上海市虹口区家庭医生职业倦怠现状及影响因素分析
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摘要
[目的]了解上海市虹口区家庭医生的职业倦怠现状,探讨职业倦怠的影响因素。[方法] 2018年1—3月,采用职业倦怠量表、社会支持评定量表、简易应对方式量表和自行设计的基本情况问卷,对虹口区全部家庭医生进行问卷调查,评估家庭医生的职业倦怠、社会支持和应对方式情况。[结果]发放问卷220份,回收有效问卷217份,问卷回收率为98.6%,职业倦怠率为51.6%。多因素logistic回归分析结果显示:社会支持、应对方式水平均不是职业倦怠的影响因素(P> 0.05);年龄大、自评健康状况差者,职业倦怠率也高:以年龄<30岁为参照,年龄为30～39岁、40～49岁和50岁以上者,职业倦怠发生的风险分别是参照组的8.62倍、20.87倍和15.06倍(P <0.01);以健康状况较好者为参照,健康状况一般和较差者职业倦怠发生的风险分别是参照组的4.59倍和41.59倍(P <0.01)。[结论]在当前不断完善的家庭医生制度和社会支持系统下,影响家庭医生职业倦怠的主要因素为年龄和身体健康状况,年龄较大、身体健康状况较差者职业倦怠情况较严重。在未来的干预过程中,应对这两类群体给予重点关注。
[Objective] To understand the condition of job burnout of family physicians in Hongkou District of Shanghai and to analyze the influencing factors. [Methods] All registered family physicians in Hongkou District were surveyed with questionnaires of Maslach Burnout Inventory-General Survey(MBI-GS),Social Support Rating Scale,Simplified Coping Style Questionnaire,and self-designed general demographic questionnaire during January to March 2018. [Results] There were 217 family physicians attending this survey with a participation rate of 98.6%,and 51.6% physicians were identified with job burnout. Multivariate logistic regression results showed that social support and coping style didn't affect the occurrence of job burnout(P > 0.05),while the old age and the worse health status played important role. Compared with the family physicians under 30 years old,the risk(OR value) of job burnout among the family physicians aged 30-,40-,and 50-years old was 8.62,20.87 and 15.06,respectively(P < 0.01). Compared with the family physicians with better health status,the risk(OR value)of job burnout among these with a worse or not so bad health status was 41.59 and 4.59,respectively(P < 0.01). [Conclusion] Job burnout is still prevalent among the family physicians in Hongkou District of Shanghai. The main influencing factors of job burnout are age and self-assessed health status under the current social support system circumstances. More efforts should be focused on the older family physicians with worse health status.
[Objective] To understand the condition of job burnout of family physicians in Hongkou District of Shanghai and to analyze the influencing factors. [Methods] All registered family physicians in Hongkou District were surveyed with questionnaires of Maslach Burnout Inventory-General Survey(MBI-GS),Social Support Rating Scale,Simplified Coping Style Questionnaire,and self-designed general demographic questionnaire during January to March 2018. [Results] There were 217 family physicians attending this survey with a participation rate of 98.6%,and 51.6% physicians were identified with job burnout. Multivariate logistic regression results showed that social support and coping style didn't affect the occurrence of job burnout(P > 0.05),while the old age and the worse health status played important role. Compared with the family physicians under 30 years old,the risk(OR value) of job burnout among the family physicians aged 30-,40-,and 50-years old was 8.62,20.87 and 15.06,respectively(P < 0.01). Compared with the family physicians with better health status,the risk(OR value)of job burnout among these with a worse or not so bad health status was 41.59 and 4.59,respectively(P < 0.01). [Conclusion] Job burnout is still prevalent among the family physicians in Hongkou District of Shanghai. The main influencing factors of job burnout are age and self-assessed health status under the current social support system circumstances. More efforts should be focused on the older family physicians with worse health status.
引文
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[3]栾先国,贾焱,吕博雅,等.医务人员职业倦怠与职业紧张现况研究[J].医院管理论坛,2018,35(8):57-60.
