基于德尔菲法构建中国医务人员职业紧张风险管理指标体系
Construction of work-related stress risk management index system for medical personnel in China based on Delphi method
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摘要:
背景 近年来医务人员职业紧张问题日趋严重，但目前国内尚未建立医务人员职业紧张风险管理指标体系，相关风险管理工作无据可依。
目的 通过德尔菲法构建我国医务人员职业紧张风险管理指标体系，为国内医务人员的职业紧张风险管理提供管理工具。
方法 在文献阅研和专家访谈的基础上，初步构建医务人员职业紧张风险管理指标池。通过两轮德尔菲法专家意见征询，收集专家对指标重要性、可操作性、熟悉程度和判断依据的意见，构建医务人员职业紧张风险管理指标体系。
结果 两轮各回收15份专家函询意见，回收率均为100％，专家意见权威系数均>0.90；第1轮指标重要性评分为9.78±0.35，变异系数为0~0.22，肯德尔协调系数为0.215（P<0.01），第2轮重要性评价为9.82±0.26，变异系数为0~0.13，肯德尔协调系数为0.208（P<0.01）。最终构建的医务人员职业紧张风险管理指标体系由10个一级指标、28个二级指标和47个三级指标组成。10个一级指标分别是工作要求、工作控制、组织支持、人际关系、角色冲突、医患矛盾和医疗纠纷、工作-生活冲突、职业认同、工作场所环境、社会环境。
结论 本研究首次初步建立了针对我国医务人员职业紧张的精细化风险管理指标体系，后续拟在指标体系的应用验证中对指标做进一步完善。
Abstract:Background Despite the growing occupational stress of medical personnel, there is no occupational stress risk management index system for medical personnel in China, and the related risk management work is unfounded.
Objective To construct a work-related stress risk management index system for medical personnel in China based on Delphi method.
Methods On the basis of literature review and expert interview, an index pool of work-related stress risk management for medical personnel was preliminarily constructed. Through two-round Delphi method, experts' opinions on the importance, operability, familiarity, and judgment basis of candidate indicators were collected, and an index system for work-related stress risk management of medical personnel was constructed.
Results Fifteen expert opinions were collected in each of the two rounds, with a recovery rate of 100%. The expert authority coefficients were all >0.9. In the first round, the importance score was 9.78±0.35, the coefficient of variation was 0-0.22, and the Kendall coordination coefficient was 0.215 ( P<0.01); in the second round, the importance score was 9.82±0.26, the coefficient of variation was 0-0.13, and the Kendall coordination coefficient was 0.208 (P<0.01). Finally, the index system of work-related stress risk management for medical personnel was composed of 10 first-level indexes, 28 second-level indexes, and 47 third-level indexes. The 10 first-level indexes were job demand, job control, organizational support, interpersonal relationships, role conflict, doctor-patient conflict and medical disputes, work-life conflict, professional self-identity, workplace environment, and social environment, respectively.
Conclusion A preliminary refined work-related stress risk management index system for medical personnel in China has been established, but the indicators will be further modified by verification and application of the indicator system.
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