Abstract: Background　 The perceptions of integrated medical and preventive services of primary care doctors and nurses，key providers for essential medical and public health services，affects the provision of such services，so it is essential to study their perceptions for formulating and implementing supportive policies of such services. Objective　 To investigate primary care doctors and nurses' subjective perceptions and associated factors of integrated medical and preventive services，providing a reference for the development of integrated medical and preventive care system. Methods　 From April to October 2019，we conducted a survey using a self-developed questionnaire on perception and evaluation of integrated medical and preventive services with questions presented using a Likert scale among a nationwide sample of primary care doctors and nurses selected by multistage sampling. The survey achieved a response rate of 89.5%（725/810）. We used factor analysis to reduce the dimensionality of the 12 variables，extracted and explained the common factors，and calculated factor scores. Results　Factors reflecting subjective perceptions of integrated medical and preventive services were summarized as follows：institutional environment support factor，departmental cooperation and interaction factor，and individual professional boundary factor. The cumulative variance explained by them reached 70.43%. By using a 4-point rating system，the factors of institutional environment support，departmental cooperation and interaction，and individual professional boundary were rated （2.97±0.54），（2.81±0.55） and （2.46±0.65） points，respectively，and the comprehensive perceptions of integrated medical and preventive services were rated （2.86±0.53） points. Conclusion　 According to the subjective perceptions of integrated medical and preventive services of primary care doctors and nurses，the institutional environment support was not high，inter-departmental cooperation was rare，and professional boundary was strong. To build an integrated health care system and achieve accessible integrated medical and preventive services in primary care，related governmental departments should offer more policy support，the cooperation between multidisciplinary professionals should be strengthened，and the thoughts of medical and preventive services being unconnected in primary care doctors and nurses should be changed.

Key words: Primary health care institutions, Integrated medical and preventive services, Medical staff, Factor analysis

摘要： 背景　基层医疗卫生机构医护人员是基本医疗和公共卫生服务的关键提供者，其对医防整合的认识影响整合服务提供，研究个体对医防整合的认识对制定和实施医防整合相关政策具有重要价值。目的　了解和评价基层医护人员主观上对医防整合的认识，分析其影响因素，为医防整合服务体系建设提供参考。方法　于2019年4—10月，设计医防整合主观认识评价问题，采用全国性多阶段抽样法，以基层医护人员为调查对象，共计发放问卷810份，回收有效问卷725份，有效回收率89.5%。借鉴Likert评分等级赋分，运用因子分析法对12个变量降维，提取和解释公因子，计算因子得分。结果　反映医防整合主观认识的因子可以归纳为机构层次的环境支持公因子、科室层次的合作互动公因子和个人层次的专业界限公因子，累积方差贡献率为70.43%。经因子四分制转化，环境支持得分（2.97±0.54）分，合作互动得分（2.81±0.55）分，专业界限得分（2.46±0.65）分，医防整合认识综合得分（2.86±0.53）分。结论　医护人员在基层卫生体系中，感知到的整合服务的环境支持程度不高，缺少科室协作，并且仍存在较强的专业界限。构建整合型卫生服务体系，实现基层卫生服务中的医防整合，需要体系和机构层面更多支持政策，加强不同卫生人员专业合作，转变医护人员医防割裂的专业思维。

关键词: 基层医疗卫生机构, 医防整合, 医务人员, 因子分析