新疆基层全科医生岗位胜任力现况调查及影响因素分析

沙玛·木拉提; 陈红; 迪丽菲亚·地力夏提; 徐培兰

doi:10.16766/j.cnki.issn.1674-4152.003121

新疆基层全科医生岗位胜任力现况调查及影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003121

1.
新疆医科大学公共卫生学院，新疆乌鲁木齐 830017
2.
新疆第二医学院党院办，新疆克拉玛依 834000

基金项目:

新疆维吾尔自治区自然科学基金项目 2022D01A134

详细信息

通讯作者:
徐培兰，E-mail：771574491@qq.com

中图分类号: R192.3 R499
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- 被引次数: 0
出版历程
- 收稿日期: 2022-12-05

Survey on the competence of general practitioners in Xinjiang and analysis of influencing factors

1.
School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang 830017, China

摘要

摘要: 目的了解新疆基层全科医生岗位胜任力现况并分析影响因素，为强化新疆基层全科医生岗位胜任力提供理论参考。方法采用问卷调查法于2022年4—6月在新疆地区随机抽取645名在职基层全科医生以自评方式考察岗位胜任力情况，采用χ²检验、t检验和方差分析对全科医生岗位胜任力自评结果进行分析，用线性回归分析法探讨岗位胜任力的影响因素。共发放658份问卷，筛除缺陷卷后共收回645份有效问卷，回收率为98.02%。结果不同地区全科医生年龄、学历、职称、工作年限、所在机构类别差异有统计学意义(均P < 0.05)；新疆基层全科医生岗位胜任力自评总均分为(51.09±15.24)分，处于中等水平；昌吉州全科医生岗位胜任力较好得分最高[(55.15±16.53)分]，其次是塔城地区[(54.11±16.53)分]；不同性别(P < 0.001)、不同学历(P=0.028)、不同工作年限(P=0.007)、不同类别医疗机构(P=0.027)的全科医生岗位胜任力自评得分差异有统计学意义；新疆基层全科医生岗位胜任力受性别和所在机构类别的影响(P < 0.01)。结论新疆基层全科医生岗位胜任力还有很大的提升空间，留住现有人才扩充全科医生队伍，基于区情同质化发展基层医疗机构，改善执业环境，开展针对性的培训重点提升全科医生的人文执业能力，强化基本医疗和公共卫生服务能力。
- 全科医生 /
- 岗位胜任力 /
- 影响因素 /
- 新疆
Abstract: Objective To investigate the current position competence of grassroots general practitioners (GPs) in Xinjiang and analyze the major influencing factors, so as to provide theoretical reference for strengthening the positional competence of grassroots GPs in Xinjiang. Methods A total of 645 in-service primary care physicians in Xinjiang were randomly selected by questionnaire survey from April to June 2022. The results of post-competence were analyzed by χ² test, t-test and variance analysis, and the influencing factors of post-competence were explored by linear regression analysis. A total of 658 questionnaires were sent out in this survey, and 645 valid questionnaires were collected after the screening of defective papers, with a recovery rate of 98.02%. Results There were statistically significant differences in age, education, professional title, years of practice and institution category of general practitioners in different regions (all P < 0.05). The total post-competence self-assessment score of grassroots general practitioners in Xinjiang was (51.09±15.24) points, which was at the medium level; Changji Prefecture had the highest competency score [(55.15±16.53) points], followed by Tacheng district [(54.11±16.53) points]. There were statistically significant differences in the self-assessed post-competence scores of general practitioners between different genders (P < 0.001), different educational backgrounds (P=0.028), different working years (P=0.007) and different categories of medical institutions (P=0.027). The post-competence of grassroots general practitioners in Xinjiang was affected by gender and the category of their institutions (P < 0.01). Conclusion There is still much room for improvement in the skills of grassroots GPs in Xinjiang. Existing talents should be retained to expand the team of general practitioners. Grassroots medical institutions should be developed based on the homogeneity of regional conditions, the practice environment should be improved, targeted training should be carried out to enhance the humanistic practice ability of general practitioners, and the capacity of basic medical and public health services should be strengthened.
- General practitioners /
- Post competency /
- Influencing factors /
- Xinjiang
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表 1 新疆地区不同地州基层全科医生基本情况对比

Table 1. Comparison of basic conditions of grassroots general practitioners in different prefectures and regions of Xinjiang

