| [Purpose]To understand the current situation of clinical physician's hospital department climate and medical professionalism,and to study the influence of the department climate on the professionalism of doctors and put forward some measures to improve the professionalism of the departments at the organizational level.[Methods]In this study,the questionnaire of the medical professionalism has been designed by new century physician occupation spirit-physician declaration,which is based on the three cardinal principles of the medical professionalism and the professional responsibility of the ten,included professional attitude of the 20 items,10 items of doctor professional behavior.The questionnaire department climate is based on the study of literature,and to find the relevant departments,the organization scale.To select the reference,try to choose the"patient-centered"related questions.There are 7 dimensions in 29 items,with Likert 1-4grades.The six dimensions are work support,interpersonal relationship,work stress,department development,rules and regulations,patient service and leadership style.Considering the level of social economy in different regions,the actual situation of the hospital development in various regions,with convenient sampling from different levels of public hospitals,this study selected Hubei city of Jingzhou Province,Sichuan city in Guang'an Province,the two hospitals were 327 doctors surveyed.A total of 8 clinical doctors were selected from each hospital to conduct semi-structured interviews.[Results]1.The situation of public hospital physicians'professional attitude and behaviorThe total score of professional spirit was(3.47±0.30),and the total score of professional attitude was(3.48±0.37),and the total score of professional behavior was(3.45±0.35).There are 20 questions in the medical professionalism attitude table,with more than 80%of the 15 entries,of which 13 are more than 90%.The last three items:Reflect obviously the incompetent colleague to the leadership or the relevant department(61.7%);the doctor qualification certificate examination regularly re-certification(65.5%);other doctors should reflect the occurrence of medical adverse events to the leadership or the relevant department(69.9%).The physician should place the patient's interests at a personal rate of consent of only 79.2%.The results of the professional behavior are better responsible for the responsibility,improve the quality of medical services,improve business ability,the incidence of behavior were 94%,93.6%,92.9%.The professional attitude and professional behavior of clinicians are related(r=0.286).2.The status of the department and its influencing factorsThe six dimensions of the department climate scale are leadership style,interpersonal relationship,patient service,safety and regulations,work support,work pressure.The total Cronbach's alpha coefficient is 0.88.The total score was(3.18±0.42),and the evaluation of interpersonal relationship was the highest(3.55±0.56),the lowest was safety and regulation(2.83±0.66).Logistic stepwise regression analysis showed that position,age,hospital,department,safety and regulation,and job support were the influencing factors of turnover intention.Safety rules and regulations are the risk factors of turnover intention(OR=2.351),job support are protective factors of turnover intention(OR=0.488).Age,education background,title,department and leadership style are the influencing factors for doctors to change to hospital.Leadership style is a protective factor for doctors'willingness to change their profession(OR=0.335).3.The relationship between the department climate and medical professionalismCorrelation coefficient between organizational climate and medical professionalism is0.403.Professional attitudes are not related to the work pressure in the department climate,and are related to the dimensions of the other departments,and the professional occupational behavior is related to the dimensions of the department climate.Regression analysis of professional attitude,medical and patient services,safety and regulation,work support into the regression model(R~2=0.264),the patient's service has the greatest impact on the attitude of doctors.Regression analysis of professional behavior,master's degree and above,contract and other,intermediate titles,patient services and professional attitude into the regression model(R~2=0.249).4.Path analysis on department climate,professional attitude and professional behaviorThe climate of the department affects the professional attitude,and the climate of the department affects the professional behavior.The dimension of the department has an impact on the professional behavior through the professional attitude of the doctor.The main dimensions of influence are equitable allocation of limited medical resources,honesty to patients,promotion of medical care,confidentiality for patients,and responsibility for the job.[Conclusions]1.The doctor's attitude toward the medical professionalism is high,most of the professional behavior and attitude are matched,but there are still some of the attitude and behavior is not highly consistent.2.The Department atmosphere scale has good reliability and validity.The doctor's overall assessment of the atmosphere of the department is on the above middle.The demographic variables have limited impact on the atmosphere of the department.3.The climate of the department has an important role in the professionalism of the doctor,and the climate of the department also affects the professional behavior through the professional attitude.4.We can improve the medical professionalism by improving the climate of the department.Doctor must adhere to the patient centered service concept and measures should be taken to protect the professional safety of doctors.Building a harmonious relationship between doctors and patients in order to alleviate the pressure on doctors.Give full play to the leading role of good department leadership.In addition,the government departments,the media,the joint efforts of patients. |
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