基于实践理论的社区慢病服务互动价值形成机制研究  

Research on the Interactive Value Formation Mechanism of Community Chronic Disease Services based on Practice Theory

作　　者：唐善阳 阎文蓉 徐坤 陈文 马敬东[1] TANG Shanyang;YAN Wenrong;XU Kun;CHEN Wen;MA Jingdong(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430030,China)

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,湖北武汉430030

出　　处：《中国社会医学杂志》2024年第4期484-488,共5页Chinese Journal of Social Medicine

基　　金：国家自然科学基金项目(7197041017)。

摘　　要：目的探究我国社区慢病服务过程中医患互动产生价值的机制,为我国慢病服务提升与改善提供策略与建议。方法于2023年3-4月期间,使用便利抽样法选取武汉市10家社区卫生服务中心的480名慢病患者作为研究对象。基于实践理论构建互动价值形成的理论模型,采用问卷调查收集慢病患者的患者参与能力、组织服务能力、医患互动实践、患者生活质量等信息。应用SmartPLS 4.0软件建立社区慢病服务互动价值形成模型,分析各因素间的作用机制。结果地区、年龄、职业、学历、月均收入、婚姻状况、医保类型7个人口学变量下的社区慢病服务互动价值形成过程的各维度得分差异具有统计学意义(P<0.05)。患者参与能力(β=0.292)正向影响医患互动实践(P<0.001),组织服务能力(β=0.553)正向影响医患互动实践(P<0.001),医患互动实践(β=0.444)正向影响患者生活质量(P<0.001)。结论患者参与能力、组织服务能力的提升,有利于促进社区慢病患者参与医患互动实践,并不断提高其生活质量。Objective To explore the mechanisms of value generation from doctor-patient interaction in the process of community chronic disease services in China,and to provide strategies and suggestions for the enhancement and improvement of chronic disease services in China.Methods Constructed a theoretical model of interactive value formation based on practice theory.From March to April 2023,a convenient sampling method was used to select 480 chronic disease patients as the study subjects from 10 community health service centers in Wuhan,Hubei province.A questionnaire was used to investigate patient engagement capabilities,organizational service capabilities,doctor-patient interactive practice,and patients'quality of life of chronic disease patients.SmartPLS 4.0 software was applied to establish the interactive value formation model of community chronic disease services and analyze the mechanism of action among the factors.Results There were significant differences(P<0.05)in the scores of the dimensions of the interactive value formation process of community chronic disease services under seven demographic variables:region,age,occupation,education,average monthly income,marital status,and type of health insurance.Patient engagement capabilities(β=0.292)positively affected doctor-patient interactive practices(P<0.001),organizational service capabilities(β=0.553)positively affected doctor-patient interactive practices(P<0.001),and doctor-patient interactive practices(β=0.444)positively affected patients'quality of life(P<0.001).Conclusion The improvement of patient engagement capabilities and organizational service capabilities will facilitate the patients with chronic diseases in the community participate doctor-patient interactive practices and continuously improve their quality of life.

关 键 词：社区慢病服务 医患互动实践 互动价值形成 实践理论 

分 类 号：R197.1[医药卫生—卫生事业管理]