村医对医疗纠纷相关知识的认知、态度、行为调查分析和启示.docVIP

村医对医疗纠纷相关知识的认知、态度、行为调查分析和启示 　　【摘要】目的了解村?t对医疗纠纷相关知识的认知、态度及行为，为加强村级医疗机构管理，规范村医的诊疗行为提供参考依据。方法采用多阶段整群随机抽样的方法，对广西603个行政村的村卫生所（室）的医务人员进行问卷调查，调查内容包括对医疗纠纷相关知识的认知、态度及行为等。结果在医疗纠纷的认知方面，1697名村医中，了解医疗纠纷含义者占88.7%，了解处理医疗纠纷的相关法律法规者占72.2%，认为医疗纠纷是由医疗技术或医德医风问题引起者占56.7%，认为医疗纠纷属于医疗责任问题者占76.3%，认为医疗纠纷难以防范者占71.1%。在医疗纠纷的态度方面，76.3%的村医对医患纠纷有忧患意识，70.1%的村医认为我国目前的医患关系紧张，74.1%的村医觉得当前的医疗纠纷让自己感到紧张，72.2%的村医认为现在的医生越来越难做，57.7%的村医认为医疗纠纷有上升趋势。在防范医疗纠纷的诊疗行为方面，67.0%的村医做到向患者耐心讲解病情和治疗方案，73.2%的村医做到向家属详细介绍病情及治疗情况，78.4%的村医能做到对患者履行告知义务，82.5%的村医能做到在诊治患者时谨记诊疗规范制度要求，38.1%的村医认为需扩大检查范围和项目，56.7%的村医认为需回避高危和疑难患者，50.5%的村医对患者会做转诊处理。在防范医疗纠纷的看法方面，77.3%的村医认为需提高待遇，91.8%的村医认为关键是提高医德，87.0%的村医认为需提高自身业务素质和诊疗技术水平，70.1%的村医认为可请村民担当监督员监督诊疗行为，90.7%的村医认为需对村医开展医疗纠纷防范知识培训。结论村医对医疗纠纷的防范知识认知程度不够，态度上存在一定负面性，应对医疗纠纷的诊疗行为也存在欠积极之处，需进一步加强医疗纠纷防范知识的宣传及培训，以及防范态度和行为的干预。 　　【关键词】医疗纠纷；认知；态度；行为；基层医务人员 　　中图分类号：R197.323.4文献标识码：ADOI：10.3969/j.issn2016.05.021 　　【Abstract】ObjectiveTo know about the status of cognition，attitudes and behaviors of rural doctors on medical disputes related knowledge，so as to provide references for the managers to strengthen management for rurallevel medical institutions and regulate the behaviors of diagnosis and treatment among rural doctors.MethodsAn multistage cluster random sampling was conducted in 1697 rural doctors who worked in 603 rural health clinics （rooms） in Guangxi，and the survey contained cognition，attitudes and behaviors，etc.of medical disputes related knowledge.ResultsIn the cognition of medical disputes，88.7% of rural doctors understood the meaning of medical disputes，72.2% knew the relevant laws and regulations of dealing with medical disputes，56.7% thought that the medical disputes were caused by medical technology or medical ethics，76.3% of them felt that the medical disputes were due to medical liability issues and 71.1% felt that it was hard to prevent the medical disputes.In the attitudes of medical disputes，76.3% of them were aware of hardship of medical disputes，70.1% thought that China’s c