Abstract: Background　The key to improving the team building of family doctors is to improve their work enthusiasm and the scientific and reasonable motivate mechanism is the key to improving their work enthusiasm.Objective　To analyze the influencing factors of family doctor team members' work enthusiasm in contracted service's and make recommendations for improving the motivate mechanism for family doctors.Methods　From July to September in 2017，287 family doctor team members of 11 community health service centers in Pukou District of Nanjing were surveyed by questionnaire，and eight leaders of community health service centers eight leaders of family doctor team，and four government health administrators were surveyed by structured interview.Guided by the two-factor theory，this paper analyzed the influencing factors of family doctor team members' work enthusiasm from two aspects of hygiene and motivation.Results　276 valid questionnaires were collected，the effective recovery was 96.2%.Main drive factors affecting the enthusiasm of family doctor team members were the policy and institutional design and remuneration levels in terms of hygiene，along with sense of achievement and personal development in terms of motivation.Conclusion　A sound and standardized management system and salary system should be established to increase the sense of achievement for family doctor team members.It is necessary to establish a career development platform and improve the incentive mechanism，so as to enhance the work enthusiasm of family doctors.

Key words: Contracted family doctor services, Motivate mechanism, Two-factor theory, Mixed research

摘要： 背景　完善家庭医生团队建设的关键在于提高其工作积极性，而科学合理的激励机制是提高其工作积极性的关键。目的　分析影响家庭医生签约服务工作积极性的因素，为完善家庭医生激励机制提供建议。方法　于2017年7—9月对南京市浦口区11家社区卫生服务中心家庭医生团队的所有成员287例进行问卷调查，对8例社区卫生服务中心负责人、8例家庭医生团队负责人及4例政府卫生行政管理人员进行结构性访谈。以双因素理论为指导，从保健因素和激励因素两方面分析家庭医生团队工作积极性的影响因素。结果　研究共回收有效问卷276份，问卷有效回收率为96.2%。在保健因素方面，政策与管理制度和薪酬水平是影响家庭医生团队成员工作积极性的主要因素；在激励因素方面，工作成就感和个人发展是影响家庭医生团队成员工作积极性的主要因素。结论　应建立健全合理规范的管理制度和薪酬制度、增加工作成就感、建立职业发展平台，完善激励机制，从而提升家庭医生团队成员工作的积极性。

关键词: 家庭医生签约服务, 激励机制, 双因素理论, 混合性研究