基于广州市某三甲医院医生视角的医患关系及防御性医疗行为研究  

Study on Doctor-Patient Relationship and Doctors’Defensive Medical Behavior from Doctors’Perspective in a Tertiary Hospital with Level 3 in Guangzhou

作　　者：周晓莹 黎莉 姚卫光 Zhou Xiaoying(School of Health Management,Southern Medical University,Guangzhou,510515)

机构地区：[1]南方医科大学卫生管理学院,广州510515 [2]南方医科大学教学发展中心,广州510515

出　　处：《医学与社会》2020年第4期109-113,共5页Medicine and Society

基　　金：广州市公共卫生服务体系建设重点研究基地资助项目。

摘　　要：目的:探讨医生自身行为、负面舆论报道对医生医患关系评价及防御性医疗行为的影响。方法:基于归因理论构建结构方程模型,通过方便抽样法对广州市某三级甲等医院的207名在职医生进行问卷调查,使用SPSS 20.0和AMOS 24.0对数据进行信度检验,并验证概念模型中的研究假设。结果:医生行为对医患关系评价及医生采取防御性医疗行为均无显著性影响(P>0.05);负面舆论报道对医患关系评价有显著性影响(β=-0.27,P<0.01),对医生采取防御性医疗行为也有显著性影响(β=0.24,P<0.01)。结论:易受负面舆论报道影响的医生,会更消极地看待当前医患关系,也更倾向于采取防御性医疗行为。医院管理者应重视医生的心理健康,引导医生改变固有的服务理念;相关卫生管理部门应尽快完善医疗保险制度,努力为医生营造和谐的诊疗环境。Objective:To investigate the effects of doctors’behavior and negative public opinion on doctor-patient relationship and defensive medical behavior.Methods:Based on the attribution theory,a structural equation model was constructed.A questionnaire survey was conducted on 207 doctors in a tertiary hospital with level 3 in Guangzhou by cluster random sampling method.Using SPSS 20.0 and AMOS 24.0 software to test the reliability of the data and verifying the research hypothesis in the conceptual model.Results:Doctors’attitudes and doctor-patient relationship had no significant impact on doctors’defensive medical behavior(P>0.05).Negative public opinion had significant impact on doctor-patient relationship(β=-0.27,P<0.01).Negative public opinion had significant impact on doctors’defensive medical behavior(β=0.24,P<0.01)Conclusion:Doctors who are more affected by negative public opinion have a more pessimistic view of the current doctor-patient relationship,and they are more inclined to take defensive medical behavior.Hospital administrators should pay attention to the mental health of doctors,and guide doctors to change the inherent service concept.Relevant health management departments should improve the medical insurance system as soon as possible,and create a harmonious medical environment for doctors.

关 键 词：医患关系 防御性医疗行为 医生 归因理论 

分 类 号：R197.323[医药卫生—卫生事业管理]