CAJ | 학술논문

目的：了解医患双方对医患关系的认知差异，为构建和谐的医患关系提供针对性的政策建议。方法根据地域和经济发展水平，选取上海、武汉及合肥3个城市为调查现场；采用单纯随机抽样，在每个城市分别选取二、三级医疗机构各1家；采用整群随机抽样方法选取医务人员1300名和患者1500名为调查对象。于2014年7—10月，采用现场问卷调查的方法，调查问卷内容主要为医患双方的一般情况、对医患关系的认知情况。回收医务人员有效问卷1172份、患者有效问卷1390份，有效回收率分别为90.2%和92.7%。结果医务人员认为医患关系的紧张度高于患者，医患双方对医患关系总体状况的认知间差异有统计学意义（ P<0.05）。对于医患关系的影响因素，患者认同率排名前三位的依次是服务态度、医疗环境、医德医风；医务人员认同率排名前三位的依次是服务流程、服务态度、医疗环境；双方认同率最低的都是文化教育。除医疗环境、收费价格外，医患双方对医患关系影响因素的认同率间差异有统计学意义（ P<0.05）。结论医患双方对医患关系的认知存在差异，客观评价和充分重视医患双方的认知差异性是建立和谐医患关系的基础；建议建立健全的医疗体制，优化医疗环境；加强医方职业修养，提高患方文化素质；加强医患沟通，提高服务水平。
목적：료해의환쌍방대의환관계적인지차이，위구건화해적의환관계제공침대성적정책건의。방법근거지역화경제발전수평，선취상해、무한급합비3개성시위조사현장；채용단순수궤추양，재매개성시분별선취이、삼급의료궤구각1가；채용정군수궤추양방법선취의무인원1300명화환자1500명위조사대상。우2014년7—10월，채용현장문권조사적방법，조사문권내용주요위의환쌍방적일반정황、대의환관계적인지정황。회수의무인원유효문권1172빈、환자유효문권1390빈，유효회수솔분별위90.2%화92.7%。결과의무인원인위의환관계적긴장도고우환자，의환쌍방대의환관계총체상황적인지간차이유통계학의의（ P<0.05）。대우의환관계적영향인소，환자인동솔배명전삼위적의차시복무태도、의료배경、의덕의풍；의무인원인동솔배명전삼위적의차시복무류정、복무태도、의료배경；쌍방인동솔최저적도시문화교육。제의료배경、수비개격외，의환쌍방대의환관계영향인소적인동솔간차이유통계학의의（ P<0.05）。결론의환쌍방대의환관계적인지존재차이，객관평개화충분중시의환쌍방적인지차이성시건립화해의환관계적기출；건의건립건전적의료체제，우화의료배경；가강의방직업수양，제고환방문화소질；가강의환구통，제고복무수평。
Objective To investigate the differences of cognition on doctor-patient relationship between medical staff and patients and put forward corresponding policy recommendations on how to construct a harmonious doctor - patient relationship. Methods Based on regional representativeness and economic level,we selected Shanghai,Wuhan and Hefei to conduct the investigation. Using simple random sampling method,we selected a first-grade medical setting and a third-grade medical setting from each city. Using cluster random sampling method,1 300 medical staff and 1 500 respondents were enrolled from the included medical settings. From July to October 2014,on-site questionnaire survey was conducted. The questionnaire content mainly included subjects' general condition and their cognition on doctor -patient relationship. The number of effective returned questionnaires was 1 172 from medical staff and 1 390 from patients,and the effective recovery rates were 90. 2% and 92. 7% respectively. Results The tensity of doctor-patient relationship evaluated by doctors was higher than that evaluated by patients;difference of cognition on doctor-patient relationship between medical staff and patients was significant ( P<0. 05 ). As for the influencing factors for doctor-patient relation,the first three factors with the highest choosing rates by patients were service attitude,medical environment and medical morality,the first three factors with the highest choosing rates by doctors were service process,service attitude,and medical environment,and the factor with the lowest choosing rate by both patients and medical staff was education level. Apart from medical environment and expenses,other influencing factors for doctor -patient relationship were significantly different in the choosing rate between medical staff and patients ( P <0. 05 ) . Conclusion Difference exists between medical staff and patients in their cognition on doctor-patient relationship. Objective evaluation and full attention to the cognitive differences between medical staff and patients are the foundation for building a harmonious doctor -patient relationship. So our advise is to establish and improve the medical system, optimize medical environment, strengthen medical staff' professional accomplishment,raise patients' cultural quality,strengthen the doctor -patient communication and raise the service level.