摘要
背景随着家庭医生签约服务的推进,基层医疗卫生机构家庭医生团队的工作负担不断加重,职业倦怠凸显。当前,尚缺乏对不同等级基层医疗卫生机构家庭医生团队成员职业倦怠的差异性研究。目的比较社区卫生服务中心/乡镇卫生院和社区卫生服务站/村卫生室家庭医生团队成员的职业倦怠情况,分析其影响因素,为改善家庭医生心理健康状况、促进基层人才队伍稳定性及提高基层卫生服务质量提供依据。方法于2020年8月1—21日,采用多阶段整群随机抽样法在山东省泰安市6个县(市、区)抽取基层医疗卫生机构家庭医生团队成员760例,其中201例(26.4%)在社区卫生服务中心/乡镇卫生院工作,559例(73.6%)在社区卫生服务站/村卫生室工作。采用一般情况调查表和职业倦怠量表(MBI-GS)对纳入对象进行问卷调查。结果760例基层医疗卫生机构家庭医生团队成员的职业倦怠发生率为68.9%(524/760),社区卫生服务中心/乡镇卫生院、社区卫生服务站/村卫生室家庭医生团队成员的职业倦怠发生率分别为63.7%(128/201)、70.8%(396/559)。社区卫生服务站/村卫生室家庭医生团队成员的职业倦怠程度高于社区卫生服务中心/乡镇卫生院,差异有统计学意义(P<0.05);社区卫生服务站/村卫生室家庭医生团队成员的MBI-GS总得分及个人成就感降低维度得分高于社区卫生服务中心/乡镇卫生院,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示:对于社区卫生服务中心/乡镇卫生院的家庭医生团队成员,年龄41~50岁者的职业倦怠发生风险高于≤30岁者〔OR(95%CI)=7.119(1.770,28.638)〕,月收入>4000元者的职业倦怠发生风险低于<2000元者〔OR(95%CI)=0.194(0.040,0.941)〕,自评工作压力较大/非常大者的职业倦怠发生风险高于自评工作压力无/较小者〔OR(95%CI)=3.629(1.475,8.929)〕,自评激励机制一般、比较有效/非常有效者的职�
Background Burnout has become a prominent issue as the increase of workload in family doctor team members in primary healthcare institutions during the promotion of contracted family doctor services.There is still a lack of research comparing the differences in burnout among family doctor team members in different types of primary healthcare institutions.Objective To compare burnout prevalence and associated factors between family doctors in community/township health centers,and those in community health stations/village clinics,providing a basis for improving the mental health status and team stability of family doctors,as well as the quality of services provided by them.Methods From August 1 to 21,2020,a multistage cluster random sampling method was used to select 760 family doctor team members〔201(26.4%)working at community/township health centers,and 559(73.6%)working at community health stations/village clinics〕as the participants from primary healthcare institutions in 6 counties/county-level cities/districts of Taian City,Shandong Province.They were invited to attend a survey to complete Demographic Questionnaire and the Chinese version of Maslach Burnout Inventory-General Survey(MBI-GS).Results Overall,the prevalence of burnout among the participants was 68.9%(524/760).Overall,the prevalence of burnout among the participants was 68.9%(524/760),and the prevalence of burnoutof family doctor team members in community/township health centers and community health stations/village clinics was 63.7%(128/201)and 70.8%(396/559),respectively.The levels of burnout of family doctor team members in community health stations/village clinics was higher than that of those in community/township health centers,with a statistically significant difference(P<0.05).Family doctor team members in community health stations/village clinics had higher total score of MBI-GS and higher subscale score of reduction of professional efficacy than did those in community/township health centers,with a statistically significant differen
作者
井玉荣
韩宛彤
秦文哲
胡芳芳
张娇
高兆溶
洪壮
孔凡磊
徐凌忠
JING Yurong;HAN Wantong;QIN Wenzhe;HU Fangfang;ZHANG Jiao;GAO Zhaorong;HONG Zhuang;KONG Fanlei;XU Lingzhong(Center for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;Shandong University Center for Health Economics Experiment and Public Policy Research,Jinan 250012,China;NHC Key Lab of Health Economics and Policy Research(Shandong University),Jinan 250012,China)
出处
《中国全科医学》
CAS
北大核心
2022年第7期829-836,845,共9页
Chinese General Practice
基金
国家自然科学基金资助项目(71974118)。
关键词
基层医疗卫生机构
家庭医生
家庭医生签约服务
倦怠
职业性
影响因素分析
Primary health care institutions
Family doctors
Contracted family doctor services
Burnout,professional
Root cause analysis
