Research On The Trust Model Of The First Diagnosis Of Resident Community

Objective: This study aims to define the concept and connotation of trust in residents' first diagnosis in the community,and sort out the elements of the residents' trust in community first diagnosis and the rules of interaction between them.Through discussing the influencing factors of trust in residents' first diagnosis in the community,this study builds an initial theoretical model of trust in residents' first diagnosis and conducts empirical analysis to provide theoretical and empirical evidence for improving the construction of the community's first diagnosis system and enhancing residents' trust in community health services.Methods:(1)Literature research.Analyze the connotation factors of the first diagnosis of residents 'community and determine the measurement dimension of the first diagnosis of residents' community.(2)The method of focus group discussion and questionnaire survey.Through conducting a number of special group discussions,the composition of the first consultation of the residents' community,the combing of internal logical relationships,and the measurement dimensions were established.Through questionnaire survey,a total of 10 community health service institutions were selected in 8 main urban districts of Hangzhou,Zhejiang Province,and a questionnaire was distributed in selected communities under the jurisdiction of the community health service institutions using fixed sampling.(3)Mathematical statistics.Cronbach's alpha coefficient,split-half reliability coefficient,factor analysis test scale reliability and validity;descriptive statistical analysis,using means,standard deviation,composition ratio and other indicators to describe the basic situation of the residents surveyed;comparison of different demographic characteristics of trust in community first diagnosis by t test and analysis of variance;weighted average method to calculate the trust score of the first consultation in the residential community;multiple linear regression analysis to explore the influencing factors of doctors' trust,institution trust,and government trust in residents' first visit trust;the structural equation model was used to verify the residents' first visit trust theoretical model.Results:(1)The Cronbach's ? coefficients of the Doctor Trust,Institutional Trust,and Government Trust scales are 0.934,0.932,and 0.936,respectively,and the Cronbach's ? coefficients of the four dimensions of the Doctor Trust Scales “loyalty”,“ability”,“honesty”,and “comprehensive trust” are: 0.776,0.869,0.871,0.807,the four-dimensional Cronbach's ? coefficients of the institution trust scale are 0.826,0.882,0.848,0.798,and the four-dimensional Cronbach's ? coefficients of the government trust scale are 0.796,0.879,0.871,0.859,respectively.The Cronbach's ?coefficients of the odd and even entries of the Doctor Trust Scale are 0.851 and 0.887 respectively,the two-part half-confidence coefficient is 0.945,and the Cronbach's ?coefficients of the odd and even entries of the institutional trust scale are 0.854 and0.878,respectively.The partial half-reliability coefficient of the part is 0.943,the Cronbach's ? coefficients of the odd and even entries of the government trust scale are0.859 and 0.885,and the half-reliability coefficient of the two parts is 0.946.The KMO values of doctor trust scale,institution trust scale and government trust scale were 0.937,0.925,0.927,P<0.001.(2)Residents of different genders,household registration,age,education,occupation,total monthly income,type of medical security,physical health status in the past half year,chronic disease status,and time walking to the community health service institution have different trust scores in the community first consultation Significance(P<0.05).(3)The residents 'trust scores for community doctors were 72.98,the residents' trust scores for community health service agencies were 73.26,the residents 'trust scores for government were 73.02,and the residents' first consultation trust scores were 73.26.(4)The influencing factors of residents' trust in community doctors include overall satisfaction with community doctors,attitudes of community doctors,communication skills of community doctors,familiarity with community doctors,health education of community doctors,and whether community doctors can refer patients in a timely manner(P<0.05));The influencing factors of residents 'trust in community health service institutions include community health service institutions' fast and convenient referrals,reputation,referral department counterparts,medical experience,health knowledge education in place,department setting layout,overall environment,feedback suggestions for improvement,timely consultation The process is efficient(P<0.05);the influencing factors of residents' trust in the government include the performance of government administrative functions,the efficiency of government personnel in medical insurance reimbursement policies,the "run once" reform,the convenience of the people,the performance of the government,the improvement of the basic drug system,The price of medical services(P<0.05).(5)The trust of residents' community doctors has the greatest impact on government trust,with a path factor of 0.690.The trust of residents' government affects the trust of residents in community doctors.The path coefficient is 0.643.The trust of residents' government affects the trust of residents incommunity health service agencies.The path coefficient is 0.490.Residents 'trust in community doctors affects residents' trust in community health services,with a path coefficient of 0.550.Residents 'trust in community health services affects residents' trust in community doctors,with a path coefficient of 0.540.Residents' trust in community health services affects residents' The trust of the government has a path factor of 0.255.Conclusion:(1)The self-designed and developed residents' community first trust scale has good reliability and validity.(2)The trust level of the first consultation in the residential community is between passing and good,and there is still room for improvement.(3)In the process of residents' trust in community health services,the trust of residents in community doctors,the trust of community health service agencies,and the trust of residents in government affect each other.Residents' trust in community doctors has the most far-reaching effect.