基于扎根理论的公立医院医生处方行为影响因素研究
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摘要
目的:在我国深化医疗卫生体制改革的背景下,本研究通过对医生处方行为影响因素的全面剖析,旨在改善医生处方行为,促进医生合理用药,更好的保障公众健康。方法:运用扎根理论的研究方法分析定性研究结果,综合相关文献研究结果,详细分析医生处方行为影响因素。结果:对定性调查和文献研究资料进行整理分析,共获得312条原始语句及对应的初始概念,共抽象出36个概念范畴,提炼出5个核心概念,分别为政策制度、医疗氛围、医药供货商、患者及其家属、医生自身。结论:本研究可为公立医院医生处方行为的深入研究奠定理论基础,也可为规范医生处方行为,促进我国医药卫生体制改革事业的顺利推进提供科学依据。
Objective This study aimed to improve doctors' prescribing behavior,to promote rational use of medicines and to enhance the population health by identifying the factors influencing doctors' prescribing behavior in the context of healthcare reform in China. Methods The grounded theory was used to analyze the results of qualitative research and literature research. Results After extracting and analyzing the results of qualitative survey and literature studies,a total of 312 original sentences and corresponding initial concepts were obtained. We abstracted 36 conceptual categories and five core concepts which were policy system,health atmosphere,health supply-side,patients and their families,and doctors themselves. Conclusion The findings contributed to update current theoretical frameworks for doctors' prescribing behaviors in public hospitals,and to provide a scientific basis for regulating doctors' prescribing behaviors and promoting the reform of China's healthcare system.
Objective This study aimed to improve doctors' prescribing behavior,to promote rational use of medicines and to enhance the population health by identifying the factors influencing doctors' prescribing behavior in the context of healthcare reform in China. Methods The grounded theory was used to analyze the results of qualitative research and literature research. Results After extracting and analyzing the results of qualitative survey and literature studies,a total of 312 original sentences and corresponding initial concepts were obtained. We abstracted 36 conceptual categories and five core concepts which were policy system,health atmosphere,health supply-side,patients and their families,and doctors themselves. Conclusion The findings contributed to update current theoretical frameworks for doctors' prescribing behaviors in public hospitals,and to provide a scientific basis for regulating doctors' prescribing behaviors and promoting the reform of China's healthcare system.
引文
[1] 柴佳鹏.临床医生处方行为的影响因素分析与实证研究[D];复旦大学,2009.
[2] 孙巍,严明.借鉴国外经验规范我国医生处方行为的措施研究[J].中国卫生标准管理,2017,8(8):17-20.
[3] 陈卫春.探索医生处方行为形成过程加强医生处方行为管理[J].江苏卫生事业管理,2014,25(3):60-62.
[4] 常峰,王晓飞.医生处方行为影响因素研究[J].科教文汇,2013(8):45-46.
[5] 张翠华,贺加.基于医生处方行为的影响因素及约束机制分析[J].中国社会医学杂志,2011,28(4):246-248.
[6] 杨增光.基于计划行为理论模型的医师处方行为研究[J].中国药房,2013,24(1):11-13
[7] 朱玄,陈高洁,褚淑贞.基于计划行为理论的医师处方基本药物行为实证研究 [J].中国药房,2014,25(32):2977-2979.
[8] 陈高洁,褚淑贞.基于计划行为理论的医生处方基本药物行为的模型构建 [J].中国卫生事业管理,2012,29(09):666-668.
[9] 朱艳梅.医师处方行为分析:基于计划行为理论模型的构建[J].药品评价,2012,9(17):16-19
[10] Galaviz KI1,Jauregui-Ulloa E,Fabrigar LR.Physical activity prescription among Mexican physicians:a structural equation analysis of the theory of planned behavior [J].Int J Clin Pract,2015,69(3):375-383.
[11] 朱琳,李瑛,程潇,等.基于扎根理论的慢性乙肝患者生命质量的构成因素分析[J].中国社会医学杂志,2018,35(6):578-581.
[12] 于兆吉,张嘉桐.扎根理论发展及应用研究评述,沈阳工业大学学报(社会科学版),2017,10(1):58-63.
[13] 田霖.扎根理论评述及其实际应用,经济研究导刊,2012,10:224-225
[14] 郭秀梅,孙睿阳,赵东海.基于扎根理论的信息处方架构研究,中国农村卫生事业管理,2016,36(12):1587-1590
[15] McGhee G.,Marland,GR.,Atkinson J.Grounded theory research:literature reviewing and reflexivity [J].J Adv Nurs,2007,60(3):334-342.
[2] 孙巍,严明.借鉴国外经验规范我国医生处方行为的措施研究[J].中国卫生标准管理,2017,8(8):17-20.
[3] 陈卫春.探索医生处方行为形成过程加强医生处方行为管理[J].江苏卫生事业管理,2014,25(3):60-62.
[4] 常峰,王晓飞.医生处方行为影响因素研究[J].科教文汇,2013(8):45-46.
[5] 张翠华,贺加.基于医生处方行为的影响因素及约束机制分析[J].中国社会医学杂志,2011,28(4):246-248.
[6] 杨增光.基于计划行为理论模型的医师处方行为研究[J].中国药房,2013,24(1):11-13
[7] 朱玄,陈高洁,褚淑贞.基于计划行为理论的医师处方基本药物行为实证研究 [J].中国药房,2014,25(32):2977-2979.
[8] 陈高洁,褚淑贞.基于计划行为理论的医生处方基本药物行为的模型构建 [J].中国卫生事业管理,2012,29(09):666-668.
[9] 朱艳梅.医师处方行为分析:基于计划行为理论模型的构建[J].药品评价,2012,9(17):16-19
[10] Galaviz KI1,Jauregui-Ulloa E,Fabrigar LR.Physical activity prescription among Mexican physicians:a structural equation analysis of the theory of planned behavior [J].Int J Clin Pract,2015,69(3):375-383.
[11] 朱琳,李瑛,程潇,等.基于扎根理论的慢性乙肝患者生命质量的构成因素分析[J].中国社会医学杂志,2018,35(6):578-581.
[12] 于兆吉,张嘉桐.扎根理论发展及应用研究评述,沈阳工业大学学报(社会科学版),2017,10(1):58-63.
[13] 田霖.扎根理论评述及其实际应用,经济研究导刊,2012,10:224-225
[14] 郭秀梅,孙睿阳,赵东海.基于扎根理论的信息处方架构研究,中国农村卫生事业管理,2016,36(12):1587-1590
[15] McGhee G.,Marland,GR.,Atkinson J.Grounded theory research:literature reviewing and reflexivity [J].J Adv Nurs,2007,60(3):334-342.