基于有序Logistic回归与决策树的上海市中医家庭康复满意度调查及影响因素分析

doi:10.3969/j.issn.1006-9771.2022.10.006

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (10): 1159-1168.doi: 10.3969/j.issn.1006-9771.2022.10.006

基于有序Logistic回归与决策树的上海市中医家庭康复满意度调查及影响因素分析

胡玉红¹,张明辉¹,鲍晓青²,孙炜^3,^4,⁵,鲍勇^3,^4,⁵,郭丽君^1,⁶()

1.上海中医药大学研究生院,上海市 201203
2.上海市申康医院管理中心,上海市 200041
3.上海交通大学健康传播发展中心,上海市 200030
4.上海交通大学中国城市治理研究院,上海市 200030
5.上海交通大学行业研究院,上海市 200030
6.上海健康医学院护理与健康管理学院,上海市 201318

收稿日期:2022-04-22 修回日期:2022-05-13 出版日期:2022-10-25 发布日期:2022-11-08
通讯作者: 郭丽君 E-mail:guolj_16@sumhs.edu.cn
作者简介:胡玉红(1997-),女,汉族,江西信丰县人,硕士研究生,主要研究方向：社区家庭康复服务。|郭丽君(1967-),女,汉族,辽宁沈阳市人,博士,教授,主要研究方向：社区家庭康复服务。
基金资助:
国家重点研发计划"主动健康和老龄化科技应对"重点专项项目(2020YFC2006400);国家自然科学基金重大项目(91646205);上海健康医学院护理与健康管理学院学科团队建设项目(社区居家老年保障体系研究)

Satisfaction and related factors of family rehabilitation of Traditional Chinese Medicine in Shanghai using ordinal logistic regression model and decision tree model

HU Yuhong¹,ZHANG Minghui¹,BAO Xiaoqing²,SUN Wei^3,^4,⁵,BAO Yong^3,^4,⁵,GUO Lijun^1,⁶()

1. Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
2. Shanghai Shenkang Hospital Management Center, Shanghai 200041, China
3. Health Communication Development Center, Shanghai Jiaotong University, Shanghai 200030, China
4. China Institute for Urban Governance, Shanghai Jiaotong University, Shanghai 200030, China
5. Institute of Industry Research, Shanghai Jiaotong University, Shanghai 200030, China
6. Shanghai University of Medicine & Health Sciences, Shanghai 201318, China

Received:2022-04-22 Revised:2022-05-13 Published:2022-10-25 Online:2022-11-08
Contact: GUO Lijun E-mail:guolj_16@sumhs.edu.cn
Supported by:
National Key Research and Development Program "Active Health and Aging Science and Technology Response" Key Special Project(2020YFC2006400);National Nature Science Foundation of China (Major)(91646205);Discipline Team Construction Project of School of Nursing and Health Management, Shanghai Health Medical College (Research on Community Home Security System for the Elderly)

摘要/Abstract

摘要：

目的调查上海市社区卫生服务机构康复人员对中医家庭康复服务满意度,探究其影响因素。

方法 2021年8月至10月,采用分阶段随机整群抽样方法,对上海市36家社区卫生服务机构的173名康复人员进行问卷调查。采用Spearman相关分析探讨中医家庭康复满意度的相关因素,采用有序Logistic回归模型和决策树模型分析影响康复人员对中医康复服务满意度的影响因素。

结果在173名康复专业人员中,对中医家庭康复开展感到满意的有85人(49.1%),满意度为一般的有83人(48%),仅有5人感到不满意(2.9%)。中医家庭康复满意度与期待的月收入呈负相关(r = -1.169, P = 0.026);与工作环境氛围、人员考核机制、晋升机制、知识在工作中的应用、发展前景、西医家庭康复了解情况、西医家庭康复满意度呈正相关(r > 0.268, P < 0.05)。有序Logistic回归结果均显示,晋升机制(OR = 0.033, 95% CI 0.003~0.341)、西医家庭康复的满意度(OR = 0.030, 95% CI 0.006~0.150)为社区康复专业人员对中医家庭康复开展满意度的独立影响因素。决策树模型显示结果与有序Logistic回归一致。

结论上海市社区康复专业人员对于中医家庭康复满意度仍有半数以上为一般及以下水平,建议提升社区康复人员中西医结合康复能力,增加在职人员康复培训机会,优化薪酬制度,拓宽晋升渠道,改善工作环境氛围,加强家庭康复宣传,探索家庭康复实施机制。

关键词: 家庭康复, 社区康复人员, 服务满意度, 有序Logistic回归, 决策树

Abstract:

Objective To investigate the satisfaction of rehabilitation staff in community health service institutions in Shanghai on family rehabilitation of Traditional Chinese Medicine (TCM), and explore the related factors.

