中国医务人员职业倦怠水平及影响因素
Prevalence of job burnout and associated influencing factors among healthcare workers in China
-
摘要:
背景 医务人员面临较大的内外部压力，容易出现职业倦怠问题。现有研究表明，抑郁症状是职业倦怠的重要影响因素且均与职业紧张关系密切。
目的 利用项目组研制的调查工具探讨医务人员职业倦怠现况及主要影响因素。
方法 于2019年8—10月、2020年6—9月，采用多阶段分层整群抽样方法开展横断面调查。本研究选取山东、湖北、湖南、广东、重庆5省（市）22家医院8738名医务人员进行分析。调查工具包括基本情况调查问卷、中文版《职业倦怠通用量表》《职业紧张测量核心量表》《患者健康问卷》《自填式睡眠问卷》分别调查研究对象的基本特征、职业倦怠、职业紧张、抑郁症状、睡眠障碍等情况。采用独立样本
t 检验或单因素方差分析进行职业倦怠的单因素组间比较；采用Spearman相关分析职业倦怠与抑郁症状、职业紧张间的相关性；采用多元线性逐步回归分析进行职业倦怠的多因素分析；采用process插件进行抑郁症状在职业紧张与职业倦怠间的中介效应检验。结果 共发放问卷8738份，回收有效问卷8456份，有效问卷回收率为96.77%。其中，有职业倦怠者占58.0%，职业紧张者占31.8%，抑郁症状者占31.0%。在有抑郁症状和职业紧张者中，职业倦怠占比分别为86.7%和83.7%。排除多种因素相互影响后，多元线性逐步回归分析结果显示，抑郁症状、职业紧张、工龄、饮酒情况、婚姻情况均是职业倦怠的独立影响因素，尤以抑郁症状和职业紧张的社会支持、组织与回报维度对职业倦怠的影响较大（
b '=0.455，−0.183、0.220，P ＜0.001）。抑郁症状在职业紧张及各维度对职业倦怠作用中存在中介效应，中介效应贡献率分别为41.00%、47.02%、43.44%、56.62%、59.45%。结论 我国5省医务人员职业倦怠问题依然突出，近1/3者存在抑郁症状和职业紧张，并且对职业倦怠的影响较大。
Abstract:Background Healthcare workers suffer from great internal and external pressure and are prone to burnout. Existing studies have shown that depressive symptoms are important influencing factors of burnout, both of which are closely related to job stress.
Objective To analyze overall prevalence of burnout among healthcare workers using a new survey tool developed by our team, and to reveal potential influencing factors related to burnout.
Methods A cross-sectional multi-center study was conducted in August–October 2019 and June–September 2020, using multi-stage stratified cluster sampling. A total of 8738 healthcare workers from 22 hospitals in 5 provinces (Shandong, Hubei, Hunan, Guangdong, and Chongqing) of China were selected in this study. A set of survey questionnaires, including the general information questionnaire and the Chinese versions of General Burnout Scale, Core Occupational Stress Scale, Patient Health Questionnaire-9, and Self-administered Sleep Questionnaire were distributed. Independent samples
t -test or one-way ANOVA were employed for inter-group comparison of burnout. Spearman correlation was used to evaluate correlations among burnout, depressive symptoms, and occupational stress. Stepwise linear regression was conducted to identify factors independently associated with burnout. Process plug-in was used to test potential mediating effect of depressive symptoms on occupational stress and burnout.Results Of the 8738 questionnaires distributed, 8456 valid questionnaires were collected, and the recovery rate was 96.77%. Among the 8456 healthcare workers, the prevalence of burnout was 58.0%, that of occupational stress was 31.8%, and that of depressive symptoms was 31.0%. Among those with depressive symptoms and occupational stress, the proportions of burnout were 86.7% and 83.7%, respectively. According to the stepwise linear regression analysis, depressive symptoms, occupational stress, work experience, drinking, and marital status were all independent influencing factors of burnout. Especially, depressive symptoms, social support, and organization and reward had significant influences on burnout (
b '=0.455, −0.183, 0.220,P <0.001). Depressive symptoms showed mediating effects on occupational stress (and its subscales) and burnout, and the contribution rates of the mediating effects were 41.00%, 47.02%, 43.44%, 56.62%, and 59.45%, respectively.Conclusion Burnout is a prominent problem among healthcare workers in the 5 provinces, with the prevalence of 58.0%. And nearly 1/3 suffering from depressive symptoms and occupational stress, which has a great impact on burnout.
下载:
