医生职业紧张、工作倦怠、抑郁症状关系的研究

Study on the Relationship Between Occupational Stress,Job-related Burnout and Depressive Symptoms Among Doctors

目的探讨医生的职业紧张、工作倦怠对抑郁症状的影响,改善医生身心健康,降低抑郁症状的发生,提高医疗服务质量。方法采用横断面调查方法,于2010年10-11月随机抽取辽宁省具有代表性的三个大、中、小城市的6所综合医院工作六个月以上的373名医生进行自填式问卷调查。问卷包括付出-回报失衡问卷(ERI),工作倦怠问卷(MBI-GS),流行病调查用抑郁自评量表(CES-D)。应用多元分层回归分析探讨医生职业紧张、工作倦怠对抑郁症状的影响,验证工作倦怠在职业紧张对抑郁症状影响中的中介作用。结果外在付出、内在投入、情绪衰竭和消极怠慢与抑郁症状呈显著正相关,回报、个人成就感与抑郁症状呈显著负相关。外在付出和回报对抑郁症状的解释变异量为15.5%,加入工作倦怠后,解释变异量为43.7%。结论医生职业紧张、工作倦怠与抑郁症状密切相关,工作倦怠在职业紧张对抑郁症状影响中起中介作用。

Objective This study was conducted to explore the influence of occupational stress and job- related burnout on the depressive symptoms among doctors, aiming at improving the physical and mental health and the quality of medical service of doctors. Methods A crosssectional study was conducted during the period of October to November, 2010. Totally, 373 doctors from six comprehensive hospitals representative of hospitals from big, middle and small cities, who had worked in the hos- pitals more than 6 months, were randomly selected and investigated with self- administered questionnaire. Effort - Reward Im- balance Questionnaire （ERI）, Maslaeh Burnout Inventory-General Survey （MBI- GS） and Center for Epidemiologic Studies Depression Scale （CES- D） were used to measure occupational stress, job- related burnout and depressive symptoms, respective- ly. The influence of occupational stress and job - related burnout on the depressive symptoms among doctors was analyzed by mul- tiple hierarchical regression. The intermediary role of job- related burnout in the relationship between occupational stress and de- pressive symptcans was verified. Results The extrinsic effort, overcorranitment, emotional exhaustion and cynicism were positively correlated with the depressive symptoms, while reward and personal accomplishment were negatively correlated with the depressive symptoms. The contribution of extrinsic effort and reward to depressive symptoms was 15.596. When the job- related burnout was introduced, the contribution increased to 43.7%. Conclusions Occupational stress and job - related burnout are closely associated with depressive symptoms arrmng doctors. Job- related burnout is a mediator in the influence of occupational stress on depressive symptoms.