城市社区全科医生职业满意度及其影响因素

The influence factors of career satisfaction of general practitioner in city 's community health service institution

目的我国医药卫生体系改革正在致力于建立一个足以应对当前及未来健康挑战的卫生系统,而建立一支队伍稳定的全科医生队伍是改革的必要前提。然而,全科医生职业满意度及其影响因素缺乏有效的学术对话。本研究旨在调查全科医生职业满意度水平并探讨其影响因素,希望为改革实践提供理论参考。方法本研究采用了成熟的调查工具,利用分层方便抽样法抽取了城市社区卫生服务机构内的215名全科医生进行问卷调查。采用多元线性回归分析法检验全科医生职业满意影响因素。结果全科医生职业满意度中,职业成就满意度为53.74%,事业发展满意度为45.12%,职业收入满意度为20.19%,自我目标实现满意度为28.80%,技能成长满意度为43.13%。全科医生职业满意度影响因素依次为:工作嵌入(β=0.381,P<0.01)、变革型领导(β=0.234,P<0.01)、工作满意度(β=0.197,P<0.01)和职业收入(β=0.147,P<0.01)。结论全科医生整体职业满意度偏低,全科医生职业驱力依次为:事业型职业驱力、自主型职业驱力、经营型职业驱力。全科医生更加在乎事业发展和自我目标实现程度,当然也对职业收入比较在意。

Objective In China,the health system reform aims to build a health system which can serve to deal with health challenge of today and future. To build a stabilized group of general practitioner（ GP） is a necessary premise of reform. However,there is a lack of effective academic dialogue on GP＇s career satisfaction and influencing factors. This study aims to investigate the career satisfaction of GP and analyze its influencing factors,thus to provide some theoretic references for reform practice. Methods Several available survey tools were used in the study. By means of the stratified and convenient sampling method we collected 215 GPs from the community health service institution in city to conduct the questionnaire survey,and the multiple liner regression analysis method was performed to examine the influencing factors.Results The rate of professional achievement satisfaction was 53. 74%,career progress was 45. 12%,career income was20. 19%,self-realization was 28. 80%,and skill development was 43. 13%. The influencing factors of career satisfaction of GP include job embedment（ β = 0. 381,P 〈0. 01）,transformational leadership（ β = 0. 234,P 〈0. 01）,job satisfaction（ β = 0. 197,P 〈0. 01） and career income（ β = 0. 147,P 〈0. 01）. Conclusions The overall career satisfaction is at a low level. The driving forces of GP are,in sequence,enterprising,autonomous and business occupational drive. GP cares more about the occupational development and realization degree of self target. To be sure,they also care about their own professional earnings.