居民视角下家庭医生签约服务医患信任对策探析

摘要

Objective To learn the current doctor-patient trust in contracted service of family physicians in suburban Beijing, and analyze its influencing factors from residents′ perspectives to propose countermeasures. Methods A total of 197 contracted residents were sampled from 12 community health service centers in 4 out of 10 suburb districts of Beijing, for a questionnaire survey using stratified random sampling method. Items of the questionnaire cover residents′knowledge of the family physicians′ contracted service, their trust of family physicians′ competence, and their trust level of the ethics and the influencing factors. Measurement data were calculated form the mean value, while the count data were subject to proportion analysis, frequency description and rank ordering. Results 175(88.8% )and 156(79.2% )of the contracted residents trust the ethics and competence of their family physicians. Whether the ethics trust exists between doctors and patients was decided by if residents′respect, care, and interests considerations taken into account by the physicians; the factors influencing the competence trust of the residents were the age, education of the residents, and whether the physicians display respect, care. Conclusions Upgrading the medical competence and ethical conduct is conducive to the establishment of doctor-patient trust. In the establishment of the family physicians contracted service, it is necessary to improve acceptance of the contracted residents. At the same time, medical ethics issues such as respect for care, privacy protection, and maximum interests of the residents in the process of medical treatment deserve further attention.%目的 了解北京郊区家庭医生签约服务中的医患信任现状,基于居民角度分析其影响因素并提出相应对策.方法 于2017年7—9月,采用分层随机抽样方法,在北京市10个远郊区抽取4个区12家社区卫生服务中心共197名签约居民进行问卷调查.问卷内容主要包括居民对家庭医生签约服务的了解情况、对家庭医生的能力信任和道德信任程度及其影响因素等.对计量资料进行均值测算,对计数资料进行构成比分析、频数描述和顺位排列.结果 签约居民对家庭医生的道德和能力表示信任者分别有175人(88.8% )和156人(79.2% );医患之间道德信任的影响因素是诊疗过程中医方是否给予居民尊重、关爱、利益顾及等; 医患之间能力信任的影响因素是居民的年龄、文化程度以及诊疗过程中医方是否给予居民尊重、关爱等.结论 提升医方的服务能力和道德品行,更有利于医患信任的建立.在推进家庭医生签约服务中,要注重提高签约居民的认知度,同时医方在诊疗过程中对居民尊重、关爱、隐私保护以及最大利益的顾及等伦理问题也不容忽视.