医方因素对医患关系和谐程度的影响——基于黑龙江省27家公立医院的调查

Analysis of medical staff perspective factors influencing a harmonious doctor-patient relationship: Based on 27 public hospitals of Heilongjiang province

目的：以黑龙江公立医院为例,了解医方视角下对医患关系和谐程度的认知。方法：选取黑龙江省5市15家市级公立医院及各市所辖的12家县级公立医院员工进行现场问卷调查,共收回有效问卷1 737份,利用SPSS18.0软件进行描述统计和logistics回归分析。结果：认为医患关系非常和谐的仅为8.2%,三级医院和二级医院对不和谐的认知分别为58.1%与53%。平均每天在岗时间超过8小时的员工对医患和谐程度的评价偏低（95%CI 1.385-2.138）;认为身边同事经常会出现药品回扣现象的员工对医患和谐认知更低（95%CI 1.050-1.720）。结论：公立医院员工对医患关系和谐程度认知整体偏低,其中三级医院最为显著;在岗时间、开回扣药品、认为政府投入不足等是医患和谐程度的影响因素。改善医疗执业环境,增进医患沟通与医德医风的建设,有助于提升和谐医患关系。

Objective： To measure the medical staff perspective factors influencing a harmonious doctor-patient relationship based on 27 public hospitals of Heilongjiang province. Methods： A total of 15 municipal public hospitals and 12county-level public hospitals staff were investigated. Investigation was conducted based on 5 cities of Heilongjiang province and a total of 1737 valid questionnaires were collected. All analysis was performed using SPSS18. 0 Software for descriptive statistics and binary logistic regression analysis. Results： A harmonious doctor-patient relationship was only 8. 2% as per medical staff perspective. Tertiary and secondary hospitals of the proportions of cognitive dissonance were 58. 1% and 53%respectively. Staff whose average daily working time were more than 8 hours were more likely to consider as low the doctorpatient harmony degree（ 95% CI 1. 385 ~ 2. 138）. The coworkers who less receive kickback of drugs consider the doctorpatient harmony were better than those who often receive kickback of drugs（ 95% CI 1. 050 ~ 1. 720）. In addition,gender and the lack of government investment also affected the degree of cognitive harmonious doctor-patient relationship.Conclusion： The doctor-patient relationship in public hospitals was generally poor especially in tertiary hospitals. The working time,lack of government investment and other factors were the factors affecting the degree of harmony between doctors and patients. Improving the medical practice environment,doctor-patient communication and promotion of medical ethics may provide a help to improve the harmony of the doctor-patient relationship.