中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
22期
2705-2708
,共4页
刘薇薇%李屹%王媛媛%王珂欣%王惠仑%周乐群
劉薇薇%李屹%王媛媛%王珂訢%王惠崙%週樂群
류미미%리흘%왕원원%왕가흔%왕혜륜%주악군
门诊病人%医患关系深度量表%评价研究%影响因素分析
門診病人%醫患關繫深度量錶%評價研究%影響因素分析
문진병인%의환관계심도량표%평개연구%영향인소분석
Outpatients%Patient-doctor depth-of-relationship scale%Evaluation studies%Root cause analysis
目的：评价门诊医患关系深度量表的信、效度，并进一步探讨门诊医患关系深度的影响因素，为该量表在我国医疗机构的应用提供依据。方法选取2013年6月—2014年2月在北京市某综合性医院所属的专科门诊、社区门诊和全科慢病管理门诊就诊的1042例患者。采用研究组翻译汉化的“医患关系深度量表”和自行设计的一般情况调查表进行现场调查，并对其中67例患者进行重测信度调查。医患关系深度影响因素分析采用多元线性回归分析。结果医患关系深度量表的Cronbach′sα为0.931，重测信度系数r为0.988，从8个条目中可提取2个因子，可解释总变异的79.85％。门诊性质、年龄、在同一医生处就诊次数是医患关系深度得分的影响因素；医患关系深度得分比较全科慢病管理门诊患者＞社区门诊患者＞专科门诊患者，在同一医生处就诊次数越高，医患关系深度得分也越高。结论医患关系深度量表的信、效度良好，受门诊性质、患者年龄、在同一医生处就诊次数的影响，可用于评估我国各类医疗机构（尤其是初级卫生保健部门，比如门诊或社区卫生服务机构）的医患关系水平，我国的全科医生和政策制定者们应该更加意识到“连续性照顾”的重要性，了解到全科医学在改善医患关系和促进卫生保健质量方面的重要作用。
目的：評價門診醫患關繫深度量錶的信、效度，併進一步探討門診醫患關繫深度的影響因素，為該量錶在我國醫療機構的應用提供依據。方法選取2013年6月—2014年2月在北京市某綜閤性醫院所屬的專科門診、社區門診和全科慢病管理門診就診的1042例患者。採用研究組翻譯漢化的“醫患關繫深度量錶”和自行設計的一般情況調查錶進行現場調查，併對其中67例患者進行重測信度調查。醫患關繫深度影響因素分析採用多元線性迴歸分析。結果醫患關繫深度量錶的Cronbach′sα為0.931，重測信度繫數r為0.988，從8箇條目中可提取2箇因子，可解釋總變異的79.85％。門診性質、年齡、在同一醫生處就診次數是醫患關繫深度得分的影響因素；醫患關繫深度得分比較全科慢病管理門診患者＞社區門診患者＞專科門診患者，在同一醫生處就診次數越高，醫患關繫深度得分也越高。結論醫患關繫深度量錶的信、效度良好，受門診性質、患者年齡、在同一醫生處就診次數的影響，可用于評估我國各類醫療機構（尤其是初級衛生保健部門，比如門診或社區衛生服務機構）的醫患關繫水平，我國的全科醫生和政策製定者們應該更加意識到“連續性照顧”的重要性，瞭解到全科醫學在改善醫患關繫和促進衛生保健質量方麵的重要作用。
목적：평개문진의환관계심도량표적신、효도，병진일보탐토문진의환관계심도적영향인소，위해량표재아국의료궤구적응용제공의거。방법선취2013년6월—2014년2월재북경시모종합성의원소속적전과문진、사구문진화전과만병관리문진취진적1042례환자。채용연구조번역한화적“의환관계심도량표”화자행설계적일반정황조사표진행현장조사，병대기중67례환자진행중측신도조사。의환관계심도영향인소분석채용다원선성회귀분석。결과의환관계심도량표적Cronbach′sα위0.931，중측신도계수r위0.988，종8개조목중가제취2개인자，가해석총변이적79.85％。문진성질、년령、재동일의생처취진차수시의환관계심도득분적영향인소；의환관계심도득분비교전과만병관리문진환자＞사구문진환자＞전과문진환자，재동일의생처취진차수월고，의환관계심도득분야월고。결론의환관계심도량표적신、효도량호，수문진성질、환자년령、재동일의생처취진차수적영향，가용우평고아국각류의료궤구（우기시초급위생보건부문，비여문진혹사구위생복무궤구）적의환관계수평，아국적전과의생화정책제정자문응해경가의식도“련속성조고”적중요성，료해도전과의학재개선의환관계화촉진위생보건질량방면적중요작용。
Objective To assess the reliability and validity of Patient -Doctor Depth-of-Relationship Scale , and to further investigate the influencing factors for the depth of patient -doctor relationship in clinic department , in order to provide references for the application of the scale in medical settings in China .Methods We enrolled 1 042 patients who received treatment in a special outpatient department , a community clinic and a general practice clinic of chronic disease management of a comprehensive hospital in Beijing .Site investigation was conducted using Patient -Doctor Depth -of -Relationship Scale in Chinese and self -designed questionnaire about general condition .Survey of test -retest reliability was conducted with 67 subjects.Multiple linear regression analysis was employed to analyze the influencing factors for the depth of doctor -patient relation.Results The Cronbach′sαof Patient-Doctor Depth-of-Relationship scale was 0.931, the test-retest reliability r was 0.988.Two factors could be extracted from 8 items and were accountable for 79.85%of total variation.The property of clinic , age and times of visits to the same doctor were influencing factors for the score of the depth of doctor -patient relation.We found the patients of the general practice clinic of chronic disease management had the highest score , followed by the patients of the community clinic and the special outpatient department .More times of visits to the same doctor was associated with higher score of the depth of doctor-patient relationship.Gonclusion Patient-Doctor Depth -of-Relationship Scale has good reliability and validity.The score is influenced by the property of clinic , patients′age, times of visits to the same doctor.The scale could be used to assess doctor -patient relation in various kinds of medical settings ( especially primary health care settings , such as clinics or community health service centers ) .General practitioners and policy makers should attach more importance to"continuity of care"and understand the important role of general practice in the improvement of doctor -patient relation and the quality of health care.
