Development of competency model for family physicians against the background of 'internet plus healthcare' in China: a mixed methods study.

BACKGROUND: Identification of the service competences of family physicians is central to ensuring high-quality primary care and improving patient outcomes. However, little is known about how to assess the family physicians' service competences in primary care settings. It is necessary to develop and validate a general model of core competences of the family physician under the stage of construction of family doctor system and implementation of 'Internet Plus Healthcare' service model in China. METHODS: The literature review, behavioural event interviews, expert consultation and questionnaire survey were performed. The scale's 35 questions were measured by response rate, highest score, lowest score, and average score for each. Delphi method was used to assess content validity, Cronbach's α to estimate reliability, and factor analysis to test structural validity. Respondents were randomly divided into two groups; data for one group were used for exploratory factor analysis (EFA) to explore possible model structure. Confirmatory factor analysis (CFA) was then performed. RESULTS: Effective response rate was 93.56%. Cronbach's α coefficient of the scale was 0.977. Factor analysis showed KMO of 0.988. Bartlett's test showed χ2 of 22 917.515 (df = 630), p < .001. Overall authority grade of expert consultation was 0.80, and Kendall's coefficient of concordance W was 0.194. By EFA, the five-factor model was retained after thorough consideration, and four items with factor loading less than 0.4 were proposed to obtain a five-dimension, 32-item scale. CFA was performed on the new structure, showing high goodness-of-fit test (NFI = 0.98, TLI = 0.91, SRMSR = 0.05, RMSEA = 0.04). Overall Cronbach's α coefficients of the scale and each sub-item were greater than 0.9. CONCLUSIONS: The scale has good reliability, validity, and credibility and can therefore serve as an effective tool for assessment of Chinese family physicians' service competences.

Career Calling as the Mediator and Moderator of Job Demands and Job Resources for Job Satisfaction in Health Workers: A Cross-Sectional Study.

Job satisfaction of health professionals is a key determinant of the quality of health services and even affects the development of the healthcare system. In this study, we sought to explore the mechanism by which job demands, job resources, and career calling affect the job satisfaction of health professionals. Our findings may provide insights for increasing their job satisfaction and improving the quality of health services. We conducted a questionnaire survey of 1,117 health workers in Hangzhou; t-test, Chi-squared analysis, hierarchical linear regression was used to analyze the state of job satisfaction of health personnel and the associated factors; path analysis with the Structural Equation Model was used to explore and verify the effects of job resources, demands, and career calling on job satisfaction, as well as their mechanism. Social support, performance feedback, working conditions, and career calling had significant positive effects on job satisfaction of health professionals, whereas work-family conflict and emotional requirements for work had significant negative effects. Path analysis indicated that job resources, demands, and career calling directly affected job satisfaction; job resources and demands showed indirect effects on job satisfaction with career calling as a mediator. Career calling had a positive moderating effect in the path of "job resources-job satisfaction," and a negative moderating effect in the path of "job demands-job satisfaction." In conclusion, hospital administrators should provide more job resources for health workers and formulate reasonable job demands while paying close attention to work-related pressure. Hospital administrators and health departments need to improve hospital policies and inculcate a sense of belonging and career calling among health professionals. Education and evaluation of career calling need to be accorded more attention so that healthcare workers can perceive a stronger sense of calling and achievement, and hence a higher degree of job satisfaction.