摘要
目的:在不完全契约理论指导下,分析家庭医生签约居民心理契约的满足水平及其对居民行为意向的影响,为提升家庭医生签约服务效能提供参考。方法:2019年9月至2020年6月,按照分层随机抽样方式抽取山东省9个乡镇/街道的1100名家庭医生签约居民作为调查对象,进行签约居民的心理契约满足水平(24个条目)和行为意向评估(9个条目)问卷调查,建立并分析签约居民心理契约对行为意向作用效应模型。相关性分析采用Pearson检验,模型验证采用结构方程模型适配度检验。结果:收回有效问卷998份,签约居民心理契约满足水平得分为(3.45±0.56)分,行为意向自评得分为(2.81±0.29)分。交易型和关系型心理契约与行为意向各维度均相关(P<0.01)。在心理契约对行为意向作用效应模型中,交易型心理契约对忠诚意向、建言意向、退出意向和忽略意向的效应系数分别为0.33、0.24、-0.25、-0.49,其中对忽略意向仅产生间接效应;关系型心理契约对忠诚意向、建言意向、退出意向和忽略意向的效应系数分别为0.26、0.10、-0.14、-0.50,其中对建言和忽略意向仅产生间接效应。结论:家庭医生签约居民的心理契约尚未得到有效满足,心理契约的满足能直接增强居民的忠诚意向,降低退出意向,并间接影响建言和忽略意向。应积极开展签约居民心理契约调查,搭建省-市-县-乡协同联动平台,以提升家庭医生签约服务效能,改善签约居民的就医体验。
Objective To analyze the psychological contract satisfaction of contracted residents and its impact on their behavioral intentions under the guidance of incomplete contract theory,for reference in improving the effectiveness of contracted family doctor services.Methods 1100 contracted residents from nine townships/streets in Shandong province were selected as subjects according to stratified random sampling from September 2019 to June 2020,and a questionnaire survey on the level of satisfaction of contracted residents′psychological contracts(24 items)and assessment of behavior intentions(9 items)was conducted,and the model of the effect of contracted residents′psychological contracts on behavior intentions was established and analyzed.The correlation was validated by Pearson test and the structural equation method was used for verifying the model.Results 998 valid questionnaires were recovered.The psychological contract satisfaction score of the contracted residents was 3.45±0.56 and the behavioral intention was 2.81±0.29.Both transactional and relational psychological contracts were correlated with all dimensions of behavioral intention(P<0.01).Concerning the impacts of residents′psychological contracts on behavioral intentions,the effect coefficients of transactional psychological contracts on loyalty intention,voice intention,exit intention and neglect intention were 0.33,0.24,-0.25 and-0.49 respectively,with an indirect effect on neglect intention;the effect coefficients of relational psychological contracts on loyalty intention,voice intention,exit intention and neglect intention were 0.26,0.10,-0.14 and-0.50 respectively,with an indirect effect on advice intention and neglect intention.Conclusions Residents′psychological contract has yet not been effectively satisfied.Satisfying and improving the residents′psychological contract can directly enhance their loyalty intention and reduce their exit intention,indirectly influencing the voice and neglect intentions.In order to enhance the effectivenes
作者
唐昌海
王安琪
尹文强
陈钟鸣
马东平
Tang Changhai;Wang Anqi;Yin Wenqiang;Chen Zhongming;Ma Dongping(School of Public Health,Weifang Medical University,Weifang 261053,China;School of Management,Weifang Medical University,Weifang 261053,China)
出处
《中华医院管理杂志》
CSCD
北大核心
2022年第3期235-240,共6页
Chinese Journal of Hospital Administration
基金
国家自然科学基金(71804131,72004164)
山东省自然科学基金(ZR2019MG010)。
关键词
医师
家庭
家庭医生签约服务
签约居民
心理契约
不完全契约
问卷调查
Physicians,family
Family doctors′contract services
Contracted residents
Psychological contract
Incomplete contract
Questionnaires
