中医医生职业承诺量表的结构模型评价研究

Structure Validity of an Occupational Commitment Scale for Traditional Chinese Medical Practitioners

目的确立中医医生的职业承诺结构模型。方法通过访谈（18例）、开放式问卷（67例）等方法，编制职业承诺问卷；对324名中医医生进行预测，采用探索性因子分析对条目进行优化和因子提取，修订得到正式问卷；重新选取507名中医医生进行正式测试，通过对数据进行验证性因子分析（结构方程模型），对问卷结构进行模型验证，考察问卷结构效度；以转职意愿为效标，检验问卷的实证效度；问卷信度采用内部一致性系数检验。结果探索性因子分析构建了4个维度共13个条目组成的中医医生职业承诺问卷，4个公因子的累积方差贡献率达61．437％，各条目的因子负荷在0．591～0．861之间；验证性因子分析各项拟合度指标x。／dr、近似误差均方根（RMSEA）、拟合优度指数（GFI）、非范拟合指数（NNFI）、比较拟合指数（CFI）、省俭规范拟合指数（PNFI）分别为1．79、0．039、0．97、0．97、0．98、0．72；转职意愿与职业承诺各维度均呈显著性负相关关系（P〈0．01）；问卷及其各维度的Cronbach’s α系数在0．602～0．847之间。结论中医医生的职业承诺为四维结构，包括情感认同承诺、限制选择承诺、专业效能承诺和职业风险承诺；中医医生职业承诺问卷具有较好的信度和效度。

Objective To test the structure validity of an occupational commitment scale for traditional Chinese medical （TCM） practitioners. Methods Based on in-depth interviews with 18 TCM practitioners and an open-ended questionnaire survey of 67 TCM practitioners, an occupational commitment scale was developed. The questionnaire was tested in 324 TCM practitioners and revised after an exploratory factor analysis （EFA）. The revised questionnaire was tested again in another 507 TCM practitioners. A measurement model （structural equation model） by confirmation factor analysis （CFA） was used to confirm the construct validity of the questionnaire. The occupational change intention was used to verify the criterion-related validity of the questionnaire. The reliability of the questionnaire was tested with Cronbach＇ s a coefficient. Results The EFA indicated that the occupational commitment scale consisted of four components from 13 items. The cumulative contribution Of the four components reached 61. 437%. The factor loading of each item attached to the relevant common factor ranged from 0. 591 to 0. 861. The CFA indicated a good fit of construct, with 1.79, 0. 039, 0.97, 0.97, 0.98, and 0.72 fit index for x^2 dr, RMSEA, GFI, NNFI, CFI, and PNFI respectively. The occupational change intention correlated with the componets of occupational commitment negatively （P〈0.01）. The Cronbach＇s α coefficients of the questionnaire and the four components ranged from 0. 602 to 0. 847. Conclusion The occupational commitment scale for TCM practitioners has a valid structure of four dimensions, measuring affective commitment, limited alternatives commitment, professional self-efficacy commitment and occupational risk commitment. The questionnaire is valid and reliable.