Analysis Of Influencing Factors Of Clinicians’ Intention To Act On Medical Emergency Disposal Rights Based On TPB Theory

Objective:The right to medical emergency treatment refers to the corresponding disposal measures made by medical institutions in order to better meet the interests of patients in emergency situations where the patient’s life is in danger.Clinicians are the main body of the implementation of the right to medical emergency disposal,this paper aims to understand the behavior intention of clinicians for emergency disposal rights,and build a theoretical model based on the classical TPB theory,and analyze the relevant factors affecting the behavior intentions of clinicians through empirical research.In practice,relevant suggestions are made to better alleviate the conflict between the patient’s right to make medical decisions and the hospital’s emergency disposal power.Methods:A questionnaire survey was conducted on clinicians at all levels of medical institutions in a city using a convenient sampling method,and a total of 766 valid questionnaires were recovered.The questionnaire mainly includes the basic characteristics of the individual,the clinician’s cognition of the emergency disposal right,and the clinician’s planned behavior scale,which is divided into the clinician’s behavior attitude,subjective norms,perceived behavior and behavioral intention.Microsoft Excel 2010 and Epidata3.1 were used for questionnaire data entry,and IBM SPSS 24.0 and Amos23.0 were used for data processing and statistical analysis.Results:1.The correctness rate of the clinicians’ cognition of the rights and obligations of emergency treatment is 16.0%,and they believe that the emergency disposal right is a right.The correctness rate of understanding the method of medical notification was 51.3%,believing that oral written notification was OK,and 41.3% of clinicians believed that only written notification had corresponding effect.The correctness of the understanding of the practice under emergency treatment was 44.8%.2.For conflicts of rights and legal liability in emergency situations.Clinicians are more concerned about the patient’s right to life and health,and believe that the patient is more concerned about his or her right to informed consent.For the legal liability of emergency disposal,85.0% of the clinicians believe that it is necessary to judge whether clinicians are liable based on whether they are at fault.In emergency situations,38.9% of clinicians believed that they were liable for failure to meet their obligation to inform.3.The difference in behavior intention is statistically significant due to the inability to obtain the valid opinion of close relatives,gender,education,medical institution,and cognition of damage liability under emergency disposal（P<0.05）.Gradual multiple regression shows that there is a significant positive correlation between academic qualifications and the level of the hospital where the behavior intention score is located,and the gender and the recognition of responsibility for the consequences of damage will have a negative correlation on the behavior intention score.4.Under the refusal of close relatives to the best treatment suggestion,different genders,academic qualifications,working years,different levels of medical institutions,damage to the patient’s right to know,and different experience of clinicians,the difference in behavior intention is of statistical significance（P<0.05）,and the gradual multiple regression shows: academic qualifications,the level of the hospital,the right to know of the injured party,and whether the experience has a significant positive impact on the behavioral intention score.5.In the absence of valid opinions from close relatives,the structural equation model shows that behavioral attitudes have a greater impact on behavioral intentions（SMC>0.67）,and subjective norms and perceptual behaviors have a moderate impact on behavioral intentions（SMC>0.33）.Clinicians’ behavioral attitudes can effectively predict behavioral intentions positively（β= 0.680,P<0.001）;subjective norms can effectively predict behavioral intentions in a positive direction（β =0.486,P<0.001）;perceptual behavior can effectively predict behavioral intentions in a negative direction（β =-0.440,P<0.001）;Demographic characteristics can effectively predict behavioral intentions in a positive direction（β =0.252,P=0.0013）.Clinicians believe that emergency treatment is beneficial to the health of patients,and the impact on behavior and attitude is the most significant,with a direct impact coefficient of 0.865;the behavior of colleagues around them has the most significant impact on subjective norms,with a direct impact coefficient of0.833;and the fear of going against the will of family members has the most significant impact on perceived behavior,with a direct impact coefficient of 0.861.6.Structural equation model showing that behavioral attitudes,subjective norms,and perceived behaviors all have a moderate effect on behavioral intent under the rejection of the best treatment opinions of close relatives（SMC>0.33）.Clinicians’ behavioral attitudes can effectively predict behavioral intentions in a positive direction（β = 0.528,P <0.001）;subjective norms can effectively predict behavioral intentions in a positive direction（β = 0.539,P<0.001）;and perceptual behavior can effectively predict behavioral intentions in a negative direction（β =-0.541,P <0.001）.Patients who can be recognized by emergency treatment have the most significant impact on behavioral attitudes,with a direct impact coefficient of0.854.The responsibility mission promotes the greatest impact on subjective norms,with a direct impact coefficient of 0.861,and the fear of going against the will of the affected family members has the most significant impact on perceptual behavior,with a direct impact coefficient of 0.915.Conclusions:1.Some clinicians are not clear about the disposal measures,rights and obligations,and notification of the emergency disposal rights prescribed by law.Clinicians’ legal literacy and cognitive abilities need to be further strengthened.2.The relevant laws need to be further clarified on the specific implementation conditions for emergency disposal,the liability for emergency disposal of damages and the definition of the responsibility for notification.3.In the absence of the effective opinions of close relatives,the factors that affect the intention of the clinician to deal with the emergency are gender,education,the level of the medical institution,and the perception of the liability for damage under the emergency treatment.4.Under the refusal of close relatives to the best treatment opinion,the factors affecting the clinician’s intention to deal with the emergency are gender,education,working age,the level of the medical institution where the patient is located,the cognitive status of the injured party’s right to know,and the clinician’s experience.5.Attitude toward the behavior,subjective norms and perceived behavior control based on TPB theoretical models can explain the behavioral intentions of clinicians to a certain extent.In both cases,attitude toward the behavior and subjective norms positively affect behavioral intent;perceptual behavior negatively affect behavioral intent.