应用Ordinal回归分析湖南省医务人员抑郁发生的影响因素

Influencing factors on depression among medical staff in Hunan province under ordinal regression analysis

目的了解湖南省医务人员抑郁发生现状及其影响因素。方法采用多阶段分层整群随机抽样方法，选取湖南省医务人员进行抑郁发生影响因素的问卷调查，秩和检验和Ordinal回归用于数据分析。结果共调查16000名医务人员，有效问卷14988份，有效率93．68％。单因素分析显示工作医院级别、性别、学历、年龄、职业、职称、科室、每年继续教育次数、月经济收入、每周加班时间、上晚班频率、每月参与抢救病例数对医务人员抑郁的影响差异有统计学意义（P〈0．05）。Ordinal回归分析显示医生和护理人员抑郁发生的概率均是药剂人员的1．58倍（OR=1．58，95％CI：1．30～1．92），大专及以下人员抑郁发生的概率是硕士及以上的1．19倍（OR=1．19，95％CI：1．05～1．34），月经济收入〈2000元者抑郁发生概率是≥3000元者的2．19倍（OR=2．19，95％CI：2．05～2．35），上晚班频率、每月参与抢救病例数及每周加班时间均为抑郁发生的危险因素，指标值越高，抑郁发生的概率越高。结论湖南省医务人员抑郁发生较为普遍。缓解压力的措施包括增加该人群经济收入，减少人均加班时间、工作量及其强度等。

Objective To understand the situation of depression and its related influencing factors among medical staff in Hunan province. Methods Data were collected through random sampling with multi-stage stratified cluster. Wilcoxon rank sum test, Kruskal-Wallis H test and Ordinal regression analysis were used for data analysis by SPSS 17.0 software. Results This survey was including 16 000 medical personnel with 14 988 valid questionnaires and the effective rate was 93.68%. Results from the single factor analysis showed that factors as： level of the hospital grading, gender, education background, age, occupation, title, departments, the number of continue education, income, working overtime every week, the frequency of night work, the number of patients treated in the emergency room etc., had statistical significances （P〈0.05）. Data from ordinal regression showed that the probabilities related to depression that clinicians and nurses suffering from were 1.58 times more than the pharmacists （OR=1.58, 95% CI： 1.30-1.92）. The probability among those whose income was less than 2000 Yuan/month was 2.19 times of the ones whose earned more than 3000 Yuan/month （OR=2.19,95%Ch 2.05-2.35）. The higher the numbers of days with working overtime every week, the frequencies of night work, and the numbers of patients being treated at the emergency room, with more probabilities of the people with depression seen in our study. Conclusion Depression seemed to be common among doctors and nurses. We suggested that the government need to increase the monthly income and to reduce the workload and intensity, lessen the overworking time, etc.