以丁香园为例探讨医学知识社交平台成员参与行为的影响因素及对处方决策的影响

Influencing Factors of Participative Behaviors of Members in Social Platforms for Medical Knowledge Discussion and Its Effects on Prescription Decision:a Case Study of Lilac Garden

目的了解医学知识社交平台成员行为与医生处方参与行为之间的关系,为促进医生更加合理的处方行为与医学知识社交平台更好的发展提供参考。方法 2015年1—5月,根据相关文献和专家咨询,设计《医学知识社交平台参与行为调查问卷——丁香园》。采取网上与现场调查相结合的方式,在丁香园中发布调查问卷,同时,在无锡市第二人民医院对医生发放调查问卷200份。结果共回收有效问卷207份。问卷整体Cronbach'sα系数为0.908,各分量表Cronbach'sα系数分别为0.920、0.934、0.849、0.917。因子分子提取4个公因子,特征根分别为20.517、8.262、1.855、1.281,累积方差贡献率为99.736%。Pearson相关性分析显示,个体动机功能评分与解决制定处方方案中的问题、情感沟通、医药产品宣传与交易、商业医药信息的传播评分呈正相关,个体动机社交评分与情感沟通、获得最新医药知识、医药产品宣传与交易、商业医药信息的传播评分呈正相关,个体动机心理、社交平台的认同感、社区的专业水平、成员需求的实现、社区效用评分与各社区行为评分均呈正相关,个体动机娱乐评分与情感沟通评分呈正相关,个体动机情感评分与医药产品宣传与交易、商业医药信息的传播评分呈正相关(P<0.05)。结构方程模型显示,解决制定处方方案中的问题、情感沟通、获得最新医药知识、医药产品宣传与交易、商业医药信息的传播对处方方案的改变有正向影响(路径系数分别为0.20、0.20、0.16、0.20、0.20),处方方案的改变对更合理的处方行为有正向影响(路径系数为1.00)。结论需加强医学知识社交平台的管理与资源整合,引导医学知识社交平台成员的动机,增强医学知识社交平台成员的归属感,以使医生的处方行为更加合理,医学知识社交平台获得更好的发展。

Objective To understand the relationship between the participative behaviors of members in social platforms of medical knowledge and prescription behaviors of doctors,and to provide references for promoting more rational prescribing practices and better development of social platforms of medical knowledge.Methods From January to May in 2015,according to relevant literatures and expert consultation,the Participative Behaviors in Social Platforms of Medical Knowledge Questionnaire-Lilac Garden was designed.With a combination of online and field investigation,the questionnaires were released in the Dingxiangyuan website,at the same time,200 questionnaires were sent to doctors in Wuxi No.2 People′s Hospital.Results A total of 207 questionnaires were valid.The overall Cronbach ′s α coefficient of the questionnaire was 0.908,the Cronbach′s α coefficients of the subscales were 0.920,0.934,0.849,0.917 respectively.Four common factors were extracted from the factor analysis,the characteristic roots were 20.517,8.262,1.855,and 1.281 respectively,and the variance ratio of accumulated explanation was 99.736%.Pearson correlation analysis showed that the scores of individual motivation for function were positively correlated with the scores of solving the problems of formulating prescription plan,emotional communication,publicity and trading of pharmaceutical products and the spread of commercial medical information（P〈0.05）.The scores of individual motivation for social contact were positively correlated with the scores of emotional communication,accessing to the latest medical knowledge,the publicity and trading of pharmaceutical products and the spread of commercial medical information（P〈0.05）.The scores of individual motivation for psychological factor,sense of identity in social platforms,professional level of the community,the realization of members′ needs,community utility were positively correlated with the scores of each community behavior.The scores of individual motivation for recreation were positively correlated with emotional communication score.There was a positive correlation between the scores of individual motivation for emotion and the scores of the publicity and trading of pharmaceutical products and the spread of commercial medical information （P〈0.05）.Structural equation model showed that solving the problems of formulating prescription plan,emotional communication,accessing to the latest medical knowledge,the publicity and trading of pharmaceutical products and the spread of commercial medical information had a positive impact on the changes of the prescription plan （path coefficients were 0.20,0.20,0.16,0.20,0.20 respectively）,the changes of the prescription plan had a positive effect on more rational prescription behaviors （path coefficient=1.00）.Conclusion In order to make doctors′ prescription behavior more rational and social platform of medical knowledge better,we should strengthen the management and resource integration of social platform of medical knowledge,guide the motivation of members in the platform,and enhance the sense of belonging of them.