杭州市基层医疗卫生机构慢性颈肩痛患者社区中医师信任度调查

Study on the Trust Degree on Community Traditional Chinese Medicine Practitioners from Patients with Chronic Neck and Shoulder Pain in Primary Healthcare Institutions in Hangzhou City

目的:了解杭州市基层医疗卫生机构慢性颈肩痛患者对社区中医师的信任度及影响因素。方法:采用自制基线调查表、维克森林医师信任度量表中文版、自制满意度量表和长海痛尺表对杭州市3家社区中的244名慢性颈肩痛患者开展信任度调查。用t检验和方差分析比较差异,采用多元线性逐步回归分析信任度得分的影响因素。结果:社区中医师平均信任度得分为(39.59±3.23)分,仁爱维度、技术能力维度得分分别为(19.32±1.96)分、(20.27±1.61分)。多因素分析结果显示,随访是否有效、文化程度、自我健康状况评分、满意度评价、中医体质以及长海痛尺评分影响对医生的信任度。结论:杭州市基层卫生机构慢性颈肩痛患者对社区中医师总体信任度处于较高水平。社区中医师要加强医学人文关怀,积极引导患者参与到诊疗过程中,重视和提高慢性病患者随访时的技术水平和关怀程度。基层医疗卫生机构应当进一步完善诊后随访流程,加大慢性病中医健康管理优势的宣传,树立分级诊疗意识,完善诊疗环境建设,形成医患信任关系的良好循环。

Objective To investigate the trust degree of patients with chronic neck and shoulder pain on community traditional Chinese medicine practitioners in primary healthcare institutions in Hangzhou City and its influencing factors.Methods A baseline survey,the Chinese version of Wake Forest Physician Trust Scale,a self-designed satisfaction scale,and the Chang-Hai Pain Scale were used to conduct a trust survey among 244 patients with chronic neck and shoulder pain in three communities in Hang⁃zhou City.Methods of t-test and analysis of variance were used to compare the differences,and multiple linear stepwise regres⁃sion analysis was conducted to identify the factors influencing trust scores.Results The average trust score for community tradition⁃al Chinese medicine doctors was(39.59±3.23)points,and the score of dimensions of benevolence,technical ability was(19.32±1.96)and(20.27±1.61),respectively.The results of multiple factor analysis showed that the effectiveness of follow-up visits,educational level,self-rated health status,satisfaction evaluation,traditional Chinese medicine constitution,and Chang-Hai Pain Scale scores influenced the trust on doctor.Conclusion Patients with chronic neck and shoulder pain in primary healthcare institutions in Hangzhou City had a relatively high trust degree on community traditional Chinese medicine practitioners.Community doctors should enhance their medical humanities care,actively guide patients in the diagnosis and treatment process,and value and improve the technical level and caring attitude during follow-up visits for chronic disease patients.Primary health⁃care institutions should further improve the follow-up process after diagnosis,intensify the publicity of the advantages of tradition⁃al Chinese medicine in chronic diseases management,foster the awareness of tiered diagnosis and treatment,improve the environ⁃ment for diagnosis and treatment,and establish a positive cycle of trust between doctors and patients.