临床医师职业紧张状况与其体检指标的相关性

Relationship between occupational stress and health indexes in clinic doctors

目的分析临床医师职业紧张状况与其体检指标的相关性,探讨临床医师职业紧张对健康的影响。方法利用职业紧张量表修订版(OSI-R)对兰州市某三甲医院临床医师进行职业紧张问卷调查,同时进行健康体检,体检指标包括体重指数、血压、心率、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血尿酸(BUA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)等。利用SPSS19.0对职业紧张状况体检结果的相关性进行分析。结果研究对象异常体检指标中体重指数异常率40%、血压异常率14%、TG异常率55%、LDL异常率8.4%、BUA异常率35.8%、ALT异常率24.2%、AST异常率11.6%、γ-GT异常率16.8%。职业紧张问卷调查结果显示,61.05%的研究对象存在中度及以上紧张反应,原因可能与职业任务问题(14.7%)及应对资源缺乏(27%)有关。男性医师职业紧张高于女性(P<0.05),外科及中级职称医师职业紧张程度最高(P<0.05),内科及高级职称临床医师职业紧张程度最低(P<0.05)。控制吸烟及饮酒因素后,职业紧张与体重指数、TG、HDL、LDL、LDL/HDL、BUA、ALT等均有相关性(P<0.05)。在控制性别、科室及职称因素后,与职业紧张相关的体检指标是LDL和BUA(P<0.05)。结论临床医师职业紧张反应明显,可能是诱发心血管疾病危险指标及肝功能异常指标的重要因素。

Objective To study the effect of occupational stress on the health of doctors.Methods Occupational stress of doctors in a first-grade hospital of Lanzhou city was estimated by OSI-R through a mental health management system.Meanwhile,information on their health conditions were collected and analyzed with the SPSS19.0 software.Results Abnormal health conditions were found in body weight index（BMI）（40%）,blood pressure（14%）,total triglyceride（TG）（55%）,lower density lipid（LDL）（8.4%）,blood uric acid（BUA）（35.8%）,alanine aminotransferase（ALT）（24.2%）,aspartate aminotransferase（AST）（11.6%）,gamma glutamyl transpeptidase（GGT）（16.8%）.The abnormality of occupational stress was 61.05%,which might be attributed to the abnormality of occupational mission（14.7%） and shortage of responding resources（27%）.There were significant differences between different genders,departments and position ranks in occupational stress,with the strongest being in male,medium-level and surgeon doctors.A strong relationship was found between occupational stress and BMI,TG,LDL,HDL,LDL/HDL,BUA and ALT when smoke and drinking were controlled,and LDL and blood uric acid when smoke,drinking,genders,departments and position ranks were controlled.Conclusion Strong occupational stresses exist among clinic doctors,which may have contributed to the abnormality of health indexes.