执业环境与医学生防御性医疗行为倾向关系研究  

Study on the Correlation between Practice Environment and Behavioral Intentions of Defensive Medicine for Medical Students

作　　者：周玥 张环宇 王晨 邹丹丹 刘伟 王楠 刘雅萍 梁立波[1] Zhou Yue;Zhang Huanyu;Wang Chen;Liang Libo(School of Health Management,Harbin Medical University,Harbin,Heilongjiang,150081,China;不详)

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]重庆市妇幼保健院,重庆401147 [3]复旦大学附属金山医院,上海201508

出　　处：《中国医院管理》2024年第7期16-20,共5页Chinese Hospital Management

基　　金：国家自然科学基金项目(71974049,71673073,72274047)。

摘　　要：目的了解医学生防御性医疗行为倾向现状,并探索执业环境与防御性医疗行为倾向之间的关系,为降低医学生防御性医疗行为倾向及改善防御性医疗产生的负面影响提供参考依据。方法选取黑龙江省4所医学院校的医学生开展网络问卷调查,采用Amos 26.0软件构建医学生执业环境与防御性医疗行为倾向关系的结构方程模型。结果医学生积极防御医疗行为倾向和消极防御性医疗行为倾向平均得分分别为(44.49±6.90)和(20.06±6.83)分。医学生积极防御性医疗行为倾向与医患关系认知呈正相关(β=0.892,P<0.05);消极防御性医疗行为倾向与环境认知、风险认知呈正相关(β=0.403、0.343,P<0.05),与医患关系认知呈负相关(β=-0.726,P<0.05)。风险认知作为中介变量,医患关系认知对消极防御性医疗行为倾向产生的直接效应与间接效应分别为-0.470和0.043,差异有统计学意义(P<0.05)。结论提升医学生医患关系认知有利于医学生正确认识防御性医疗行为。通过降低医学生对环境的消极认知或改善医学生对医患关系的认知来降低医学生消极防御性医疗行为倾向。Objective To understand the status of behavioral intentions of defensive medical treatment in medical students,and explore the relationship between practice environment and behavioral intentions of defensive medical treatment.To provide reference for reducing the tendency of defensive medicine(DM)behavior of medical students and improving the negative effects of DM.Methods A web-based questionnaire survey was conducted among medical students in four medical colleges in Heilongjiang Province.The structural equation modeling of the relationship between practice environment and behavioral intentions of defensive medical treatment in medical students was constructed by Amos 26.0 software.Results The mean score of medical students'behavioral intentions of positive and negarive defensive medical treatment was 44.49±6.90 and 20.06±6.83,respectively.The behavioral intention of positively defensive medical treatment was positively associated(β=0.892,P<0.05)with cognition of doctor-patient relationship.While the behavioral intention of negative defensive medical treatment was positively correlated(β=0.403,0.343,P<0.05)with environment cognition,perception of risk and negatively correlated(β=-0.726,P<0.05)with cognition of doctor-patient relationship.As an intermediary variable,the direct and indirect effects of cognition of doctor-patient relationship on negative defensive medical behavior tendency were-0.470 and 0.043,the difference was statistically significant(P<0.05).Conclusion Improving cognition of medical students'doctor-patient relationship is beneficial to understand defensive medical treatment for medical students.The negative defensive medical behavior tendency of medical students should be reduced by reducing their negative cognition of environment or improving their cognition of doctor-patient relationship.

关 键 词：医学生 防御性医疗 执业环境 结构方程模型 

分 类 号：R197.3[医药卫生—卫生事业管理]