Influence Of The Leadership Style Of Department Directors On The Professional Spirit Of Clinic Physicians In Secondary Public Hospitals

[Objective]To develop the scale for measuring leader behavior of clinic department director.To investigate professionalism of physicians and their evaluation of the director’s leadership behavior,and explore the influence path of directors’ leadership behavior on professionalism of physicians.To put forward measures on improving leadership behavior of clinic department directors and professionalism of physicians.[Methods]The scale of professionalism for physicians was designed based on the Medical professional-ism in the new millennium: a physicians’ charter,including professionalism part and professional behaviors part.It has been testified by former research.We selected 26 items based on focus group discussion to measure professionalism of physicians.They were related to “focusing on medical quality” and “patient-oriented” and involved 7 professional duties in the Medical professional-ism in the new millennium: a physicians’ charter.The So LB was self-designed based on UK medical leadership framework and healthcare leadership model.We conducted two rounds of expert consultations and selected 20 items based on reliability and validity test focus group discussion.We conducted convenient sampling in four cities(Wuhan,Jinzhou from Hubei province and Zhengzhou Xinyang from Henan province),and chose 5 hospitals to investigate.The effective sample size was 234.SPSS20.0 software was used for statistical analysis.Statistical methods include descriptive analysis,T test,variance analysis,correlation analysis,factor analysis,regression analysis,path analysis and so on.[Results] 1.Design of So LBReferring to UK medical leadership framework and healthcare leadership model,we developed item pool based on literature research and focus group discussion,which include 35 items in 5 dimensions.We conducted two rounds of expert consultations,and 12 items were deleted.We further deleted 3 items with methods of frequency distribution analysis,item discrimination analysis,item variation coefficient analysis,internal consistency reliability analysis,correlation analysis,factor analysis,reliability and validity test,and panel discussion,based on the survey.The final scale showed good reliability and validity.The final So LB includes five dimensions(20 items): leadership charisma(6 items),goal setting(4 items),participation in team(4 items),service improvement(3 items),and capacity development(3 items).2.Leader behavior of clinic department director and influencing factorsPhysicians showed high evaluation on the leadership behavior of clinical directors,with an overall average score of(3.47 ± 0.61).The goal setting dimension had lowest score(3.37 ± 0.56).The regression results showed that gender,title,annual salary,and working hours were the influencing factors of the director’s leadership behavior score.3.Professionalism of physicians and influencing factorsThe overall average of professional attitude was(3.66 ± 0.32),and 13 of the 15 items had a recognition degree of over 80%.The overall average of professional behavior was(3.67 ± 0.36).The incidence rate of all positive behavior items was higher than 95%,and the incidence rate of all passive behavior items was lower than 20%.The regression results showed that age and performance system were the influencing factors of professional attitude.The professional attitude of doctors is the influencing factor of professional behavior.4.The relationship of clinic department directors’ leader behavior and physicians’ professionalismEach dimension of leader behavior was conducted correlation analysis with professional attitude and professional behavior,and the results showed that all the 5 dimensions of leader behavior had positive correlation with professional attitude and professional behavior(P<0.01).5.Path analysis of clinic department directors’ leader behavior and physicians’ professionalismPath analysis showed that leadership charisma influenced dimensions of fair allocation of resources,medical quality improvement,resolution of interest conflicts and trust maintaining,capacity development influenced dimensions of capacity improvement and honesty,service improvement influenced dimensions of medical quality improvement and patient confidentiality.[Conclusions]The So LB has good reliability and validity and can basically reflect leader behavior of clinic department directors.leader behavior of clinic department directors has positive correlation with professional attitude and professional behavior.physicians’ professional attitude coordinate with their professional behavior.Physicians has high evaluation on leader behavior of clinic department directors and their professionalism.Demographic variables have limited effect on the evaluation of the clinical department directors’ leadership behavior.Physicians’ satisfaction with performance system and promotion system can influence their evaluation on clinic department directors.Measures should be taken to improve the leadership effect of the clinical director so as to promote the improvement of the professional spirit of physicians.