Methods From August to October, 2021, a questionnaire survey was conducted among 173 rehabilitation workers from 36 community health service institutions in Shanghai by using a phased random cluster sampling method. Spearman correlation analysis was used to explore the related factors of TCM family rehabilitation satisfaction, and ordinal logistic regression model and decision tree model were used to analyze the independent related factors of TCM rehabilitation service satisfaction.

Results Among the 173 rehabilitation professionals, 85 (49.1%) were satisfied with the development of family rehabilitation of TCM, 83 (48%) were generally satisfied, and only 5 (2.9%) were dissatisfied. Family rehabilitation satisfaction of TCM was negatively correlated with expected monthly income (r = -1.169, P= 0.026), and was postively correlated with working environment, personnel assessment mechanism, promotion mechanism, application of knowledge in work, development prospect, understanding of western medicine family rehabilitation, and satisfaction of western medicine family rehabilitation (r > 0.268, P< 0.05). Ordinal logistic regression results showed that the promotion mechanism (OR = 0.033, 95%CI 0.003 to 0.341) and the satisfaction of family rehabilitation in western medicine (OR = 0.030, 95%CI 0.006 to 0.150) were independent related factors of community rehabilitation professionals' satisfaction on TCM family rehabilitation. The decision tree model showed consistent result with ordinal logistic regression.

Conclusion More than half of the community rehabilitation professionals in Shanghai are still satisfied with TCM family rehabilitation at the general level or below. It is suggested to improve the capacity of Chinese and western medicine combined rehabilitation, increase the training of in-service rehabilitation personnel, optimize the salary system, broaden the promotion channels, improve the working environment, strengthen the publicity of family rehabilitation, and explore the implementation mechanism of family rehabilitation.

Key words: family rehabilitation, community rehabilitation personnel, service satisfaction, ordinal logistic regression, decision tree

中图分类号:

胡玉红,张明辉,鲍晓青,孙炜,鲍勇,郭丽君. 基于有序Logistic回归与决策树的上海市中医家庭康复满意度调查及影响因素分析[J]. 《中国康复理论与实践》, 2022, 28(10): 1159-1168.

HU Yuhong,ZHANG Minghui,BAO Xiaoqing,SUN Wei,BAO Yong,GUO Lijun. Satisfaction and related factors of family rehabilitation of Traditional Chinese Medicine in Shanghai using ordinal logistic regression model and decision tree model[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(10): 1159-1168.

图/表 7

表1

变量赋值及基本特征(n = 173)"

变量类别	变量名称	变量赋值	n(%)	变量类别	变量名称	变量赋值	n(%)
个人一般情况	民族	1 =汉族	168(97.10)	工作情况	岗前业务培训	0 =否	10(5.80)
		2 =其他	5(2.90)			1 =是	163(94.20)
	性别	1 =男	47(27.20)		西医康复培训	0 =否	54(31.20)
		2 =女	126(72.80)			1 =是	119(68.80)
	年龄/岁	1 = 20~< 30	73(42.20)		中医康复培训	0 =否	92(53.20)
		2 = 30~< 40	65(37.60)			1 =是	81(46.80)
		3 = ≥ 40	35(20.20)		继续深造	0 =否	17(9.80)
	地区	1 =徐汇区	61(35.30)			1 =是	156(90.20)
		2 =闵行区	65(37.60)		工作环境氛围	1 =满意	142(82.10)
		3 =金山区	47(27.20)			2 =一般	28(16.20)
	婚姻	1 =已婚	111(64.20)			3 =不满意	3(1.70)
		2 =未婚	62(35.80)		人员考核机制	1 =满意	124(71.70)
	平均月收入/元	1 = <10 000	150(86.70)			2 =一般	43(24.90)
		2 = 10 000~15 000	23(13.30)			3 =不满意	6(3.50)
	工资是否满意	1 =满意	9(5.20)		晋升机制	1 =满意	106(61.30)
		2 =一般	95(54.90)			2 =一般	53(30.60)
		3 =不满意	30(17.30)			3 =不满意	14(8.10)
	期待月收入/元	1 = < 10 000	39(22.50)		知识在工作中的应用	1 =满意	136(78.60)
		2 = 10 000~15 000	33(19.10)		知识在工作中的应用	2 =一般	34(19.70)
		3 = > 15 000~20 000	92(53.20)			3 =不满意	3(1.70)
		4 = > 20 000	48(27.70)		发展前景	1 =满意	110(63.60)
	最高学历	1 =硕士及以上	17(9.80)			2 =一般	59(34.10)
		2 =本科	130(75.10)			3 =不满意	4(2.30)
		3 =大专及以下	26(15.00)	家庭康复认知及满意度情况	中西医优势对比	1 =中医康复	8(4.60)
	职称	1 =高级	13(7.50)			2 =西医康复	9(5.20)
		2 =中级	63(36.40)			3 =中西医结合康复	156(90.20)
		3 =初级及以下	97(56.10)		西医家庭康复了解	1 =了解	90(52.00)
	工作年限/年	1 = < 5	48(27.70)		情况	2 =一般	63(36.40)
		2 = 5~ 10	58(33.50)			3 =不了解	20(11.60)
		3 = > 10~20	44(25.40)		西医家庭康复满意	1 =满意	78(45.10)
		4 = > 20	23(13.30)		度	2 =一般	87(50.30)
						3 =不满意	8(4.60)

