摘要 近年来我国的社区卫生服务机构得到了快速发展，但总体仍处在初级阶段，加之居民的 就诊观念尚未发生根本转变、倒三角的资源配置结构以及不同层级医疗机构间的协同功效不 足，使得我国社区首诊的建设仍以群众自愿、政策引导为主，而引导和推进居民社区首诊的 关键是解决群众对基层医疗服务的信任问题。89148

目的 测量居民参与和信任水平，分析居民参与行为对社区卫生服务信任的影响。 方法运用自制的居民信任量表对杭州市不同经济片区 701 名居民进行拦截抽样调查。采用卡 方检验和多元线性回归分析居民信任的影响因素。源Y于U优I尔O论P文W网wwW.yOueRw.com 原文+QQ75201-8766

结果自制的包含技术信任、人际信任、环境信任、管理信任四个维度的居民信任量表 Cronbach’s α 系数为 0。95，累计方差贡献率达 59。38%。居民总体信任得分为 77。80±0。51， 处在一般信任水平；居民参与(信息收集、责任行为、人际互动)得分为 76。69±0。51，参与 主动性一般。卡方检验显示文化程度、医疗保险类型和信息收集、人际互动、责任行为等居 民参与行为是影响居民信任的主要促进因素（P<0。05）。多元 logistic 回归分析显示居民参 与行为对居民信任的影响顺序为：责任行为>信息收集>人际互动。

结论居民信任的建设需要发挥政府、社区卫生服务机构及社区医生、社区的力量，也要充分 激发居民自身责任及义务。提高居民责任行为、信息收集意识和人际互动交往对增进居民信 任和社区首诊工作具有现实意义。

毕业论文关键词：基层首诊 ；社区卫生服务；居民参与 ；居民信任

Abstract Background In recent years, China's community health service agencies have been development rapidly, but the overall is still in the initial stage, with the residents’concept of treatment has not fundamentally changed, inverted triangle allocation of resources and different levels of medical institutions between the lack of synergies, which make the construction of the community's first consultation is still based on the voluntary and policy guidance of the masses, and the key to

guiding and promoting the first consultation of the residents' community is to solve the trust of the masses at the primary level。

Objective To measure the level of residents' participation and trust; To analyze the impact of residents' participation on residents' community health service trust。

Method A self-designed questionnaire is adopted to investigate 701 residents of different economic areas in Hangzhou。 Chi-square test and multiple liner regression analysis were used to analyze the influencing factors of trust。

Results The Cronbach's α coefficient is 0。95 and the cumulative variance contribution rate is 59。38%，which includes four dimensions: trust of technology、interpersonal trust、environmental trust and management trust。 Residents' overall trust score is 77。80 ± 0。51，which is at the level  of

general trust; Residents' participation score is 76。69 ± 0。51，initiative is at the level of general。 The chi-square  test  showed  that  the  participation  of  residents，such as  education level、 medical

insurance and information collection, interpersonal interaction and responsible behavior，were the main factors influencing residents' trust (P <0。05)。 The order of impact of residents 'behavior on residents'  trust  was:  Responsible  behavior>  Information  collection>  Interpersonal  interaction。

Conclusions

It is of practical significance to improve residents 'responsibility behavior，information collection consciousness and interpersonal interaction to enhance residents' trust and community first visit。