| 韩永燕,王静,任锦芳,等.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[J].安徽医药,2024,28(3):631-636. |
| 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 |
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| DOI：10.3969/j.issn.1009-6469.2024.03.045 |
| 中文关键词: 临床决策 决策风格 影响因素 临床工作者 医院，教学 |
| 英文关键词: Clinical decision-making Decision-making style Influence factor Clinical worker Hospitals, teaching |
| 基金项目: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) |
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| 中文摘要: |
| 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，确保临床工作的安全性。 |
| 英文摘要: |
| 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 Affiliat.ed Hospital of Xi' an Jiaotong University and Northwest Women and Children's Hospital were selected as the research objects accord.ing to the random number table method, including 192 doctors and 315 nurses. General data questionnaire, clinical decision scale andcomprehensive decision style scale were used to investigate and study, and 493 valid questionnaires were collected. The influencingfactors of clinical decision-making ability of clinical front-line medical staff in Grade A teaching hospitals were analyzed by single fac. tor 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 stan. dard (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-mak. ing style was negatively correlated with the scores of seeking information or new information, identifying goals and values, clinical deci.sion-making ability, and finding alternative plan dimensions (P < 0.05). The results of multiple linear regression showed that the ratio. nal 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 decision-making style could negatively affect the decision-making ability of clinical front-line medical staff in third-level A-level teaching hospitals (F=8.47, P < 0.01, adjusted correlation index R2=0.42). Conclusions The clinical decision-making ability of the clinical front-line medical staff in the third-grade A teaching hospital is generally above the average level, and the rational decision-making style occupies a dominant position. The clinical decision-making ability is greatly af. fected by the intellectual and avoidant decision-making styles. Medical managers need to organize targeted training activities and othermeasures to promote the construction and growth of the rational decision-making style of clinical front-line medical staff in third-level A-level teaching hospitals, minimize the influence of avoidant decision-making style, so as to improve the clinical decision-making abil. ity of clinical front-line medical staff in third-level A-level teaching hospitals and ensure the safety of clinical work. |
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