浙江省全科医师岗位培训学员社区卫生服务影响因素评价及培训意向调查

目的调查并了解社区卫生服务（community health services，CHS）影响因素、居民对CHS不满意的主要原因．影响学员参加培训的主要原因，学员参加培训的主要目的，培训教学方式需求等，为制定适合区域CHS规划和培训计划提供参考依据。方法采用问誊调查法．以浙江省全科医师岗位培训在读学员全样本为调查对象，发放问卷5199份，有效回收4259份，回收率81．92％。结果调查人群认为：机构设置布局、管理及经费到位、高素质全科医师是影响CHS机构建设的重要因素（70．00％）；硬件建设不到位、宣传不够、服务动机不纯是导致居民对CHS不满意的可能原因（63．70％）：全科医学重要性认识不足、配套政策不落实、学习时间没有保障是影响学员培训积极性的首要因素（68．70％）；掌握全科医学概念与内涵、提高对疾病的防治能力、了解和转变全科医疗服务理念是岗位培训应解决的主要问题（72．80％）；采用业余集中面授和理论实践相结合的教学方式最受欢迎（49．20％）。结论在CHS机构建设中，除应注重人才培养外．更需关注合理设置CHS机构．加大硬件建设力度和经费投入。全科医师素质与CHS关联强度高。是重要影响因素。但非首要唯一因素．应注重培训的重要性宣传和培训经费的落实。培训应采用实践和理论课程相结合的教学方式．

Survey on Influencing Factors of Community Health Services and Intention to On-the-job Training of General Practitioners In Zhejiang Province

OBJECTIVES To understand the influencing factors of community health services（CHS）, main causes of residents＇ discontent to CHS, to know the main causes and intentions of trainees attending the on-the-job training, to provide basis for making local CHS development programs and training plans. METHODS A questionnaire investigation was carried out among 5 199 trainees receiving on-the-job training of general practitioners. Ultimately, 4 259 questionnaires（81.92%）were collected successfully. RESULTS Organization settings, adequate fund investment and management, and high-standard general practitioners mainly accounted for the CHS development（70.00%）. The inadequate hardware construction, no fully publicity and an ulterior motive of CHS organization might result in residents＇ dissatisfaction to CHS （63.70%）. The most important influencing factors for trainees attending on-the-job training were lack of understanding the importance of general medicine, not implementing the related policies and no adequate study time （68.70%）. Understanding the definition and connotation of general medicine, improving the abilities of preventing and treating diseases, and building up the new conceptions of general medical care were the main measures in solving on-the-job training of general medicine （72.80%）. CONCLUSIONS In CHS organization construction, we should pay the same attention to talents training, laying out CHS organization well, strengthening the fund investment and infrastructure. As for on-the-job training of general practitioners, we should attach importance to fully publicity of its importance and fully financial funding.