双因素理论视角下三省乡镇卫生人员离职意愿影响因素分析

Turnover intention among township health workers in three provinces of China:a motivator-hygiene theory based survey

目的基于双因素理论,分析我国乡镇卫生院卫生人员离职意愿的影响因素。方法采取多阶段整群抽样,对山东、安徽和陕西省45个乡镇卫生院的803名卫生人员进行问卷调查,并对138名卫生人员进行访谈。结果卫生人员最重视的3项因素依次为收入水平、工作条件和社会保障,分别为(3.00±4.62)、(5.31±3.64)和(5.93±5.03)分;最不满意的3项因素依次为收入水平、社会保障和培训机会,分别为(2.28±0.90)、(2.47±0.92)和(2.66±0.95)分;多元回归分析结果显示,收入水平(β=–0.265)、生活环境(β=–0.274)、单位管理制度(β=–0.162)以及工作量(β=–0.126)对离职意愿有显著影响。访谈中发现,工作条件、职业发展前景以及对工作的感情是影响乡镇卫生人员离职意愿的主要因素,生活不便、缺乏机会、能力不足是限制离职的主要因素。结论乡镇卫生院人员工作满意度水平一般,更重视保健因素的满足。基层管理者应提高卫生人员的薪酬待遇并改善生活和工作环境,同时注重职业发展的公平性,并根据人员的不同需求进行差异化管理。

Objective To analyze factors influencing turnover intention among health workers in township hospitals in China based on motivator-hygiene theory.Methods We recruited health workers using multistage cluster sampling at 45 township health centers in three provinces of China.Then we conducted a self-administered questionnaire survey and deep interviews among 803 and 138 selected health workers in August 2013.Results Among the turnover intention related factors reported by the participants,the three most concerned were income level(3.00±4.615),working condition(5.31±3.636),and social security(5.93±5.029)and the three least satisfied to were income level(2.28±0.899),social security(2.47±0.919),and training opportunities(2.66±0.954),respectively.The results of multiple regression analysis indicated that income level(β=–0.265),living environment(β=–0.274),unit management system(β=–0.162)and workload(β=–0.126)had significant impact on turnover intention.Among the participants interviewed,working condition,career development prospect and emotional impact on work were the main influence factors of turnover intention;while,inconvenience in daily life,lack of opportunity and lack of self ability were the main constraint factors for turnover.Conclusion The job satisfaction is at a general level and health factor is more concerned than motivator factor for turnover among health workers in township hospitals in China.The results should be considered for the improvement of grassroots health care services.