發(fā)布時(shí)間：2019-05-29 13:03

【摘要】：目的：立足于重慶市鄉(xiāng)鎮(zhèn)衛(wèi)生人員培訓(xùn)現(xiàn)狀的現(xiàn)場(chǎng)調(diào)查情況，深入研究其素質(zhì)狀況、培訓(xùn)需求及滿(mǎn)意度，分析需求和滿(mǎn)意度差異及影響因素，為做好鄉(xiāng)鎮(zhèn)衛(wèi)生人員培訓(xùn)工作，提升其醫(yī)療技術(shù)和綜合素質(zhì)，穩(wěn)定農(nóng)村衛(wèi)生人才隊(duì)伍、制定基層衛(wèi)生政策和管理框架提供參考意見(jiàn)。 方法： 1文獻(xiàn)研究 通過(guò)檢索維普、萬(wàn)方、中國(guó)知網(wǎng)（CNKI）等數(shù)據(jù)庫(kù)，查閱、整理與分析相關(guān)書(shū)籍、調(diào)查報(bào)告、政府文件等文獻(xiàn)資料，了解鄉(xiāng)鎮(zhèn)衛(wèi)生院衛(wèi)生人員培訓(xùn)相關(guān)的概念及理論、觀點(diǎn)及措施、以及研究進(jìn)展和發(fā)展趨勢(shì)。 2定量資料分析 根據(jù)重慶市經(jīng)濟(jì)社會(huì)發(fā)展情況采取整群隨機(jī)抽樣方法，于2011年10月至2012年2月按重慶市都市發(fā)達(dá)經(jīng)濟(jì)圈D渝西經(jīng)濟(jì)走廊D三峽庫(kù)區(qū)生態(tài)經(jīng)濟(jì)區(qū)D三大特色區(qū)域經(jīng)濟(jì)的科學(xué)劃分分別抽取了渝北區(qū)、永川區(qū)以及豐都縣，各個(gè)區(qū)縣再分別隨機(jī)抽取8所共計(jì)24所鄉(xiāng)鎮(zhèn)衛(wèi)生院對(duì)當(dāng)天衛(wèi)生院里所有上班的衛(wèi)生人員發(fā)放問(wèn)卷進(jìn)行現(xiàn)場(chǎng)調(diào)查�，F(xiàn)場(chǎng)調(diào)查使用自行設(shè)計(jì)的調(diào)查問(wèn)卷：重慶市鄉(xiāng)鎮(zhèn)衛(wèi)生院衛(wèi)生人員培訓(xùn)現(xiàn)狀調(diào)查問(wèn)卷D，問(wèn)卷內(nèi)容主要包括四方面：調(diào)查對(duì)象基本情況、培訓(xùn)需求情況、培訓(xùn)滿(mǎn)意度情況、總體評(píng)價(jià)及建議�，F(xiàn)場(chǎng)由經(jīng)過(guò)培訓(xùn)的調(diào)查人員發(fā)放問(wèn)卷、指導(dǎo)填寫(xiě)并當(dāng)場(chǎng)回收，共發(fā)放850份問(wèn)卷，回收828份(回收率為97.41%)，經(jīng)審核，其中有效問(wèn)卷819份(有效率為98.91%)。 3定性訪談 根據(jù)本課題研究需要，明確訪談目的和所要獲取的信息，自行設(shè)計(jì)半結(jié)構(gòu)化訪談提綱，在征得調(diào)查對(duì)象同意后，進(jìn)行個(gè)人深度訪談27人次，每人次訪談時(shí)間為15～20分鐘，其中訪談各區(qū)縣主管培訓(xùn)的衛(wèi)生行政部門(mén)負(fù)責(zé)人3人次、鄉(xiāng)鎮(zhèn)衛(wèi)生院領(lǐng)導(dǎo)12人次、鄉(xiāng)鎮(zhèn)衛(wèi)生院職工12人次。訪談采取面對(duì)面、二對(duì)一的方式進(jìn)行，其中一人訪談一人記錄，訪談資料經(jīng)過(guò)審核，在尊重原始信息的前提下整理、歸類(lèi)后提煉成主要觀點(diǎn)和看法。 4統(tǒng)計(jì)分析 數(shù)據(jù)處理采用EpiData3.1軟件建立數(shù)據(jù)庫(kù)進(jìn)行錄入、整理及邏輯檢錯(cuò)，運(yùn)用SPSS18.0進(jìn)行統(tǒng)計(jì)描述、Cmh檢驗(yàn)。運(yùn)用Excel進(jìn)行圖表制作，綜合運(yùn)用管理學(xué)、人口學(xué)、社會(huì)心理學(xué)等相關(guān)知識(shí)進(jìn)行分析和評(píng)價(jià)。 5質(zhì)量控制 正式調(diào)查前選取一所鄉(xiāng)鎮(zhèn)衛(wèi)生院進(jìn)行預(yù)調(diào)查，對(duì)問(wèn)卷不合理?xiàng)l目進(jìn)行了調(diào)整和補(bǔ)充，現(xiàn)場(chǎng)調(diào)查時(shí)問(wèn)卷由經(jīng)過(guò)統(tǒng)一培訓(xùn)的調(diào)查人員現(xiàn)場(chǎng)發(fā)放、指導(dǎo)填寫(xiě)并當(dāng)場(chǎng)回收。問(wèn)卷經(jīng)審核整理后，由調(diào)查人員統(tǒng)一編碼錄入、分析處理。訪談過(guò)程采用一人訪談一人記錄的方式，并且當(dāng)天的訪談資料當(dāng)天整理，避免隔天整理造成遺漏和遺忘，經(jīng)過(guò)小組討論、審核、驗(yàn)證和補(bǔ)充，最后形成主要觀點(diǎn)和看法。 結(jié)果： 鄉(xiāng)鎮(zhèn)衛(wèi)生人員綜合素質(zhì)不高，性別比和醫(yī)護(hù)比失衡，學(xué)歷和職稱(chēng)結(jié)構(gòu)不合理。培訓(xùn)覆蓋率不高（63.00%），培訓(xùn)時(shí)間以為期1～3個(gè)月的短期培訓(xùn)為主（57.98%），培訓(xùn)地點(diǎn)主要集中在區(qū)縣醫(yī)院（41.14%），培訓(xùn)次數(shù)分布呈中間小兩頭大的特征，培訓(xùn)1次（33.33%）和±5次(22.16%)較頻繁，培訓(xùn)方式以醫(yī)院技能進(jìn)修為主（38.16%），培訓(xùn)內(nèi)容以崗位技能培訓(xùn)為主（35.46%）。采用Likert5點(diǎn)量表評(píng)分法，培訓(xùn)總體滿(mǎn)意度水平不高（3.29±1.034），介于一般D與較滿(mǎn)意D之間，，且更偏向于一般D。三個(gè)區(qū)縣滿(mǎn)意度得分最高和最低的分別是永川區(qū)（3.34±1.017）和豐都縣（3.20±0.996）。培訓(xùn)組織方式中，得分最高和最低的分別是培訓(xùn)地點(diǎn)（3.48±1.032）和培訓(xùn)內(nèi)容（3.31±1.044）；培訓(xùn)支持條件中，得分最高和最低的分別是師資水平（3.59±0.989）和費(fèi)用承擔(dān)(2.93±1.128)；參訓(xùn)學(xué)員動(dòng)機(jī)實(shí)現(xiàn)情況得分3.41±1.029。經(jīng)Cmh檢驗(yàn)，不同年齡組之間、不同文化程度之間、不同崗位之間、不同從業(yè)年限之間、不同人事關(guān)系之間滿(mǎn)意度的差異均有統(tǒng)計(jì)學(xué)意義(p0.05)；不同人事關(guān)系之間滿(mǎn)意度的差異有顯著的統(tǒng)計(jì)學(xué)意義(p0.01)。88.40%的鄉(xiāng)鎮(zhèn)衛(wèi)生院衛(wèi)生人員對(duì)培訓(xùn)有不同程度的需求。經(jīng)Cmh檢驗(yàn)，不同年齡組之間需求的差異有統(tǒng)計(jì)學(xué)意義(p0.05)；不同崗位之間、不同從業(yè)年限之間、不同人事關(guān)系之間需求的差異均有顯著的統(tǒng)計(jì)學(xué)意義(p0.01)。 討論與建議： 鄉(xiāng)鎮(zhèn)衛(wèi)生人員素質(zhì)不高且結(jié)構(gòu)欠佳，培訓(xùn)覆蓋率和培訓(xùn)滿(mǎn)意度偏低，培訓(xùn)需求非常強(qiáng)烈。政府必須增加財(cái)政投入，建立健全培訓(xùn)機(jī)制，加強(qiáng)宣傳教育，完善配套政策和措施；鄉(xiāng)鎮(zhèn)衛(wèi)生院領(lǐng)導(dǎo)及衛(wèi)生人員自身有必要提高培訓(xùn)意識(shí)，創(chuàng)造培訓(xùn)條件，編制計(jì)劃并精心組織落實(shí)；大型綜合醫(yī)院要進(jìn)一步強(qiáng)化對(duì)口支援；醫(yī)藥高等院校須為鄉(xiāng)鎮(zhèn)衛(wèi)生人力培訓(xùn)提供優(yōu)質(zhì)師資保障。
