家庭医生团队签约服务能力培训课程体系构建研究
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摘要
背景对于家庭医生团队在岗健康管理服务能力提升,我国尚缺乏成熟的培训体系。目的构建以人为本一体化服务(PCIC)模式下,家庭医生团队签约服务能力培训课程体系。方法于2017年6—9月,在查阅相关文献的基础上,对武侯区深度开展全科医生服务模式转型机构的家庭医生团队和专家进行深入访谈,初步拟定课程体系。于2017年10月—2018年1月,通过发送电子邮件的方式对遴选的15名专家开展2轮咨询,由专家对课程模块和课程内容的重要性进行评分,根据专家意见集中程度和协调程度以及相关建议对课程体系进行调整。结果 2轮咨询的问卷有效回收率均为100.0%,专家对咨询内容的平均权威系数为0.91。最终形成的课程体系包括9个课程模块、57项课程内容,专家对课程模块和课程内容重要性评价的平均分为3.55～4.82分,变异系数为0.08～0.24。9个课程模块分别为PCIC模式理念解读、标准健康管理流程、人群管理、服务质量管理、患者参与、协调能力、服务包的开发与设计、团队构建、团队运行,各课程模块的Cronbach's α系数为0.780～0.945。结论本研究构建的家庭医生团队签约服务能力培训课程体系具有科学性和实用性,适用于在PCIC模式下开展家庭医生签约服务能力培训。
Background There is no mature service capability training curriculum system for family doctor teams in China.Objective To construct a capability training curriculum system for family doctor teams delivering integrated personcentered services(PCIC).Methods From June to September 2017,we drew up the initial version of family doctor team service capability training curriculum system based on literature review and results of in-depth interviews with family doctor teams and experts responsible for intensively transforming general practice service delivery patterns in Wuhou District.Then,during October 2017 to January 2018,we conducted two rounds of email consultation among 15 selected experts,during which the importances of modules and contents of the initial curriculum system were evaluated by the experts,and the system was revised according to the consensus and coordination of experts' opinions and suggestions.Results The response rates of the two rounds of consultation were all 100.0%,with an average authority coefficient of 0.91.Finally,a formal curriculum system was constructed in which 9 modules(PCIC model concept interpretatin,standardized health management process,population management,service quality management,patient participation,coordination ability,service package development and designation,team building,team operation),and 57 courses are included,with scores of 3.55-4.82 points on average in terms of importance evaluated by experts,and coefficients of variation of 0.08-0.24.The Cronbach's αof the courses ranged from 0.780 to 0.945.Conclusion This service capability training curriculum system is scientific and practical,and is suitable for family doctor teams delivering integrated person-centered contracted services.
Background There is no mature service capability training curriculum system for family doctor teams in China.Objective To construct a capability training curriculum system for family doctor teams delivering integrated personcentered services(PCIC).Methods From June to September 2017,we drew up the initial version of family doctor team service capability training curriculum system based on literature review and results of in-depth interviews with family doctor teams and experts responsible for intensively transforming general practice service delivery patterns in Wuhou District.Then,during October 2017 to January 2018,we conducted two rounds of email consultation among 15 selected experts,during which the importances of modules and contents of the initial curriculum system were evaluated by the experts,and the system was revised according to the consensus and coordination of experts' opinions and suggestions.Results The response rates of the two rounds of consultation were all 100.0%,with an average authority coefficient of 0.91.Finally,a formal curriculum system was constructed in which 9 modules(PCIC model concept interpretatin,standardized health management process,population management,service quality management,patient participation,coordination ability,service package development and designation,team building,team operation),and 57 courses are included,with scores of 3.55-4.82 points on average in terms of importance evaluated by experts,and coefficients of variation of 0.08-0.24.The Cronbach's αof the courses ranged from 0.780 to 0.945.Conclusion This service capability training curriculum system is scientific and practical,and is suitable for family doctor teams delivering integrated person-centered contracted services.
引文
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[2]肖蕾,张太慧,张雅莉,等.分级诊疗视角下家庭医生签约服务“签而不约”的原因及对策研究[J].中国全科医学,2018,21(25):3063-3068.DOI:10.12114/j.issn.1007-9572.2018.25.007.XIAO L,ZHANG T H,ZHANG Y L,et al.Reasons and countermeasures of residents signing the contract with the family doctor but not making appointments during the implementation of hierarchical medical system[J].Chinese General Practice,2018,21(25):3063-3068.DOI:10.12114/j.issn.1007-9572.2018.25.007.
[3]苏瑾,吴立明,李竹,等.制定上海市空调通风系统地方标准中德尔菲法的应用[J].上海预防医学,2007,19(12):1-8.DOI:10.3969/j.issn.1004-9231.2007.12.001.SU J,WU L M,LI Z,et al.Application of Delphi in the establishment of Shanghai local standard"hygienic code for the operation of central ventilation and air conditioning systems"[J].Shanghai Journal of Preventive Medicine,2007,19(12):1-8.DOI:10.3969/j.issn.1004-9231.2007.12.001.
[4]HASSON F,KEENEY S,MC KENNA H.Research guidelines for the Delphi survey technique[J].Journal of Advanced Nursing,2000,32(4):1008-1015.DOI:10.1046/j.1365-2648.2000.t01-1-01567.x.
[5]POWELL C.The Delphi technique:myths and realities[J].Journal of Advanced Nursing,2003,41(4):376-382.DOI:10.1046/j.1365-2648.2003.02537.x.
[6]邹玉莲.新形势下高职护理专业课程体系改革的研究与实践[J].卫生职业教育,2006,24(10):65-66.DOI:10.3969/j.issn.1671-1246.2006.10.035.ZOU Y L.Research and practice on curriculum system reform of higher vocational nursing major under new situation[J].Health Vocational Education,2006,24(10):65-66.DOI:10.3969/j.issn.1671-1246.2006.10.035.
[7]张虎,田茂峰.信度分析在调查问卷设计中的应用[J].统计与决策,2007,23(21):25-27.DOI:10.13546/j.cnki.tjyjc.2007.21.058.ZHANG H,TIAN M F.Application of reliability analysis in questionnaire design[J].Statistics and Decision,2007,23(21):25-27.DOI:10.13546/j.cnki.tjyjc.2007.21.058.2018122020190410