本文關鍵詞： 結(jié)核病防治新模式 結(jié)核病防治臨床醫(yī)生 勝任度　出處：《清華大學》2014年碩士論文　論文類型：學位論文

【摘要】：我國是結(jié)核病高負擔國家，為有效應對結(jié)核病防治工作的新挑戰(zhàn)，，我國的結(jié)核病防治模式也在逐步向新模式轉(zhuǎn)型中。在結(jié)核病防治新模式下，定點醫(yī)院成為結(jié)核病診斷和治療的主要負責機構，這一機構定位的轉(zhuǎn)型使得定點醫(yī)院的結(jié)核病防治臨床醫(yī)生的主要職責產(chǎn)生了較大的變化。本研究試圖了解在結(jié)核病防治新模式下，結(jié)核病防治臨床醫(yī)生所需具備的能力和素質(zhì)要項以及現(xiàn)有結(jié)核病防治臨床醫(yī)生的勝任度水平及其影響因素，希望能為新模式下結(jié)核病防治臨床醫(yī)生人力資源的發(fā)展提供參考和借鑒。 本研究通過對鎮(zhèn)江、宜昌和漢中三個結(jié)核病防治新模式試點地區(qū)的結(jié)核病防治臨床醫(yī)生進行問卷調(diào)查和深度訪談，結(jié)合勝任素質(zhì)模型的構建原理，構建了結(jié)核病防治臨床醫(yī)生的勝任素質(zhì)模型，模型具體包括以下21項勝任素質(zhì)要項：知識的扎實、可靠性、知識的應用性、特定知識的掌握程度、知識的針對性、識別病癥、并發(fā)癥的防治與其他傳染病的鑒別、結(jié)核病與艾滋病的綜合治療方法的掌握情況、合理用藥的知識與能力、自我發(fā)展、把握實時資訊、對區(qū)域傳染性流行病知識的掌握程度、熟悉患者情況、醫(yī)患關系、溝通能力、常規(guī)健康教育和行為干預、特殊人群的保護（婦女兒童）、并發(fā)其他傳染病的特殊患者的健康教育和行為干預、直面壓力、職業(yè)道德、職業(yè)使命感、價值認同。 在此基礎上，本研究運用構建出來的勝任素質(zhì)模型，對鎮(zhèn)江、宜昌和漢中的結(jié)核病防治臨床醫(yī)生進行了問卷調(diào)查。基于樣本數(shù)據(jù)，本研究首先對結(jié)核病防治臨床醫(yī)生的勝任度進行了描述性統(tǒng)計分析。本研究發(fā)現(xiàn)，試點地區(qū)區(qū)縣級綜合醫(yī)院和地市級�？漆t(yī)院的結(jié)核病防治臨床醫(yī)生的勝任度都處于所認知的合格標準附近，在部分要項上的勝任度有待提升。然后本研究又對教育背景和工作經(jīng)驗對結(jié)核病防治臨床醫(yī)生勝任度的影響進行了探究，結(jié)果發(fā)現(xiàn)對于地市級及以下定點醫(yī)院的結(jié)核病防治臨床醫(yī)生來說，結(jié)核病防治臨床工作經(jīng)驗的多寡可能是影響勝任度的重要因素，而學歷可能不是勝任度的重要影響因素。 針對調(diào)查和研究的結(jié)果，本研究提出了提高結(jié)核病防治新模式下臨床醫(yī)生勝任度的政策建議。第一，健全結(jié)核病防治臨床醫(yī)生的薪酬福利制度，提升崗位吸引力。第二，開展針對結(jié)核病防治臨床醫(yī)生的規(guī)范化培訓，提升現(xiàn)有人員的能力和素質(zhì)。
[Abstract]:China is a high-burden TB country. In order to effectively meet the new challenges of TB prevention and control, China's TB control model is also gradually changing to a new model, under the new TB control model. Designated hospitals have become the main agencies responsible for the diagnosis and treatment of tuberculosis. The transformation of this institutional orientation has made the major responsibilities of TB clinicians in designated hospitals have changed greatly. This study attempts to understand the new model of TB prevention and treatment. The ability and quality of TB clinicians and the competence level of existing TB clinicians and their influencing factors are also discussed. We hope to provide reference and reference for the development of human resources of TB clinicians under the new mode. This study through the three pilot areas of Zhenjiang, Yichang and Hanzhong tuberculosis prevention and control model pilot areas of tuberculosis control clinicians questionnaire survey and in-depth interviews, combined with the construction of competency model principles. The competency model of TB clinicians was constructed. The model includes the following 21 items: solid knowledge, reliability, application of knowledge and mastery of specific knowledge. Knowledge pertinence, identification of disease, prevention and treatment of complications and other infectious diseases, comprehensive treatment of tuberculosis and AIDS, knowledge and ability of rational use of drugs, self-development. Grasp real-time information, knowledge of regional infectious epidemic, familiar with patients, doctor-patient relations, communication skills, routine health education and behavioral intervention, protection of special groups (women and children). Health education and behavioral intervention of special patients with other infectious diseases, direct pressure, professional ethics, professional mission, value identity. On this basis, this study uses the competency model to investigate the tuberculosis clinicians in Zhenjiang, Yichang and Hanzhong, based on the sample data. In this study, first of all, the competency of TB clinicians was analyzed by descriptive statistics. The competence of TB clinicians in county level general hospitals and prefectural specialized hospitals in the pilot area is near the recognized eligibility criteria. Then the influence of educational background and working experience on the competence of TB clinicians was explored. The results showed that the number of clinical experience in TB prevention and treatment may be an important factor influencing the competence for the clinicians of TB prevention and treatment in the designated hospitals of prefectural and municipal level and below. Education may not be an important factor in competency. According to the results of the investigation and research, this study put forward some policy recommendations to improve the clinicians' competence under the new TB control model. First, improve the pay and welfare system of TB clinicians. Second, develop standardized training for TB clinicians to improve the ability and quality of existing staff.
【學位授予單位】：清華大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R52

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本文編號：1445740