[Abstract]:Objective: To study the situation of health personnel training in the town of Chongqing, and to study the quality status, training demand and satisfaction, analyze the difference of demand and satisfaction, and to improve the medical technology and comprehensive quality of the health personnel in the town. To stabilize the rural health personnel and provide reference for the development of the grass-roots health policy and management framework. square Method:1 The paper studies the concepts and theories related to the training of health personnel in the township health center through the search of the databases such as the Weipu, Wanfang and CNKI, and the related books, investigation reports, government documents and so on. Points of view and measures, as well as the progress of research And the development trend. 2. The quantitative data analysis is based on the economic and social development of Chongqing By taking the cluster random sampling method, the regional economic scientific division of the three characteristics of the ecological economic zone D of the D-Chongqing Economic Corridor of the Three Gorges Reservoir of the City of Chongqing was taken from October,2011 to February,2012, respectively. In the Yongchuan district and the Fengdu county, the counties and counties of Fengdu County, respectively, respectively,8 total of 24 township health centers in the same day, and all the health personnel working in the health center of the day are sent. On-site survey was carried out on the questionnaire. The site investigation used a self-designed questionnaire: the questionnaire of the current status of health personnel training in the township health center of Chongqing. The content of the questionnaire mainly includes four aspects: the basic situation of the investigation object, the situation of training demand, and the satisfaction degree of the training. Status, overall evaluation and recommendations. The site was issued by trained investigators, instructed to complete and recovered on the spot, and 850 questionnaires were issued and 828 (97.41%) were recovered, and the effective questionnaire was 819 (effective). The rate is 98. 91%). The qualitative interview is based on the research needs of the subject, the purpose of the interview and the information to be obtained, and the outline of the semi-structured interview is designed by a self-designed semi-structured interview outline. After the consent of the investigation object is obtained, the individual depth interview is conducted for 27 persons, each of which The time of the interview is 15-20 minutes, among which,3 people in charge of the health administration department of the district and county competent training are interviewed, and 12 people in the township health center The interview was conducted in a face-to-face and two-to-one way, one of which was interviewed by one person, the interview data was reviewed and the original information was respected on the premise of respecting the original information. post-classification it is the main point of view and view. The statistical analysis data processing uses the Epidata 3.1 software to set up the database for entry, sorting and logical error detection, using the SPS "S18.0 carries out statistical description and Cmh test. The chart is made by using