【摘要】 目的 构建并评估临床医学专业人才医防融合能力评价指标体系，为医防融合国家战略的推进提供参考依据。方法 采用文献查阅法和系统综述法初步确定临床医学专业人才医防融合能力评价指标体系框架，遴选20名从事相关领域的专家进行德尔菲专家咨询，应用层次分析法计算各级指标权重系数；采用该指标体系通过问卷星形式对2025年5月在福建省随机抽取的360名临床医学专业本科生和220名临床专业执业医师进行医防融合能力评估。结果 2轮专家咨询的积极系数分别为90%(18/20)和100%(18/18)，专家积极程度较高；2轮专家咨询的专家权威程度分别为0.564和0.777，第2轮专家咨询的专家权威程度较高；2轮专家咨询的肯德尔系数分别为0.187和0.542（均P<0.001），且第2轮专家咨询的肯德尔系数较第1轮明显提高（χ~2=325.89,P<0.001），第2轮专家咨询的专家意见协调程度较好；经专家咨询后，最终构建的临床医学专业人才医防融合能力评价指标体系共包括一级指标4个、二级指标12个和三级指标36个，最终一级指标、二级指标和三级指标重要性得分均值分别为4.67～4.89分、4.39～4.78分和4.31～4.94分，指标满分率分别为44.44%～72.22%、38.89%～72.22%和33.33%～61.11%，变异系数分别为0.06～0.10、0.08～0.12和0.04～0.13；在构建的评估指标中，一级指标权重为0.075??0.331，二级指标权重为0.139??0.528，三级指标权重为0.075～0.625。最终纳入分析的福建省临床医学专业本科生和临床专业执业医师分别为342人和211人，其医防融合能力总平均分分别为（2.096±0.696）和（3.076±0.632）分，临床专业执业医师医防融合能力总平均分高于临床医学专业本科生（t=9.609,P<0.001），临床专业执业医师除二级指标“预防医学知识”外的其他一级指标、二级指标和三级指标平均分亦均高于临床医学专业本科生（均P<0.001）。结论 本研究构建的临床医学专业人才医防融合能力评价指标体系具有良好的科学性和可靠性，可为精准评估临床医学专业人才的医防融合服务能力提供参考。更多还原

【Abstract】 Objective To construct and evaluate an index system for assessing the medical care-prevention integration capabilities of clinical medical professionals, providing a reference for advancing the national strategy of medical careprevention integration. Methods A literature review and a systematic review were conducted to preliminarily establish the framework for the index system. Twenty experts in relevant fields were selected for Delphi expert consultation, and the analytic hierarchy process(AHP) was employed to calculate the weights for each level of indexes. The established evaluation index system was then adopted to assess the medical care-prevention integration capabilities of 360 randomly selected undergraduates majoring in clinical medicine and 220 licensed clinical physicians in Fujian province in May2025 via an online questionnaire. Results The expert positive coefficients in the two rounds of expert consultation were90%(18/20) and 100.0%(18/18), indicating a high positive degree of experts. The expert authority coefficients in the two rounds were 0.564 and 0.777, with the second round demonstrating higher expert authority. The Kendall’s coefficients of concordance in the two rounds of expert consultation were 0.187 and 0.542(both P < 0.001), being higher in the second round(χ~2 = 325.89, P < 0.001), which indicated better concordance among experts. Following expert consultation, the final evaluation index system for medical care-prevention integration capabilities of clinical medical professional was established, comprising 4 first-level indexes, 12 second-level indexes, and 36 third-level indexes. The mean importance scores of the first-, second-, and third-level indexes ranged from 4.67 to 4.89, 4.39 to 4.78, and 4.31 to 4.94, respectively.The full-score rates of the first-, second-, and third-level indexes ranged from 44.44% to 72.22%, 38.89% to 72.22%, and33.33% to 61.11%, with coefficients of variation ranging from 0.06 to 0.10, 0.08 to 0.12, and 0.04 to 0.13, respectively.The weights of the first-, second-, and third-level indexes ranged from 0.075 to 0.331, 0.139 to 0.528, and 0.075 to 0.625,respectively. The final sample included 342 undergraduates majoring in clinical medicine and 211 licensed clinical physicians from Fujian province, who showed the overall mean scores of(2.096 ± 0.696) and(3.076 ± 0.632),respectively, in medical care-prevention integration capabilities. The overall average score of licensed clinical physicians was higher than that of undergraduates majoring in clinical medicine(t = 9.609, P < 0.001). Licensed clinical physicians scored higher than undergraduates on all the three levels of indexes except the second-level index “preventive medicine knowledge”(all P < 0.001). Conclusions The established evaluation index system for medical care-prevention integration capabilities among clinical medical professionals demonstrates sound scientific validity and reliability. It provides a reference for accurately assessing the medical care-prevention integration service capabilities of clinical medical professionals.更多还原