上海市嘉定区医护人员职业倦怠调查分析

Investigation on occupation burnout of physicians and nurses in hospitals of Jiading district in Shanghai

目的了解上海市嘉定区医护人员职业倦怠水平并探讨影响职业倦怠的相关因素。方法采用工作倦怠问卷及社会支持评定量表对上海嘉定区342名精神科、内科及外科医护人员进行调查。结果未婚医护人员成就感低落得分显著高于已婚医护人员（P〈0.01）。18-30岁、31-40岁的医护人员玩世不恭得分显著高于41-50岁的医护人员（P〈0.05）,18-30岁的医护人员成就感低落得分显著高于41-50岁的医护人员（P〈0.05）。工作年限在11-20 a的医护人员情绪衰竭得分显著高于其他工作年限的医护人员（P〈0.05）,而≤5 a和11-20 a的医护人员玩世不恭、成就感低落得分显著高于≥21 a的医护人员（P〈0.05）。上海户籍医护人员情绪衰竭及玩世不恭得分显著高于外地户籍的医护人员（P〈0.05）。内、外科医护人员情感衰竭得分显著高于精神科（P〈0.01）;外科医护人员玩世不恭得分显著高于内科和精神科（P〈0.01）;精神科医护人员成就感低落得分显著高于内、外科（P〈0.05）。医护人员情绪衰竭与健康状况、收入状况及人际关系状况呈显著负相关（P〈0.01）;玩世不恭与健康状况、收入状况、家庭状况及人际关系状况呈显著负相关（P〈0.01）;成就感低落与社会支持各维度、家庭状况、人际关系呈显著负相关（P〈0.01）。多元逐步回归分析显示,收入状况、健康状况、人际关系、客观支持4个因素能有效预测医护人员情绪衰竭程度（P〈0.05）。收入状况、人际关系及健康状况3个因素能有效预测医护人员玩世不恭程度（P〈0.05）。主观支持、工作年限、人际关系及年龄4个因素能有效预测医护人员成就感低落程度（P〈0.05）。结论各科室医护人员均有不同程度职业倦怠,应关注未婚及上海户籍的医护人员;职业倦怠与年龄、工作年限、收入状况、身体健康状况、人际关系、社会支持等因素密切相关。

Objective To investigate the job burnout level of doctors and nurses in hospitals of Jiading district in Shanghai and explore related factors influencing job burnout. Methods The Maslach burnout inventory-general survey and social support rating scale were adopted to investigate 342 doctors and nurses from psychiatry,internal medicine and surgery in Jiading district of Shanghai. Results In terms of reduced personal accomplishment,the score of unmarried medical staff were significantly higher than that of the married（ P〈0. 01） and the score of staff aged 18- 30 was significantly higher than that of aged 41- 50（ P〈0. 05）;on cynicism,the score of medical personnel aged 18- 30,31- 40 was dramatically higher than that of personnel aged 41- 50（ P〈0. 05）;on the emotional exhaustion,the score of medical staff having work experience 11- 20 years was significantly higher than that with other working years（ P〈0. 05）;on the cynicism and reduced personal accomplishment,the scores of personnel with work experience under 5 years or 11- 20 years were significantly higher than those who had worked over 21 years（ P〈0. 05）. On the emotional exhaustion and cynicism,the scores of medical personnel with Shanghai registered permanent residence were significantly higher than non-Shanghai personnel（ P〈0. 05）. On the emotional exhaustion,the score of doctors and nurses in surgery was significantly higher than that in psychiatry（ P〈0. 01）;on the cynicism,the score of surgical professionals was significantly higher than that of staff in internal medicine and psychiatry（ P〈0. 01）;in the aspect of reduced personal accomplishment,the scores of psychiatric staff were significantly higher than those of internal medical and surgical health care workers（ P〈0. 05）. The emotional exhaustion of medical personnel was negatively associated with health status,personal income,and interpersonal relationships（ P〈0. 01）;cynicism had a negative correlation with health status,personal income,family status and interpersonal relationships（ P〈0. 01）;reduced personal accomplishment was negatively correlated with each dimension of social support,family status and interpersonal relationships（ P〈0. 01）. Multiple stepwise regression analysis showed that the emotional exhaustion of medical staff could be effectively predicted according to four factors：personal income,health status,interpersonal relationships and objective support（ P〈0. 05）; cynicism could be predicted through personal income,interpersonal relationships and health status（ P〈0. 05）;subjective support,length of service,interpersonal relationships and age were significant predictors of reduced personal accomplishment（ P〈0. 05）. Conclusions The doctors and nurses in every department had different degrees of occupation burnout,and special attentions should be paid to the unmarried and Shanghai registered staff. The job burnout was closely related to age,working years,income,health status,interpersonal relationships and social support.