表1

表2

表3

各组中医康复满意度比较"

变量	分类	中医家庭康复满意度			χ²值	P值
变量	分类	满意(n = 85)	一般(n = 83)	不满意(n = 5)	χ²值	P值
民族	汉族	81	83	4	0.901	0.342
	其他	4	0	1
性别	男	19	25	3	2.614	0.106
	女	66	58	2
年龄	20~29岁	36	36	1	2.103	0.349
	30~39岁	29	32	4
	≥ 40岁	20	15	0
地区	徐汇区	30	28	3	0.283	0.868
	闵行区	31	32	2
	金山区	24	23	0
婚姻	已婚	50	57	4	2.249	0.134
	未婚	35	26	1
平均月收入/元	1 = <10 000	71	74	5	1.699	0.192
	2 = 10 000~15 000	14	9	0
工资是否满意	满意	24	9	0	9.813	0.007
	一般	38	51	3
	不满意	23	23	2
期待月收入/元	1 = < 10 000	5	3	1	6.395	0.094
	2 = 10 000~15 000	39	53	3
	3 = > 15 000~20 000	16	13	1
	4 = > 20 000	25	14	0
最高学历	硕士及以上	8	8	1	0.136	0.934
	本科	64	62	4
	大专及以下	13	13	0
职称	高级	9	4	0	2.600	0.272
	中级	29	31	3
	初级及以下	47	48	2
工作年限/年	1 = < 5	26	21	1	6.436	0.092
	2 = 5~ 10	21	34	3
	3 = > 10~20	25	18	1
	4 = > 20	13	10	0
岗前业务培训	是	80	79	4	0.032	0.859
	否	5	4	1
西医康复培训	是	64	50	5	2.183	0.140
	否	21	33	0
中医康复培训	是	43	35	3	0.691	0.406
	否	42	48	2
继续深造	是	78	73	5	0.285	0.593
	否	7	10	0
工作环境氛围	满意	79	59	4	12.367	0.002
	一般	5	23	0
	不满意	1	1	1
人员考核机制	满意	78	44	2	33.654	< 0.001
	一般	6	36	1
	不满意	1	3	2
晋升机制	满意	69	37	0	35.363	< 0.001
	一般	16	34	3
	不满意	0	12	2
知识在工作中的应用	满意	77	56	3	15.837	< 0.001
	一般	8	25	1
	不满意	0	2	1
发展前景	满意	65	44	1	13.343	0.001
	一般	19	36	4
	比较不满意	1	3	0
中西医优势对比	中医康复	2	6	0	1.629	0.443
	西医康复	4	5	0
	中西医康复	79	72	5
西医家庭康复了解情况	了解	60	29	1	27.359	< 0.001
	一般	22	40	1
	不了解	3	14	3
西医家庭康复满意度	满意	73	5	0	109.723	< 0.001
	一般	9	76	2
	不满意	3	2	3