[4]苏雪飞,晏丽娟.海淀区社区医院青年医务人员职业倦怠状况调查[J].中国社区医师,2017,33(20):163-164,166.
[5]谢国军,WENDY L,徐彩霞,等.医务人员职业倦怠与工作满意度现状调查[J].四川精神卫生,2017,30(6):551-555.
[6]王富华,谢铮,张拓红.医务人员职业倦怠的国内外研究[J].中国社会医学杂志,2013,30(3):188-190.
[7]梁沛枫,李红,王强,等.医务人员职业倦怠测量工具的信效度检验[J].现代预防医学,2017,44(23):4314-4317.
[8]黄丽,戴俊明,张浩,等.医务人员职业倦怠与健康生产力受损的关联[J].环境与职业医学,2013,30(5):321-327.
[9]郭月平,许明智.通用版工作倦怠量表的编制及信效度研究[J].中国全科医学,2017,20(33):4167-4173.
[10]肖水源.《社会支持评定量表》的理论基础与应用研究[J].临床精神医学杂志,1994,4(2):98-100.
[11]解亚宁.简易应对方式量表信度和效度的研究[J].中国临床心理学杂志,1998,6(2):114-115.
[12]朱鸿雁,戴俊明,华钰洁,等.上海市闵行区家庭医生职业倦怠状况及影响因素[J].环境与职业医学,2016,33(8):731-735.
[13]葛文珍,戴俊明,玄泽亮,等.社区卫生服务员工中职业紧张与倦怠的调查分析[J].工业卫生与职业病,2010,36(2):69-73.
[14]范恩芳,严燕.上海浦东远郊社区全科医生职业倦怠与离职意愿现状[J].职业与健康,2017,33(11):1473-1477.
[15] PEYROT M F,MCMURRY J J. Stress buffering and glycemic control.The role of coping styles[J]. Diabetes Care,1992,15(7):842-846.
[2]李烟然,吕红亮,刘毅.医务人员职业倦怠研究进展[J].现代预防医学,2015,42(19):3489-3492.
[3]栾先国,贾焱,吕博雅,等.医务人员职业倦怠与职业紧张现况研究[J].医院管理论坛,2018,35(8):57-60.
[4]苏雪飞,晏丽娟.海淀区社区医院青年医务人员职业倦怠状况调查[J].中国社区医师,2017,33(20):163-164,166.
[5]谢国军,WENDY L,徐彩霞,等.医务人员职业倦怠与工作满意度现状调查[J].四川精神卫生,2017,30(6):551-555.
[6]王富华,谢铮,张拓红.医务人员职业倦怠的国内外研究[J].中国社会医学杂志,2013,30(3):188-190.
[7]梁沛枫,李红,王强,等.医务人员职业倦怠测量工具的信效度检验[J].现代预防医学,2017,44(23):4314-4317.
[8]黄丽,戴俊明,张浩,等.医务人员职业倦怠与健康生产力受损的关联[J].环境与职业医学,2013,30(5):321-327.
[9]郭月平,许明智.通用版工作倦怠量表的编制及信效度研究[J].中国全科医学,2017,20(33):4167-4173.
[10]肖水源.《社会支持评定量表》的理论基础与应用研究[J].临床精神医学杂志,1994,4(2):98-100.
[11]解亚宁.简易应对方式量表信度和效度的研究[J].中国临床心理学杂志,1998,6(2):114-115.
[12]朱鸿雁,戴俊明,华钰洁,等.上海市闵行区家庭医生职业倦怠状况及影响因素[J].环境与职业医学,2016,33(8):731-735.
[13]葛文珍,戴俊明,玄泽亮,等.社区卫生服务员工中职业紧张与倦怠的调查分析[J].工业卫生与职业病,2010,36(2):69-73.
[14]范恩芳,严燕.上海浦东远郊社区全科医生职业倦怠与离职意愿现状[J].职业与健康,2017,33(11):1473-1477.
[15] PEYROT M F,MCMURRY J J. Stress buffering and glycemic control.The role of coping styles[J]. Diabetes Care,1992,15(7):842-846.