所在地区	人数	性别(人)		年龄(x±s，岁)	学历[人(%)]			所在机构[人(%)]		职称[人(%)]			工作年限[人(%)]
所在地区	人数	男性	女性	年龄(x±s，岁)	高中/中专及以下	大专	本科及以上	社区卫生服务中心(乡镇卫生院)	社区卫生服务站(村卫生室)	初级及以下	中级	高级	＜5年	5~15年	16~25年	＞25年
阿克苏地区	71	26	45	36.04±8.75	8(11.3)	30(42.2)	33(46.5)	69(97.2)	2(2.8)	57(80.3)	12(16.9)	2(2.8)	9(12.7)	43(60.5)	6(8.5)	13(18.3)
和田地区	86	43	43	33.34±5.70	8(9.3)	40(46.5)	38(44.2)	86(100.0)	0	70(81.4)	15(17.4)	1(1.2)	10(11.6)	63(73.3)	7(8.1)	6(7.0)
喀什地区	87	34	53	31.89±5.94	1(1.1)	49(56.3)	37(42.6)	85(97.7)	2(2.3)	77(88.6)	9(10.3)	1(1.1)	29(33.3)	48(55.2)	4(4.6)	6(6.9)
巴州	78	22	56	37.09±9.45	8(10.3)	29(37.2)	41(52.5)	71(91.0)	7(9.0)	51(65.4)	18(23.1)	9(11.5)	12(15.4)	34(43.6)	15(19.2)	17(21.8)
阿勒泰地区	48	16	32	41.60±9.73	10(20.8)	19(39.6)	19(39.6)	48(100.0)	0	27(56.3)	10(20.8)	11(22.9)	6(12.5)	15(31.2)	3(6.3)	24(50.0)
伊犁州	104	38	66	35.17±9.07	15(14.4)	32(30.8)	57(54.8)	98(94.2)	6(5.8)	88(84.6)	15(14.4)	1(1.0)	33(31.7)	43(41.4)	11(10.6)	17(16.3)
塔城地区	70	25	45	37.53±9.78	5(7.1)	29(41.5)	36(51.4)	68(97.1)	2(2.9)	46(65.7)	14(20.0)	10(14.3)	8(11.4)	38(54.4)	5(7.1)	19(27.1)
昌吉州	101	29	72	37.48±8.37	5(5.0)	20(19.8)	76(75.2)	95(94.1)	6(5.9)	64(63.4)	27(26.7)	10(9.9)	15(14.9)	52(51.5)	18(17.8)	16(15.8)
统计量		12.212^a		104.870^b	54.190^a			12.968^a		57.644^a			101.320^a
P值		0.094		< 0.001	< 0.001			0.042		< 0.001			0.001
注：^a为χ²值，^b为F值。

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表 2 新疆地区不同地州不同维度下基层全科医生岗位胜任力得分情况(x ±s，分)

Table 2. The post competency scores of grass-roots general practitioners in different regions and states of Xinjiang(x ±s, points)

所在地区	人数	基本医疗服务能力	公共卫生服务能力	人文执业能力	教育学习能力	总均分
阿克苏地区	71	2.49±0.93	2.44±0.89	2.25±0.88	2.66±1.03	48.76±17.20
和田地区	86	2.30±0.83	2.35±0.82	2.19±0.87	2.43±0.85	46.10±15.37
喀什地区	87	2.48±0.78	2.58±0.82	2.40±0.88	2.54±0.87	49.91±15.44
巴州	78	2.62±0.79	2.59±0.82	2.41±0.79	2.77±0.88	51.65±15.00
阿勒泰地区	48	2.59±0.75	2.66±0.74	2.43±0.79	2.68±0.75	51.62±13.75
伊犁州	104	2.55±0.78	2.55±0.78	2.45±0.80	2.79±0.94	51.14±14.93
塔城地区	70	2.75±0.84	2.71±0.89	2.52±0.86	2.93±0.82	54.11±16.53
昌吉州	101	2.80±0.69	2.75±0.74	2.56±0.76	3.03±0.86	55.15±16.53
合计	645	2.57±0.81	2.58±0.82	2.41±0.84	2.73±0.90	51.09±15.24
F值		3.499	2.256	1.924	4.274	3.062
P值		0.001	0.028	0.063	< 0.001	0.004

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表 3 不同特征全科医生岗位胜任力自评总分结果分析

Table 3. Analysis of total score of post competency self- evaluation of general practitioners with different characteristics

项目	人数	得分(x±s，分)	统计量	P值
性别			4.311^d	< 0.001
男性	233	47.65±15.33
女性	412	53.03±15.15
年龄(岁)			1.920^e	0.125
20~29	178	52.79±13.74
30~39	263	51.30±16.28
40~49	138	50.00±15.24
≥50	66	47.89±16.27
学历			3.595^e	0.028
高中/中专及以下	60	46.99±17.98
大专	248	50.34±15.74
本科及以上	337	52.36±14.57^ab
职称			1.006^e	0.366
初级及以下	480	51.20±15.75
中级	120	49.73±14.59
高级	45	53.46±14.01
工作年限(年)			4.065^e	0.007
＜5	122	55.02±13.93
5~15	336	50.91±15.74^c
16~25	69	49.20±14.85^c
＞25	118	48.62±15.72^c
所在机构类别			2.210^d	0.027
社区卫生服务中心(乡镇卫生院)	620	51.35±15.38
社区卫生服务站(村卫生室)	25	44.42±15.37
注：与高中/中专及以下比较，^aP＜0.05；与大专比较，^bP＜0.05；与工作年限＜5年比较，^cP＜0.05；^d为t值，^e为F值。

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表 4 新疆样本地州全科医生岗位胜任力影响因素多元线性回归分析

Table 4. Multivariate linear regression analysis of influencing factors of post competence of general practitioners in Xinjiang sample prefectures

项目	B	SE	β	t值	P值
性别	4.598	1.259	0.143	3.653	< 0.001
学历	-1.155	1.097	-0.049	-1.053	0.293
工作年限	-1.007	0.834	-0.064	-1.207	0.228
所在机构类别	-6.496	3.130	-0.081	-2.075	0.038
注：赋值情况如下，性别(男性=1，女性=2)；学历(高中/中专及以下=1，大专=2，本科及以上=3)；工作年限(＜5年=1，5~15年=2，16~25年=3，＞25年=4)；社区卫生服务中心(乡镇卫生院)=1，社区卫生服务站(村卫生室)=2。

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