Excel, and management and demography are applied in a comprehensive way." social psychology 5. Before the formal investigation of quality control, a township health center is selected to carry out the pre-investigation, and the unreasonable entry of the questionnaire is adjusted and supplemented, and the questionnaire on site investigation is unified The survey personnel of the training shall issue, guide and recover the questionnaire on the spot. The questionnaire shall be submitted for approval. After the core is finished, the survey personnel will be used for unified code entry and analysis. The interview process adopts one person to interview one person to record the same day, and the interview data of the same day is arranged on the same day, so as to avoid the omission and forgetting caused by the other day, and the panel discussion will be conducted. , Review And finally to form a main point of view and view. The training coverage is not high (63.00%), and the training time is based on short-term training for 1-3 months (57.98%). The training site is mainly concentrated in the district and county hospital (41.14%). The training frequency is distributed in the middle and small two-end features and training. 1 (33.33%) and 5 (22.16%) were more frequent, and the training method was mainly based on the hospital skills (38.1). 6%). The training content is mainly based on post skill training (35.46%). The quality of the training is not high (3.29% 1.034), which is between the general D and the better D, and is more inclined to the general D. The highest and lowest satisfaction score of the three districts is the Yongchuan area (3). 34 (1.017) and Fengdu (3.20, 0.996). In the training organization mode, the highest and lowest scores are the training sites (3.48-1.032) and the training content (3.31-1.044); in the training support conditions, the highest and the lowest of the scores are the level of teachers (3.5 9 (0.989) and cost (2.93. 1.12 8). The achievement score of the trainees' motivation is 3.41-1.029. After the Cmh test, there are no differences among the age groups, between different positions, among different positions, among different working years, different people There was a significant difference in the degree of satisfaction between the relationships (p0.05), and there was a significant difference in the degree of satisfaction between different personnel relationships (p0.01). 40% of the health personnel of the township health center have a different degree of demand for the training. The difference of the needs between different age groups is statistically significant through the Cmh test (p0.05); among the different positions, the different people are concerned with the different working years. inter-system There is a significant difference in the difference (p0.01). The discussion and suggestion: the quality of the health personnel in the township is not The government must increase the financial input, establish and improve the training mechanism, strengthen the publicity and education, and improve the supporting policies and measures; the leaders of the township health center and the health personnel It is necessary to improve the awareness of the training, to create the training conditions, to prepare the plan and to elaborate the implementation of the plan, and to further strengthen the large-scale comprehensive hospital
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R197.6

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