医疗环境危机的弹性分析:基于危机管理组件的结构方程模型

S. Ghiyasi, Fatemeh Verdi Baghdadi, Farshad Hashemzadeh, A. Soltanzadeh
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引用次数: 0

摘要

提高危机应变能力指数是医疗环境中的关键目标之一。各种参数可以影响危机复原力。本研究旨在分析医疗环境中危机应变能力的危机管理成分。这项横断面和描述性分析研究于2020年在14家医院和医疗中心进行。根据科克伦公式确定343.5个样本量。我们使用Azadian等人的44项危机管理问卷来收集数据。问卷的组成部分包括管理承诺、错误学习、文化学习、意识、准备、灵活性和透明度。采用IBM SPSS AMOS v. 23.0结构方程建模方法对数据进行分析。年龄和工作经验平均为37.78±8.14岁和8.22±4.47岁。危机应变能力指数为2.96±0.87。结果显示,危机管理各组成部分与该指数有显著相关(p <0.05)。对弹性指数影响最大和最小的因素分别是准备程度(E=0.88)和透明度(E=0.60)。模型的RMSEA、CFI、NFI、NNFI (TLI)的拟合优度分别为2.86、0.071、0.965、0.972、0.978。医疗环境危机应变能力指数处于中等水平。此外,结构方程建模结果表明,在优先考虑提高弹性水平的措施时,应考虑危机管理各组成部分的影响。
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Resilience Analysis of Crisis in Medical Environments: A Structural Equation Modeling based on Crisis Management Components
Enhancing the index of crisis resilience is one of the key goals in medical environments. Various parameters can affect crisis resilience. The current study was designed to analyze crisis resilience in medical environments based on the crisis management components. This cross-sectional and descriptive-analytical study was performed in 14 hospitals and medical centers, in 2020. A sample size of 343.5 was determined based on the Cochran's formula. We used a 44-item crisis management questionnaire of Azadian et al. to collect data. The components of this questionnaire included management commitment, error learning, culture learning, awareness, preparedness, flexibility, and transparency. The data was analyzed based on the structural equation modeling approach using IBM SPSS AMOS v. 23.0. The participants’ age and work experience mean were 37.78±8.14 and 8.22±4.47 years. The index of crisis resilience was equal to 2.96±0.87. The results showed that all components of crisis management had a significant relationship with this index (p <0.05). The highest and lowest impact on the resilience index were related to preparedness (E=0.88) and transparency (E=0.60). The goodness of fit indices of this model including RMSEA, CFI, NFI, and NNFI (TLI) was 2.86, 0.071, 0.965, 0.972, and 0.978. The index of crisis resilience in the medical environments was at a moderate level. Furthermore, the structural equation modeling findings indicated that the impact of each component of crisis management should be considered in prioritizing measures to increase the level of resilience.  
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