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基于结构方程模型的全科医生职业认同感的形成机制研究 预览

Formation Mechanism of Professional Identity of General Practitioners:a Structural Equation Model Analysis
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摘要 背景全科医生职业认同感的形成有助于激发其对基层医疗卫生工作的积极性和主动性。科教驱动和职业期望可以影响全科医生职业认同感的形成,但三者之间的相关性及全科医生职业认同感的具体形成机制尚不明确。目的探索全科医生职业认同感的形成机制,为提高全科医生职业认同感提供有效的科教激励策略。方法采用分层抽样法于2017年9-11月选取上海市区、城郊结合部、郊区社区卫生服务中心的全科医生397例,采用全科医生个人基本信息调查表、全科医生科教驱动感知量表、职业期望量表、职业认同感量表进行问卷调查,根据调查结果,构建全科医生职业认同感形成机制的结构方程模型,并进行检验。结果共发放问卷397份,有效问卷383份,有效回收率为96.5%。科教驱动感知量表:资源保障得分为(10.3±3.0)分,组织管理得分为(11.4±2.9)分,绩效激励得分为(6.1±2.2)分,创新支持得分为(11.3±2.7)分;职业期望量表:职业发展得分为(9.5±3.1)分,职业成就得分为(6.7±1.9)分,工作生活平衡得分为(6.8±1.8)分;职业认同感量表:职业认知得分为(10.5±3.0)分,职业行为得分为(8.6±1.6)分,职业价值观得分为(8.4±1.7)分。除职业发展得分与绩效激励得分、工作生活平衡得分无直线相关关系(P>0.05)外,其余各量表维度得分间均呈正相关(P<0.05)。中介效应显著性检验的Bootstrap分析结果显示,以职业成就、工作生活平衡为中介变量,组织管理、绩效激励和创新支持对职业认知路径的95%CI均未包括0,中介效应显著。结构方程建模结果显示职业期望在组织管理对职业认同感的影响过程中起完全中介作用,在绩效激励、创新支持对职业认同感的影响过程中起部分中介作用。组织管理因素对职业认同感有较弱的正向影响;绩效激励因素对职业认知存在正向影响,对职业行为和职业价值观存在负向影响;创 Background Professional identity of general practitioners(GPs)can stimulate enthusiasm and initiative of GPs in primary health care.Driving forces of research and teaching and career expectations can affect the professional identity of GPs.However,their relationship and formation mechanism of professional identity are unclear.Objective To explore the formation mechanism of professional identity of GPs,in order to provide effective incentive approaches of research and teaching for the improvement of GPs’ professional identity.Methods From September to November 2017,using stratified random sampling,we selected 397 GPs from community health centers in urban area,urban and rural intersections and suburbs of Shanghai.All of them were surveyed with 4 self-administered questionnaires,GPs’ Basic Personal Characteristics Questionnaire,GPs’ Selfperceived Driving Forces of Research and Teaching Scale(SDFRT),Career Expectation Scale(CES) and Professional Identity Scale(PIS).On the basis of the survey results,we constructed a structural equation model(SEM) and tested it for the analysis of the formation mechanism of GPs’ professional identity.Results A total of 397 questionnaires were issued,383 of which were valid.The effective recovery rate was 96.5%.The mean scores of 4 dimensions of the SDFRT,resource support,organization management,performance incentive and innovation support,were(10.3±3.0),(11.4±2.9),(6.1±2.2),and(11.3±2.7),respectively.The mean scores of dimensions of career development,career achievement and work-life balance of the CES were(9.5±3.1),(6.7±1.9),and(6.8±1.8),respectively.The mean scores of 3 dimensions of the PIS,professional cognition,professional behavior and professional values were(10.5±3.0),(8.6±1.6),and(8.4±1.7),respectively.The mean scores of all the dimensions of the scales showed positive correlations(P<0.05) except that the mean score of career development presented no linear correlation with that of performance incentive and work-life balance(P>0.05).Bootstrap analysis for t
作者 陈欣 王洁 钱宁 李黎 沈群 CHEN Xin;WANG Jie;QIAN Ning;LI Li;SHEN Qun(Hongqiao Community Health Center of Changning District,Shanghai 200051,China)
出处 《中国全科医学》 CAS 北大核心 2019年第20期2506-2513,共8页 Chinese General Practice
基金 上海市中西医结合学会社区医学与健康管理科研课题专项基金计划(2016SH54).
关键词 全科医生 科教驱动 职业期望 职业认同感 结构方程模型 绩效激励 General practitioners Research and teaching driving forces Career expectation Professional identity Structural equation model Performance incentive
作者简介 通信作者:王洁,副主任医师;E-mail:wangjiecat@163.com.
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