上海市浦东新区全科医生的家庭医生信心指数调查

Family Doctor Confidence Index of General Practitioners in Shanghai Pudong New Area

目的了解上海市浦东新区全科医生的家庭医生信心指数情况,为家庭医生工作的进一步推进提供帮助。方法依据城乡差别,将上海市浦东新区划分为城镇地区、城郊结合地区、郊区3类,采用计算机在各区随机抽取3家社区卫生服务中心,共9家社区卫生服务中心,以其全部全科医生为调查对象。2014年10月,采用调查问卷进行调查。问卷根据上海市浦东新区的实际情况结合《中国医学论坛报·全科医学周刊》的家庭医生信心指数调查内容自行设计,主要调查内容包括:对家庭医生工作的关注度、家庭医生执业的主要影响因素、从事家庭医生工作的需求、家庭医生信心指数。结果共发放问卷203份,回收有效问卷201份,有效回收率为99.0%。201例全科医生中,总是关注家庭医生工作的有102例(50.8%),经常关注的有75例(37.3%),偶尔关注的有22例(10.9%),从来没有关注的有2例(1.0%);关于家庭医生执业的主要影响因素,选择收入水平的有69例(34.3%),选择执业环境的有67例(33.3%),选择社会尊重的有21例(10.4%),选择工作压力的有19例(9.5%),选择个人价值实现程度的有18例(9.0%),选择职业晋升空间的有7例(3.5%)。201例全科医生的2014年家庭医生信心指数为(24.65±22.75)分;其中非常失望93例(46.3%),比较失望55例(27.3%),有点失望29例(14.4%),中立8例(4.0%),有点满意5例(2.5%),比较满意4例(2.0%),非常满意7例(3.5%)。2017年家庭医生信心指数为(65.99±20.85)分;其中非常失望3例(1.5%),比较失望19例(9.5%),有点失望15例(7.5%),中立13例(6.5%),有点满意45例(22.3%),比较满意77例(38.3%),非常满意29例(14.4%)。2014年与2017年的家庭医生信心指数比较,差异有统计学意义(P<0.001)。不同单位所在地区的全科医生2014年家庭医生信心指数比较,差异有统计学意义(P<0.001);不同单位所在地区、从事社区卫生服务工作年限、从事家庭医生相关工作年限的全科医生2017年家庭医生信心指数比较,差异有统计学意义(P<0.01)。所有类别的全科医生2014年与2017年家庭医生信心指数组内比较,差异均有统计学意义(P<0.001)。结论上海市浦东新区全科医生2014年家庭医生信心指数较低,可能与目前的收入水平、执业环境有关;2017年家庭医生信心指数提高。

Objective To investigate the family doctor confidence index of general practitioners（ GPs） in Shanghai Pudong New Area,in order to provide further support for the work of family doctors. Methods According to the differences between urban and rural areas,Shanghai Pudong New Area was divided into three parts,namely urban area,urban- suburb area,and suburb area. Computer was used to randomly select three community health service centers from each area,with totally9 community health service centers selected and all GPs as subjects. In October 2014,questionnaire survey was conducted. The questionnaire was designed based on the actual condition of Shanghai Pudong New Area and the content about family doctor confidence index in China Medical Tribune General Practice weekly. The content of the questionnaire included the concern with family doctor service,the major influencing factors for the practice of family doctors,the demands in the occupation of family doctor service,and family doctor confidence index. Results A total of 203 questionnaires were distributed,and 201 effective questionnaires were returned with an effective recovery rate of 99. 0%. Among 201 GPs,102（ 50. 8%） were always concerned with family doctor service,75（ 37. 3%） were often concerned with that,22（ 10. 9%） were occasionally concerned with that,2（ 1. 0%） had never been concerned with that. As for the major influencing factors for family doctor service,69（ 34. 3%）chosed income level,67（ 33. 3%） chosed working environment,21（ 10. 4%） chosed social respect,19（ 9. 5%） chosed work pressure, 18（ 9. 0%） chosed the degree of personal value realization, and 7（ 3. 5%） chosed space for career promotion. In 2014,the average family doctor confidence index of the 201 GPs was（ 24. 65 ± 22. 75）,and among these GPs,93（ 46. 3%） were very disappointed,55（ 27. 3%） were disappointed,29（ 14. 4%） were a bit disappointed,8（ 4. 0%）had neutral attitude,5（ 2. 5%） were a bit satisfied,4（ 2. 0%） were satisfied,and 7（ 3. 5%） were very satisfied. In 2017,the average family doctor confidence index of the 201 GPs was（ 65. 99 ± 20. 85）,and among these GPs,3（ 1. 5%） were very disappointed,19（ 9. 5%） were disappointed,15（ 7. 5%） were a bit disappointed,13（ 6. 5%） had neutral attitude,45（ 22. 3%） were a bit satisfied,77（ 38. 3%） were satisfied,and 29（ 14. 4%） were very satisfied. There were significant differences in family doctor confidence index between 2014 and 2017（ P〈0. 001）. In 2014,GPs of work settings in different places were significantly different in family doctor confidence index（ P〈0. 001）. In 2017,GPs of working settings in different places,working years in community health service center,and working years as family doctors were significantly different in family doctor confidence index（ P〈0. 01）. There was significant difference in family doctor confidence index of each category between 2014 and 2017（ P〈0. 001）. Conclusion GPs in Shanghai New Pudong Area had low family doctor confidence index in 2014,which may be related with the current income level and working environment. The family doctor confidence index of 2017 had an increase.