Abstract: Background　In the context of high-quality development of family doctor contract services, stimulating the effectiveness of family doctor teams and exploring strategies to enhance team performance have become important tasks in primary healthcare human resource management. Measuring and evaluating team effectiveness can help develop targeted management strategies.Objective　To develop and validate an evaluation scale for assessing the service efficacy of family doctor contract service teams, providing a basis for effectively evaluating and improving their work performance. Methods　The study was conducted from July 2023 to January 2024. Initially, a literature intelligence analysis method was employed, using the "input-process-output" framework as the indicator construction model. Based on the conceptual and operational definitions of team effectiveness, systematic principles, logical principles, and inductive techniques were applied to develop an initial item pool comprising 3 dimensions, 4 second-level indicators, and 34 third-level indicators. The Delphi questionnaire consultation method was used to screen and optimize the item pool, resulting in an evaluation scale with 3 dimensions, 4 second-level indicators, and 36 third-level indicators. The scale was then adapted into a survey version for research purposes. A questionnaire survey was administered to 509 staff members engaged in general practice and family doctor services from 20 high-quality community health service centers in Shanghai. The reliability and validity of the scale were tested using exploratory factor analysis, confirmatory factor analysis, split-half reliability, and internal consistency coefficient (Cronbach's α). Criterion-related validity was also analyzed. Results　A stratified exploratory factor analysis of the team effectiveness evaluation scale from 509 respondents yielded a KMO value of 0.975, and Bartlett's sphericity test showed χ2 =29 360.476, P<0.001. Using principal component analysis and varimax orthogonal rotation, four common factors were extracted. After discussion, one item that did not meet the requirements was deleted. All factor item loadings were >0.5, with a cumulative variance contribution rate of 77.906%. The 35 items were categorized into four dimensions: human resource allocation, capability reserve, team operation, and output execution, forming four subscales. Confirmatory factor analysis of the four subscales met the test requirements. Criterion-related validity analysis indicated that the four subscales and the total scale of the team effectiveness tool were positively correlated with personal efficacy (P<0.01). Split-half reliability and internal consistency analysis showed that Cronbach's α coefficients for the total scale and subscales were all above 0.9, and the split-half coefficients were above 0.85. Conclusion　The evaluation scale for family doctor contract service team efficacy demonstrates good reliability and validity, and can serve as a subjective assessment tool for evaluating the performance of family doctor teams.

Key words: Family doctor team, Team efficacy, Scale, Evaluation scale, Reliability

摘要： 背景　在家庭医生签约服务高质量发展背景下，如何激发家庭医生团队工作的有效性，探索提升团队工作绩效水平的策略是基层卫生人力资源管理的重要工作之一。开展团队效能的测量和评价助于建立针对性的管理策略。目的　构建家庭医生签约服务团队服务效能评价量表，为有效评价、提升家庭医生团队工作效能提供依据。方法　研究周期为2023年7月—2024年1月，首先运用文献情报分析方法，以“投入-过程-产出”为指标构建框架，从团队效能的概念及测量定义出发，采用系统原则、逻辑原则、归纳技术形成包含3个维度，4个二级指标和34个三级指标的量表条目池；使用德尔菲问卷函询方法对条目池进行筛选和优化，形成包含3个维度，4个二级指标和36个三指标的家庭医生团队效能评价量表，将家庭医生团队效能评价量表转化为研究所需的调查版本。采用问卷调查方法对509名上海市20家高质量社区卫生服务中心从事全科医疗和家庭医生服务的人员进行调研，对指标体系进行探索性因子分析、验证性因子分析、折半信度和内部一致性系数（Cronbach's α）检验其信效度，进行效标关联效度分析。结果　对509名调查对象的团队效能评价量表进行分层探索性因子分析，KMO值为0.975，Bartlett's球形度检验球形检验χ2＝29 360.476，P<0.001；运用主成分分析法和方差最大正交旋转法提取出4个公因子，经讨论删除1个不符合要求条目，各因子条目载荷均>0.5，累积方差贡献率77.906％；35个条目可以分为4个维度，包括人力配置、能力储备、团队运行、产出执行四个分量表，对4个分量表进行验证性因子分析满足检验要求；校标关联度分析显示团队效能工具的4个分量表和总量表均和个人效能感呈正比（P<0.01）；对量表进行折半信度和内部一致性系数分析，总量表和分量表的Cronbach's α系数均大于0.9，折半系数大于0.85。结论　家庭医生签约服务团队服务效能评价指标体系具有良好的信效度，可作为家庭医生团队效能的主观评价量表。

关键词: 家庭医生团队, 团队效能, 量表, 评价量表, 信度