健康教育能力对临床医学本科生支持性沟通能力和一般自我效能感关系的中介作用研究

Mediating role of health education competency in the relationship between supportive communication and general self-efficacy among medical undergraduates

目的探讨影响临床医学本科生支持性沟通能力的因素,并提出提升这种能力的策略。方法采用整群抽样法,选取哈尔滨医科大学2017和2018级临床医学专业388名本科生作为研究对象,进行支持性沟通能力、一般自我效能感及健康教育能力问卷调查。应用SPSS 22.0进行描述性统计分析,并使用AMOS 22.0构建结构方程模型,验证三者之间的关系,同时进行中介效应检验。结果临床医学本科生支持性沟通能力较好,总分为(74.28±10.84),一般自我效能感得分为(27.81±5.58),健康教育能力总得分为(25.50±4.76)。一般自我效能感对支持性沟通能力和健康教育能力存在直接正向作用(β=0.75,P<0.001;β=0.31,P<0.001),健康教育能力对支持性沟通能力有直接正向作用(β=0.14,P<0.001)。健康教育能力在一般自我效能感影响支持性沟通能力中发挥显著的中介作用(标准化后中介效应值为0.042,P<0.01),中介效应占比为5.1%。结论临床医学本科生健康教育能力能够中介一般自我效能感对支持性沟通能力的作用路径。可以通过加强医学人文教育,提高一般自我效能感,同时重视培养健康教育能力,以实现对临床医学专业本科生支持性沟通能力的提升。

Objective To explore the factors influencing the supportive communication ability of medical undergraduates,and to propose strategies to improve supportive communication.Methods By cluster sampling,we selected 388 medical undergraduates of grades 2017 and 2018 from Harbin Medical University for a questionnaire survey on supportive communication,general self-efficacy,and health education abilities.SPSS 22.0 was used for descriptive statistical analysis.AMOS 22.0 was used to construct a structural equation model to verify the relationship between the three variables.Mediating effects were also tested.Results The students showed good supportive communication ability,with a total score of(74.28±10.84)points.The general self-efficacy score was(27.81±5.58)points,and the total score of health education ability was(25.50±4.76)points.General self-efficacy had direct positive effects on supportive communication and health education abilities(β=0.75,0.31,both P<0.001).Health education ability had a direct positive effect on supportive communication ability(β=0.14,P<0.001).Health education ability played a significant mediating role in the influence of general self-efficacy on supportive communication ability(standardized mediating effect value=0.042,P<0.01),with the mediating effect accounting for 5.1%.Conclusions The health education competency of medical undergraduates can mediate the effect of general self-efficacy on supportive communication ability.By strengthening medical humanities education to increase general self-efficacy and also emphasizing the cultivation of health education competency,the supportive communication ability of students can be improved.