我国144家三级公立医院医护人员自评健康现状及影响因素分析

Survey on the self-rated health of doctors and nurses at China′s 144 tertiary public hospitals

目的了解我国医护人员自评健康现状及其影响因素。方法2019年3月18日至4月9日,"第四次全国进一步改善医疗服务行动计划第三方评估"项目组在全国31个省、自治区、直辖市和新疆生产建设兵团的144家三级公立医院中,对医护人员的自评健康进行问卷调查。采用Mann-Whitney U检验分析医生和护士之间自评健康分布的差异,采用χ^2检验、二分类多因素logistic回归分析医护人员自评健康的影响因素。结果144家样本医院医护人员中,医生自评为"健康"的比例是20.30%(4 979/24 529),护士是28.92%(8 361/28 910),低于一些发达国家,也低于国内一般人群。多因素分析结果显示,医护人员睡眠时间越充足、对工作的满意程度越高、对"本院医患关系正在好转"的认同程度越高,其自评"健康"的比例越高(P<0.05);平均每周工作时间越长、工作负荷越重,其自评"健康"的比例越低(P<0.05)。结论睡眠时间、工作满意度、工作负荷和医患关系是医护人员自评健康的主要影响因素。

Objective To establish comprehensive understanding of the self-rated health of the Chinese doctors and nurses and probe into their influencing factors. Methods Data were drawn from a hospital performance survey, which was conducted by the Peking Union School of Public Health from March 18th to April 9th, 2019, among the 144 tertiary public hospitals in 31 provinces, autonomous regions, and municipalities. The survey included a cell-phone based questionnaire filled out by the sampled doctors and nurses, in which they were asked to rate their health using a 5-level Likert scale(from " very poor" to " very good"). Mann-Whitney U test was used to analyze the differences in self-rated health between doctors and nurses. Chi-square test and two-class multivariate logistic regression were performed to analyze factors affecting self-rated health of the providers. Results Among the 144 sample hospitals, the proportion of doctors, who rated their health as " healthy", was 20.30%(4 979/24 529), that of nurses was 28.92%(8 361/28 910). It was worse than that in some developed countries and lower than the general population in China. Multi-variate analysis showed that adequate sleeping time, satisfaction with the work and with the doctor-patient relationship, were positively associated with the level of self-rated health of the sampled doctors and nurses(P<0.05). It was also found that the longer the average weekly working time, the higher the recognition of " the work load is too heavy", the lower the proportion of doctors and nurses who rated their health as " healthy"(P<0.05). Conclusions Sleep time, job satisfaction, workload and doctor-patient relationship are important factors affecting self-rated health of the Chinese doctors and nurses.