week period using a self-administered questionnaire. Multivariate analysis using logistic regression was performed to investigate predictors of physicians' job satisfaction and to examine whether trust in HIRA was related to job satisfaction. RESULTS: Overall, the job satisfaction of physicians was very low. The payment denial rate was not related to job satisfaction. Physicians who trusted HIRA were more likely to be satisfied with their job. CONCLUSIONS: Physicians who trusted in the HIRA were more likely to report satisfaction. These results emphasize that trust in the HIRA is key to physicians' job satisfaction.     

Impact of practice arrangements on physicians' satisfaction

This research examines the effect of practice arrangements on five dimensions of physicians' satisfaction (i.e., personal factors, resources, peer review, profession, and state regulations) and the moderating effect of job autonomy and decision making on this relationship. This research finds that physicians who work for HMOs and hospitals are more satisfied with job resources, regulatory climate, and their professions, compared with physicians who are self-employed (solo and group practices). Physicians who work for HMOs and hospitals have less autonomy and decision-making power, compared with self-employed physicians. Also, job autonomy partially moderates the relationship between organizational arrangement and physicians' satisfaction with job resources and satisfaction with the profession. Decision making does not moderate the organizational arrangement and physicians' satisfaction relationship.     

Continuing medical education and primary physicians' job stress, burnout and dissatisfaction

OBJECTIVES: The association between opportunities for continuing medical education (CME) and primary physicians' job stress, burnout and job dissatisfaction has not been investigated. It was hypothesized that participation in CME activities and perceived opportunities at work for keeping up-to-date with medical and professional developments would be correlated negatively with job stress and burnout, and positively with job satisfaction. METHOD: 309 primary care physicians (183 family physicians and 126 paediatricians) employed in health maintenance organizations in Israel responded to a mailed questionnaire. The independent variables were the extent of engagement in CME activities and perceived opportunities at work for professional updating. The dependent variables were job stress, burnout and job satisfaction. Multiple regression analyses were employed. RESULTS: After controlling for age, sex and professional status, participation in CME activities was associated negatively with job stress and positively with job satisfaction, among family physicians. Among paediatricians, CME was associated negatively with burnout. Perceived opportunities for professional updating were associated negatively with burnout and (marginally) with stress among family physicians, and negatively with stress and positively with satisfaction among paediatricians. A third of the paediatricians and a quarter of the family physicians wanted to increase their involvement in CME. DISCUSSION: In this cross-sectional study, causality cannot be established and the CME measures should be refined. However, the results are consistent with the study's hypotheses and suggest that opportunities for CME and professional updating may reduce physicians' job distress and dissatisfaction.     

The role of job satisfaction, job dissatisfaction and demographic factors on physicians' intentions to switch work sector from public to private

This study is based on a unique data set for the years 1988-2003 and uses structural equation models to examine the impact of job satisfaction and job dissatisfaction on physicians' intention to switch from public- to private-sector work. In Finland, physicians who work primarily in a public-hospital or health-centre setting can also run a private practice. Therefore, we also analysed the impact of having a private practice on a physician's intention to change sector. We found that private practice had a positive, statistically significant effect on the intention to switch sector in 1998 and 2003. Results also suggest that job satisfaction decreases a physician's intention to switch sector, although for 1998 it had no effect. Surprisingly, job dissatisfaction significantly increased the physicians' intentions to leave the public sector only in the 1988 data.     

Australian GPs are satisfied with their job: even more so in rural areas

BACKGROUND: Australia has seen a constriction of the scope of practice and of professional prerogatives for GPs in the 1990s, which is said to have led to lower job satisfaction, particularly for rural GPs. OBJECTIVE: The aim of this study was to determine levels of job satisfaction and mental health in a rural and an urban sample of GPs, and to correlate population and practice characteristics with lower job satisfaction and morale. METHODS: A postal survey of GP members of two urban and four rural Divisions of General Practice in New South Wales was carried out using the Wall-Cook-Warr scale and the 12-item General Health Questionnaire (GHQ-12). The overall response rate was 74%. RESULTS: Both urban and rural Australian GPs were generally satisfied with their jobs; however, rural GPs had significantly higher job satisfaction scores. The highest levels of satisfaction were recorded for factors denoting autonomy. The lowest ranked factors were hours of work, income and government policy in general practice. GPs without psychological disturbance were significantly more satisfied with their work than those who were disturbed. Lower job satisfaction was significantly associated with urban GPs, GPs who worked full-time and those who used a language other than English during consultations. Poor mental health and working in an urban area were predictive of lower job satisfaction in men, and bulk-billing all patients (i.e. not charging patients a co-payment, but making a consolidated claim to the government funder Medicare) and working full-time were predictive of lower job satisfaction in women. CONCLUSIONS: Both urban and rural GPs derive a large measure of satisfaction from their job. In particular, rural GPs are satisfied, especially so with their autonomy. Poor mental health was the strongest predictor of lower job satisfaction. The high percentage of GPs with psychological disturbances raises the problem of their access to appropriate mental health services, in particular in rural areas.     

细节护理在骨科手术的应用

目的：探讨细节护理在骨科手术的应用。方法：将收治的100例骨科手术患者,随机分为对照组和实验组,每组50例,对照组给予常规护理,实验组在常规护理的基础上给予细节护理。比较两组的患者满意度、医生满意度。结果：两组的患者满意度、医生满意度比较,实验组高于对照组,差异有统计学意义（P<0.05）。结论：将细节护理模式引入骨科患者的手术中,能显著提高患者满意度和医生满意度,值得推广。     

湖北省城乡基层医务人员工作满意度研究*

目的测量湖北省基层卫生机构医务人员的工作满意度状况,发现影响因素,为提高湖北省基层医务人员工作满意度提供政策依据。方法根据经济发展情况选取湖北省武汉市、黄冈市和荆州市3个地区共12家基层卫生机构,其中,城市社区卫生服务中心和农村乡镇卫生院各6家,对408名医务人员进行满意度问卷调查。结果湖北省基层卫生服务机构员工的总体工作满意度评分为65.99分,程度为一般满意,其中,城市总满意度为64.66分,农村总满意度为66.05分;各个维度中,员工对个人胜任(72.79分)和人际关系(70.92分)满意度最高,而对薪资(37.01分)和工作强度(43.69分)满意度最低。根据logis-tic回归分析结果可见,工作环境、技术水平、工作回报和职业发展均对工作满意度有较大程度的影响。结论湖北省城乡基层卫生服务机构工作人员工作满意度水平一般,需要进一步重视基层卫生机构职工的工作回报和职业发展。     

基于双因素理论的乡村医生工作满意度及影响因素调查

目的 调查乡村医生工作满意度及影响因素,并提出改善措施。方法 于2020年6月,使用自行设计调查问卷,对潍坊市7个县市区737名乡村医生进行调查。采用SPSS 22.0软件对数据进行统计分析,采用χ²检验和Kruskal-Wallis H秩和检验及Logistic回归分析法分析乡村医生工作满意度影响因素。结果 737名乡村医生工作满意度为16.55%。在保健因素方面,生存现状满意度、养老保障满意度是主要影响因素(P<0.05);在激励因素方面,近3年培训次数、是否愿意长期从事乡村医生工作是主要影响因素(P<0.05)。结论 潍坊市乡村医生工作满意度较低。建议从改善生存现状、提升养老保障水平、关注培训需求、增强职业获得感等方面综合提高乡村医生工作满意度。