医务人员职业紧张对生命质量的影响

Influence of occupational stress on quality of life in medical workers

目的：评价医务人员生命质量，探讨职业紧张对其生理、心理健康和生命质量的影响。方法：整群抽取某市省、市级医院5所，从中随机抽取临床各科和检验、放射科医务人员1630人，采用OSI-R和SF-36量表对职业紧张和生命质量进行评价。结果：30～40岁年龄段医务人员生命质量最差（P〈0．01）；职业任务、个体紧张反应与生理、心理健康和生命质量呈负相关（P〈0．01），个体应对资源与生理、心理健康和生命质量呈正相关（P〈0．01）；职业任务、个体紧张反应和应对资源与心理健康的相关系数大于生理健康，且对心理健康的预测能力大于生理健康；任务过重、工作环境、任务不适、任务冲突、躯体紧张反应、心理紧张反应、娱乐休闲、社会支持和自我保健是医务人员生理健康的主要影响因素，职业任务问卷各子项，心理紧张反应、躯体紧张反应及个体应对资源各子项是心理健康的主要影响因素。结论：医务人员的生命质量具有明显的年龄特征；职业紧张水平越高其生命质量越差，应对资源能够降低职业紧张对生命质量的影响；职业紧张、应对资源的性质和特征不同，对生理、心理健康的影响也有差异，且对心理健康的影响大于生理健康。

Aim ： To evaluate the status of medical workers＇quality of life and explore the influence of occupational stress on physical health, mental health and quality of life. Methods：A total of 1 630 medical workers were sampled from five provincial and municipal hospitals which were randomly selected using the method of cluster sampling. Measuring instruments （OSI-R and SF-36） were adopted to investigate the status of medical workers′ occupational stress and quality of life. Results： The medical workers of 30 - 40 years old had the worst quality of life（ P 〈0.01 ） ;occupational role and personal stress were negatively related with physical component summary, mental component summary and quality of life（P 〈 0.01）, whereas personal coping resources was positively correlated with physical component summary, mental component summary and quality of life（ P 〈 0.01 ）. The correlation coefficients between occupational role, personal stress, coping resources and mental component summary were greater than those between occupational role,personal stress, coping resources and physical component summary respectively. Occupational role, personal stress and coping resources were more predictive to mental component summary than to physical component summary. The main influencing factors of medical workers′physical component summary were role overload, physical environment, role boundary, role conflict, physical strain response, mental strain response, recreation, social support and self-care, whereas the influencing factors of medical workers′mental component summary were the scales of occupational role, mental strain response, physical strain response, and the scales of personal coping resources. Gonclusion： The medical workers＇quality of life is different in different age groups. Medical workers who have high level of occupational stress would have lower quality of life. Coping resources could alleviate the impact of occupational stress on quality of life. Different kinds of occupational stress and coping resources could have different impacts on physical and mental health. The influence of occupational stress and coping resources on mental health is larger than that on physical health.