西安三级甲等教学医院临床一线医护人员临床决策能力现状及其影响因素分析  

Analysis on the current situation and influencing factors of clinical decision-making ability of clinical frontline medical staff in Xi'an Grade A teaching hospital

作　　者：韩永燕 王静 任锦芳 刘娇 李亚萌 张飒乐[2] 李英[2] 卫钰 白小丽 HAN Yongyan;WANG Jing;REN Jinfang;LIU Jiao;LI Yameng;ZHANG Sale;LI Ying;WEI Yu;BAI Xiaoli(Disinfection Supply Center,Northwest Women and Children's Hospital,Xi'an,Shaanxi 710061,China;Department of Nursing,School of Medicine,Xi'an Peihua University,Xi'an,Shaanxi 710125,China)

机构地区：[1]西北妇女儿童医院消毒供应中心,陕西西安710061 [2]西安培华学院医学院护理系,陕西西安710125

出　　处：《安徽医药》2024年第3期631-636,共6页Anhui Medical and Pharmaceutical Journal

基　　金：陕西省自然科学基础研究计划(2022JM-597,2023-JC-YB-806);西安培华学院2022年校级科研项目(PHKD2202)。

摘　　要：目的调查西安三级甲等教学医院临床一线医护人员临床决策能力现状,分析其影响因素。方法2021年10—12月,按照随机数字表法选取西安交通大学第一附属医院、西安交通大学第二附属医院和西北妇女儿童医院的507名三级甲等教学医院临床一线医护人员为研究对象,其中医生192名,护士315名。采用一般资料调查表、临床决策量表和综合决策风格量表进行调查研究,回收有效答卷493份。用单因素分析及多元线性回归等方法分析三级甲等教学医院临床一线医护人员临床决策能力影响因素。结果三级甲等教学医院临床一线医护人员临床决策能力总分为(164.40±18.92)分,达到临床决策能力高水平标准(146.68~200.00分)范围。Pearson相关性分析显示:临床决策能力的总得分及各维度的得分结果与理智型决策风格得分结果均呈正相关关系(P<0.05);寻找信息或新信息维度的得分情况与直觉-冲动型决策风格的得分情况呈负相关关系(P<0.05);回避型决策风格与寻找信息或新信息、明确目标和价值、临床决策能力总分、寻找可选择的方案维度等得分均呈负相关关系(P<0.05)。多元线性回归结果显示:理智型决策风格能够正向影响三级甲等教学医院临床一线医护人员临床决策能力,回避型决策风格能够负向影响三级甲等教学医院临床一线医护人员的决策能力(F=8.47,P<0.001,调整后相关指数R2=0.42)。结论三级甲等教学医院临床一线医护人员的临床决策能力总体处于中等偏上水平,理智型决策风格占有主导地位。临床决策能力受理智型和回避型决策风格影响的程度比较大。医疗管理者需要举办针对性培训活动等措施,促使三级甲等教学医院临床一线医护人员理智型决策风格的构建和成长,尽量减少回避型决策风格的影响,从而提高三级甲等教学医院临床一线医护人员的临床决策能力,确保临床Objective To investigate the current situation of clinical decision-making ability of clinical front-line medical staff in Xi'an Grade A teaching hospital and analyze its influencing factors.Methods From October to December 2021,507 front-line clinical medical staff from the third-level A teaching hospitals in the First Affiliated Hospital of Xi 'an Jiaotong University,the Second Affiliated Hospital of Xi' an Jiaotong University and Northwest Women and Children's Hospital were selected as the research objects according to the random number table method,including 192 doctors and 315 nurses.General data questionnaire,clinical decision scale and comprehensive decision style scale were used to investigate and study,and 493 valid questionnaires were collected.The influencing factors of clinical decision-making ability of clinical front-line medical staff in Grade A teaching hospitals were analyzed by single factor analysis and multiple linear regression.Results The total score of clinical decision-making ability of clinical front-line medical staff in third-level A-level teaching hospitals was(164.40±18.92),which reached the high level of clinical decision-making ability standard(146.68-200.00).Pearson correlation analysis showed that the total score of clinical decision-making ability and the scores of each dimension were positively correlated with the scores of rational decision-making style(P < 0.05).The score of seeking information or new information was negatively correlated with the score of intuition-impulse decision-making style(P < 0.05).Avoidant decision-making style was negatively correlated with the scores of seeking information or new information,identifying goals and values,clinical decision-making ability,and finding alternative plan dimensions(P < 0.05).The results of multiple linear regression showed that the rational decision-making style could positively affect the clinical decision-making ability of the clinical front-line medical staff in third-level A-level teaching hospitals,while the avoidance

关 键 词：临床决策 决策风格 影响因素 临床工作者 医院 教学 

分 类 号：R197.32[医药卫生—卫生事业管理]