表3

表4

表5

表6

图1

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变量名	共线性统计		变量名	共线性统计
变量名	Tolerance	VIF	变量名	Tolerance	VIF
工资是否满意	0.835	1.198	知识在工作中的应用	0.650	1.402
工作环境氛围	0.548	1.823	发展前景	0.497	2.011
人员考核机制	0.416	2.404	西医家庭康复了解情况	0.650	1.583
晋升机制	0.412	2.248	西医家庭康复满意度	0.669	1.494

连接函数	χ²值	P值	伪R²
分对数	F = 160.537	< 0.001	C = 0.605
	P = 162.156	0.038	N = 0.756
	D = 87.338	0.999	M = 0.577
	L = 20.310	0.207
互补双对数	F = 256.855	< 0.001	C = 0.773
	P = 91.387	0.997	N = 0.967
	D = 100.813	0.980	M = 0.923
	L < 0.001	1.000
负双对数	F = 160.465	< 0.001	C = 0.604
	P = 127.270	0.600	N = 0.756
	D = 87.410	0.999	M = 0.577
	L = 16.603	0.412
概率	F = 159.874	< 0.001	C = 0.603
	P = 128.308	0.575	N = 0.754
	D = 88.001	0.999	M = 0.575
	L = 96.981	< 0.001
逆柯西	F = 170.922	< 0.001	C = 0.628
	P = 258.401	<0.001	N = 0.785
	D = 76.953	1.000	M = 0.614
	L = 30.479	0.016

自变量		β	Wald	P值	OR	95%CI
工资是否满意(不满意为参照)	满意	-0.404	0.561	0.454	0.668	0.232~1.921
工资是否满意(不满意为参照)	一般	0.240	0.397	0.528	1.271	0.602~2.683
工作环境氛围(不满意为参照)	满意	2.374	3.145	0.076	10.740	0.779~147.969
工作环境氛围(不满意为参照)	一般	0.956	0.481	0.488	2.601	0.175~38.706
人员考核机制(不满意为参照)	满意	-0.923	0.673	0.412	0.397	0.044~3.600
人员考核机制(不满意为参照)	一般	-0.963	0.800	0.371	0.381	0.046~3.149
晋升机制(不满意为参照)	满意	-3.423	8.169	0.004	0.033	0.003~0.341
晋升机制(不满意为参照)	一般	-1.689	2.614	0.106	0.185	0.024~1.432
知识在工作中的应用(不满意为参照)	满意	-1.660	1.192	0.275	0.190	0.010~3.743
知识在工作中的应用(不满意为参照)	一般	-2.217	2.080	0.149	0.109	0.005~2.217
发展前景(不满意为参照)	满意	0.419	0.170	0.680	1.520	0.208~11.123
发展前景(不满意为参照)	一般	0.188	0.037	0.848	1.207	0.176~8.265
西医家庭康复了解情况(不了解为参照)	了解	-0.473	0.679	0.410	0.623	0.202~1.919
西医家庭康复了解情况(不了解为参照)	一般	-0.415	0.578	0.447	0.660	0.227~1.923
西医家庭康复满意度(不满意为参照)	满意	-3.499	18.279	< 0.001	0.030	0.006~0.150
西医家庭康复满意度(不满意为参照)	一般	0.278	0.187	0.666	1.320	0.374~4.670

基于有序Logistic回归与决策树的上海市中医家庭康复满意度调查及影响因素分析

Satisfaction and related factors of family rehabilitation of Traditional Chinese Medicine in Shanghai using ordinal logistic regression model and decision tree model

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变量	r值	P值
民族	-0.072	0.344
性别	-0.123	0.106
年龄	-0.028	0.715
地区	-0.031	0.689
婚姻	-0.114	0.134
平均月收入	-0.099	0.193
工资是否满意	0.142	0.062
期待月收入	-1.169	0.026
最高学历	-0.028	0.719
职称	0.032	0.679
工作年限	-0.049	0.519
岗前业务培训	-0.014	0.859
西医康复培训	-0.113	0.140
中医康复培训	-0.063	0.407
继续深造	-0.041	0.595
工作环境氛围	0.268	< 0.001
人员考核机制	0.442	< 0.001
晋升机制	0.446	< 0.001
知识在工作中的应用	0.294	< 0.001
发展前景	0.278	< 0.001
中西医优势对比	-0.081	0.290
西医家庭康复了解情况	0.396	< 0.001
西医家庭康复满意度	0.771	< 0.001

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