基于结构方程模型的医学生岗位胜任力与防御性医疗行为倾向的关系研究  

Study on the Relationship between Post Competency and Behavioral Intentions of Defensive Medicine for Medical Students Based on Structural Equation Modeling

作　　者：刘智新 刘俊萍 赵娟 王晨 邹丹丹 李雨泽 冯亚杰 张环宇 王楠 吴琳 刘沼悦 刘欣儒 梁立波[1,6] Liu Zhixin(School of Health Management,Harbin Medical University,Harbin,P.R.China)

机构地区：[1]哈尔滨医科大学卫生管理学院,黑龙江哈尔滨150081 [2]陆军军医大学第一附属医院(西南医院) [3]陆军军医大学第二附属医院(新桥医院) [4]复旦大学附属金山医院 [5]佳木斯大学口腔医学院 [6]国民健康社会风险预警协同创新中心

出　　处：《中国卫生事业管理》2023年第6期471-475,共5页Chinese Health Service Management

基　　金：国家自然科学基金资助项目“多维视域下防御性医疗形成机制及治理策略研究”(71974049)。

摘　　要：目的:了解医学生防御性医疗行为倾向现状,并探索岗位胜任力与防御性医疗行为倾向之间的关系。方法:于2020年6月30日到8月8日对黑龙江省四所医学院校医学生进行网络问卷调查,采用因子分析法提取医学生防御性医疗行为倾向类型,运用Amos 26.0构建医学生岗位胜任力与防御性医疗行为倾向关系的结构方程模型。结果:医学生积极性防御医疗和消极防御性医疗行为倾向平均得分分别为5.18±0.73分和2.97±1.19分。医学生积极防御性医疗行为倾向与医患沟通能力(β=0.673,P<0.001)、临床知识与技能(β=0.144,P<0.001)、职业精神与价值观(β=0.371,P<0.001)成正相关,与自我认知(β=-0.373,P=0.012)成负相关;消极防御性医疗行为倾向与临床知识与技能(β=0.193,P<0.001)成正相关关系,与医患沟通能力(β=-0.303,P<0.001)、职业精神与价值观(β=-0.317,P=0.018)成负相关。结论:医学生积极防御性医疗行为倾向得分高于消极防御性医疗行为倾向得分。医学生岗位胜任力与防御性医疗行为倾向存在相关关系,提升医学生医患沟通能力、职业精神与价值观、自我认知有利于医学生正确认识防御性医疗行为。Objective To understand the status of behavioral intentions of defensive medical treatment in medical students,and explore the relationship between post competency and behavioral intentions of defensive medical treatment.Methods A web-based questionnaire survey was conducted among medical students in four medical colleges in Heilongjiang Province.The types of defen-sive medical treatment among medical students were extracted using exploratory factor analysis.The structural equation modeling of the relationship between post competency and behavioral intentions of defensive medical treatment in medical students was con-structed by Amos 26.0.Results The mean score of medical students'behavioral intentions of positive and negative defensive medi-cal treatment was 5.18±0.73 and 2.97±1.19,respectively.The behavioral intention of positively defensive medical treatment was positively associated with doctor-patient communication skills(β=0.673,P<0.001),clinical knowledge and skills(β=0.144,P<0.001),and professionalism and values(β=0.371,P<0.001),and negatively associated with self-perception(β=-0.373,P=0.012).While the behavioral intention of negative defensive medical treatment was positively correlated with clinical knowledge and skills(β=0.193,P<0.001),and negatively correlated with doctor-patient communication skills(β=-0.303,P<0.001)and professionalism and values(β=-0.317,P=0.018).Conclusion The scores of behavioral intentions of positive defensive medical treatment were higher than those of negative defensive medical treatment in medical students.Post competence is correlated with behavioral intentions of defensive medical treatment in medical students.Improving doctor-patient communication skills,professionalism and values,and self-awareness is beneficial to understand defensive medical treatment for medical students.

关 键 词：医学生 防御性医疗行为倾向 岗位胜任力 结构方程模型 

分 类 号：R-4[医药卫生] G642[文化科学—高等教育学]