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中文摘要：
目的：分析乡村医生合理用药现状，探讨其影响因素和作用机理。方法通过处方、问卷和访谈获取资料，分层随机抽取山东省5市621名乡村医生进行调查，并分析有效处方3091张，了解乡村医生合理用药影响因素。结果基本药物制度实施后，乡村医生合理用药处方指标有明显改善，抗生素使用率从65.4%下降至62.2%；乡村医生职业素质及合理用药相关培训效果、一体化管理水平、基本药物目录、患者对制度的认可程度及服务满意度，是乡村医生合理用药的主要影响因素。结论通过完善国家基本药物制度和相关政策、强化乡村一体化管理和业务技术培训、加强基本药物政策宣传、营造有利于乡村医生合理用药的执业环境等，可影响乡村医生的行为态度、主观规范和知觉控制，促进合理用药。
英文摘要：
Objective To analyze the present rational use of rural doctors,and explore the influence factors and mechanism of action.Methods 621 rural doctors from five cities of Shandong province were surveyed in a stratified random sampling,by means of prescription,questionnaire and interview,along with analysis of 3 091 valid prescriptions to learn such influence factors.Results The essential medicine system has effectively enhanced the indicators of rational drug use of rural doctors,as evidenced by a drop of antibiotics use from 65.4% to 62.2%.Main influence factors for such change include rural doctors＆#39;professionalism,training of policy and rational drug use,integrated management,the essential medicine list,the degree of patients＆#39;satisfaction and recognition of the essential medicine system. Conclusion Perfection of the regulations and policies of the system,strengthening of integrated management and training of medicine policy and medical technology,creation of an environment for them to prescribe rationally,can encourage their behavioral attitude,subjective norms and perceived behavioral control,so as to promote rational drug use.
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