山东三地县级公立医院卫生技术人员离职意向分析

Analysis on the turnover intention of the health technicians of county-level public hospitals in three cities of Shandong province

目的了解山东省县级公立医院卫生技术人员的离职意向和工作状况的关系，分析离职的影响因素，为引导有离职意向的人员做出正确选择和改善其工作状况提供建议。方法采用第四次国家卫生服务调查问卷，通过多阶段分层整群随机抽样，对山东省三地县级公立医院的2903名在职卫生技术人员进行现场问卷调查，并采用二分类Logistic回归、基于2种权重的3种综合评价方法等进行分析。结果有32．4％的卫生技术人员具有离职意向；离职意向的高危因素有在内科工作、执业环境评价差者、工作技能多样性程度低、工作对个人能力提高的程度小、工作满意度低、工作自主性程度高、工作对个体控制情绪表达的要求高、工作压力感大和职业倦怠程度高；离职意向程度越高者，工作状况综合评分越低。结论医院应重点关注离职意向程度高者，通过谈心、培训、职业规划等方法，正确引导员工做出慎重选择，并改善其工作状况。

Objective The turnover intention and the work states of the health technicians were investigated to analyze the influencing factors of turnover and the relationship between turnover intention and work state,to guide the health technicians who want to dimission to make a correct decision, and to make some suggestions to improve their work states. Methods Multistage stratified cluster random sampling method was adopted to survey 2903 health workers on the job of all the county-level public hospitals in Shandong Province by the questionnaire of the Fourth National Health Services Survey. Analysis methods included Two Logistic classification regression and three evaluation methods based on two weights. Results 32.4 percent health technicians had turnover intention. The risk factors of the turnover intention were as follows：medical department, bad assessments of the practice environment, low degree of the diversity of job skills, small level of improving the individual＇s capacity, low degree of job satisfaction, high degree of job autonomy, high requirement for the expression of individual emotions, high working pressure, high job burnout. The higher turnover intentions were, the lower synthetical evaluation scores of the work states were. Conclusion The county hospitals ought to pay more attention to the health technicians with high turnover intention, and to guide the health technicians who want to dimission to make a correct decision, and to make some suggestions to improve their work states through having a heart-to-heart talk, training, and career planning, etc.