全科医生离职倾向水平及影响因素研究

Turnover Intention of General Practitioners and Its Influencing Factors

目的了解全科医生离职倾向水平,并探讨其影响因素。方法拟采用方便抽样法,抽取哈尔滨、大庆、绥化、黑河、大兴安岭和齐齐哈尔6个城市263个社区卫生服机构的全科医生,最终以参加黑龙江省卫生厅在齐齐哈尔举办的社区医务工作者培训现场的215例作为研究对象。于2015-03-21,采用基本信息、职业满意度、工作满意度、工作倦怠、工作嵌入及离职倾向6个问卷在培训现场对其进行调查,问卷填写后一次性收回。共发放问卷362份,回收有效问卷323份,其中全科医生填写问卷215份。全科医生离职倾向的影响因素采用单因素和多因素Logistic回归分析。结果 62.3%(134/215)的全科医生有离职倾向。单因素Logistic回归分析结果显示,工作年限、职业成就、事业进展、职业收入、目标实现度、技能培养、工作满意度、工作倦怠和工作嵌入对全科医生离职倾向的影响有统计学意义(P<0.05);进一步多因素Logistic回归分析结果显示,工作年限、工作嵌入对全科医生离职倾向有负向预测作用(b值分别为-0.05、-0.93,P≤0.05);工作倦怠对全科医生离职倾向有正向预测作用(b=0.74,P<0.05)。结论近2/3的全科医生报告自己具有离职倾向;工作倦怠是影响全科医生产生离职倾向的危险因素,工作年限以及工作嵌入是影响全科医生产生离职倾向的保护因素,缓解全科医生的工作倦怠、提高工作嵌入可有效降低其离职风险。

Objective To understand the level of turnover intention of general practitioners and investigate its influencing factors. Methods By convenience sampling method, general practitioners in 6 cities＇ community health service institutions（ Harbin, Daqing, Suihua, Heihe, Great Khingan and Qiqihar） were selected, and finally 215 general practitioners,who participated in the training of community health workers in Qiqihar held by Heilongjiang Provincial Health Bureau,were enrolled as research objects. In March 21,2015,field investigation was made in the scene of community health workers. The investigation included six questionnaires——basic information,career satisfaction,job satisfaction,job burnout,job embededness and turnover intention. All the questionnaires would be recovered at once after filling in. 362 questionnaires were sent out,323 were effectively recovered,of which 215 were filled in by general practitioners. Univariate and multivariate Logistic regression analysis was applied to analyze the influencing factors of general practitioners＇ turnover intention. Results 62. 3%（ 134 /215） of the general practitioners had the turnover intention. Univariate Logistic regression analysis showed that years of working,achievement of career, progress of career, occupational income, realization degree of target, skills training, job satisfaction,job burnout and job embededness significantly influenced the turnover intention of general practitioners（ P 〈0. 05）;multivariate Logistic regression analysis further presented that years of working and job embededness had negatively predictive effects on the turnover intention of general practitioners（ value of b was- 0. 05,- 0. 93 respectively; P≤0. 05）; job burnout had a significantly positive prediction on their turnover intention（ b = 0. 74,P 〈0. 05）. Conclusion Nearly two- thirds of the general practitioners reported that they had turnover intentions; job burnout is a risk factor that influences general practitioners having turnover intentions, years of working and job embeddedness are the protective factors of general practitioners having turnover intentions. Relieve job burnout of general practitioners and improve embededness degree can effectively reduce their turnover risk.