谌金花, 张明峰, 王意君, 杜文, 肖竹, 伍悦蕾, 刘述益. 成都市家庭医生团队职业认同现状和影响因素研究[J]. 环境与职业医学, 2022, 39(12): 1373-1378, 1385. DOI: 10.11836/JEOM22024
引用本文: 谌金花, 张明峰, 王意君, 杜文, 肖竹, 伍悦蕾, 刘述益. 成都市家庭医生团队职业认同现状和影响因素研究[J]. 环境与职业医学, 2022, 39(12): 1373-1378, 1385. DOI: 10.11836/JEOM22024
CHEN Jinhua, ZHANG Mingfeng, WANG Yijun, DU Wen, XIAO Zhu, WU Yuelei, LIU Shuyi. Analysis of occupational identity among family doctor teams and its influencing factors in Chengdu[J]. Journal of Environmental and Occupational Medicine, 2022, 39(12): 1373-1378, 1385. DOI: 10.11836/JEOM22024
Citation: CHEN Jinhua, ZHANG Mingfeng, WANG Yijun, DU Wen, XIAO Zhu, WU Yuelei, LIU Shuyi. Analysis of occupational identity among family doctor teams and its influencing factors in Chengdu[J]. Journal of Environmental and Occupational Medicine, 2022, 39(12): 1373-1378, 1385. DOI: 10.11836/JEOM22024

成都市家庭医生团队职业认同现状和影响因素研究

Analysis of occupational identity among family doctor teams and its influencing factors in Chengdu

  • 摘要: 背景

    家庭医生签约服务是落实新医改政策的体现,是基层服务模式的转变。研究表明医务人员职业紧张水平较高。职业认同的提升有利于加强家庭医生团队队伍建设,缓解职业倦怠,减少离职意愿。

    目的

    了解成都市家庭医生团队职业认同现状,探讨职业认同的影响因素,为促进成都市家庭医生团队的职业发展和队伍建设提供参考依据。

    方法

    于2021年3月4—26日,采用多阶段分层整群抽样法在成都市23个区市县各随机抽取2家(共46家)已开展家庭医生签约服务的基层卫生医疗机构,采用问卷调查对2 681名家庭医生团队的成员进行调查。采用自制问卷进行一般资料采集,采用付出-回报失衡量表调查家庭医生成员的职业紧张,采用职业认同量表调查其职业认同。

    结果

    本研究回收有效问卷2 327份,有效率为86.80%,其中女性1 715名(73.7%)、男性612名(26.3%),年龄集中在26~35岁(43.3%)和36~45岁(30.4%),已婚者占比高(82.8%),以大专(36.0%)和本科(47.3%)文凭为主,初级职称(66.0%)为主,无编制者占比高(66.1%)。88.7%家庭医生团队工作者存在职业紧张,其职业认同平均值为(3.68±0.62)分。不同职称、编制、医疗机构、工作年限、收入和付出/回报比值(ERR)组的职业认同得分差异均有统计学意义(P<0.05)。相关性分析显ERR和职业认同呈负相关(rs=−0.495,P<0.05)。多因素分析结果显示:无编制的工作者的职业认同得分低于有编制者(OR=0.429,95%CI:0.299~0.825);副高及以上者的职业认同得分高于无职称者(OR=1.424,95%CI:1.194~2.328);工作年限越长,家庭医生团队工作者的职业认同得分越高,其中工作时间超过20年组的得分是小于5年组的1.820(95%CI:1.342~2.543)倍;收入越高,其职业认同得分越高,9001~12000元·月−1组的得分是1000~3000元·月−1组的1.977(95%CI:0.811~9.696)倍,12000元·月−1以上组是1000~3000元·月−1组的2.283(95%CI:1.199~10.267)倍。

    结论

    成都市家庭医生团队工作者普遍存在职业紧张,职业认同处于中等水平;相关管理者应针对主要影响因素进行实施干预措施,减轻工作紧张感,提高职业认同。

     

    Abstract: Background

    The contracted family doctor services are the embodiment of the implementation of the new medical reform policy, and the transformation of the grass-roots health service mode. Studies have proved that the occupational stress in medical staff was at a high level. The enhancement of professional identity will contribute to strengthen team building, alleviate job burnout, and reduce turnover intention of family doctors.

    Objective

    To investigate the current situation of occupational identity among family doctor teams in Chengdu, to examine potential influencing factors of occupational identity, and to provide a reference for promoting career development and team building of family doctor teams.

    Methods

    Multi-stage random cluster sampling was adopted to enroll study participants form 46 primary healthcare centers where family doctor contract services were implemented among 23 districts and counties in Chengdu between March 4 and 26, 2021. A total of 2 681 family doctors participated in this survey. A self-reported survey was conducted to collect participants' demographic and occupational data. The Effort-Reward Imbalance (ERI)questionnaire was implemented to assess occupational stress. The Professional Identity Scale was used to appraise occupational identity.

    Results

    A total of 2 327 valid questionnaires were collected, with a valid recovery rate of 86.80%, involving 1 715 females (73.7%) and 612 males (26.3%), with dominant age groups of 26−35 years (43.3%) and 36−45 years (30.4%), a high proportion of being married (82.8%), having college (36.0%) and undergraduate (47.3%) education, a high proportion of primary titles (66.0%) and informal work contract (66.1%). About 88.7% of family doctor team workers reported occupational stress. The average score of occupational identity was (3.68±0.62) points. There were significant differences in occupational identity scores among different professional title, work contract, working years in medical institutions, income, and effort/reward ratio (EER) groups (P < 0.05). ERR was negatively correlated with occupational identity (rs=−0.495, P<0.05). The multiple regression model showed that occupational identity score in the non-staffed participants was lower than the score in the staffed ones (OR=0.429, 95%CI: 0.299−0.825). The occupational identity score in the participants having associate senior title or above was higher than in without professional title (OR=1.424, 95%CI: 1.194−2.328). The longer the working years, the higher the occupational identity score among the participants. The score of the more than 20 working years group was 1.820 times that of the less than 5 working years group (95%CI: 1.342−2.543). The higher the income, the higher the occupational identity score. The score of the 9001−12000 yuan per month group was 1.977 times that of the 1000−3000 yuan per month group (95%CI: 0.811−9.696) , and the score of the more than 12000 yuan per month group was 2.283 times that of the 1000−3000 yuan per month group (95%CI: 1.199−10.267).

    Conclusion

    The family doctor team workers generally report occupational stress, and their occupational identity is at a medium level in Chengdu. Relevant managers should implement intervention measures against the main influencing factors to reduce their work tension and improve their occupational identity.

     

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