Construction And Research Of Doctor's And Nurse's Practice Environment Indicator System And The Scale

Objective: Explore and construct a system of practice environmental evaluation indicators for doctors and nurses in line with the characteristics of China's medical development,compile a scale for doctors and nurses' practice environment,and provide content basis and quantitative standards for medical practice environment assessment.It provides the basis for improving the practice environment of doctors and nurses and realizing multidirectional scientific hospital management.Methods: This study,which is based on the nurse's practice environment scale at home and abroad,through the literature research,qualitative interviews and quantitative analysis combined,according to the characteristics and the development of Chinese medical to the actual requirement of the medical staff,screening of doctors,nurses,practicing environment evaluation index respectively,and at the same time increase the index of occupational psychology,preliminary construction of the index system.Two-round Delphi method was used to screen and revise the evaluation index to determine the final doctors,nurses practice environmental evaluation index system.SPSS and Excel were used to evaluate the importance and operability of indicators,and the experts' active degree,authority degree,concentration degree and coordination degree.Determine the weights of indicators at all levels using the percent weight calculation method.From July to November 2019,180 doctors and 400 nurses were randomly selected from 5 hospitals in China.A questionnaire survey of the practice environment was conducted.SPSS and AMOS software were used for project analysis and reliability and validity testing.Results: 1.The evaluation index system of doctor's practice environment includes 3 firstlevel indicators,6 second-level indicators and 28 third-level indicators.The nurse practice environmental evaluation index system includes 3 first-level indicators,7 second-level indicators and 24 third-level indicators.The recovery rate of Delphi questionnaire was 100%,and the expert's authority coefficient was 0.812.Kendall's W coordination test experts were consistent(P < 0.001)2.Project analysis results: The correlation coefficient of all index items in the medical practice environment scale was between 0.522-0.997,and the correlation was all significant.The correlation coefficients of all levels of indicators in the nurse practice environment scale were between 0.600-0.996,all of which were significant.3.Reliability analysis results: In this study,180 questionnaires were distributed among doctors,of which 144 were valid.The effective recovery rate was 80.00%.The Cronbach's coefficients of the three dimensions of the doctors' professional environment index are0.970-0.989,the Cronbach's values of the six dimensions of the secondary indicator are 0.877-0.989,and the Cronbach's coefficients of the 28 items of the third-level indicator are 0.946.The internal consistency of the scale was better.In this study,400 questionnaires were given to nurses,with 375 valid questionnaires.The effective recovery rate was 93.75%.The Cronbach's coefficients of the three dimensions of the nurses' professional environment index are 0.963-0.991,the Cronbach's values of the seven dimensions of the secondary indicator are 0.907-0.991,and the Cronbach's coefficients of the 24 items of the third-level indicator are 0.978.The internal consistency of the scale was better.4.Validity analysis results: The variance contribution rate of factor analysis was 79.42% and 88.32%,respectively,the questionnaire has better structure validity.It can be known from exploratory factor analysis,the evaluation index system of practicing environment for doctors and nurses is composed of three first-level indicators,organizational support,professionalism,social atmosphere.The confirmatory factor analysis results show that the structural equation models fit well.Conclusion: This study has completed the exploration and verification of the environmental evaluation index system for doctors and nurses.Study shows that doctors,nurses,practicing environment evaluation index system of the theoretical framework of highly consistent with the test result,scale internal consistency reliability is higher,the content,structure validity are conform to the requirements of the indicators,has a perfect scientific and reliability,to improve the doctors,nurses,practice environment,to achieve targeted provide a scientific basis for health management.