重庆市15家综合医院急诊科医护人员职业倦怠调查

Study on the job burnout of medical staff in emergency department of 15 comprehensive hospitals in Chongqing

目的了解急诊科医护人员职业倦怠现状,明确其影响因素并探讨预防机制。方法采用职业倦怠量表,随机选取重庆市15家综合医院250名从事急诊医疗工作的医护人员进行职业倦怠问卷调查,最终纳入统计249人。采用描述性统计、χ^2检验、多因素Logistic回归分析等进行统计分析。结果249名急诊医护人员中有69人(27.71%)重度情绪衰竭,87人(34.94%)重度去人格化,69人(27.71%)重度个人成就感低落,综合职业倦怠率为44.98%(112/249)。不同学历、每周工作时长、每周加班频次组间急诊医护人员重度情绪衰竭率不同,差异有统计学意义(χ^2=7.89、8.77、14.45,均P<0.05);不同工龄组间重度去人格化率不同,差异有统计学意义(χ^2=4.05,P<0.05);不同工龄、每周工作时长组间重度个人成就感低落率不同,差异有统计学意义(χ^2=4.55、10.34,均P<0.05)。职业倦怠多因素Logistic回归分析结果显示,每周工作时长40~60 h(OR=3.30,P<0.01)、每周加班频次3次(OR=4.97,P=0.01)是重度情绪衰竭的危险因素;工龄≥10年(OR=0.28,P=0.04)、每周工作时长40~60 h(OR=0.20,P<0.01)是重度个人成就感低落的保护因素。结论急诊医护人员的职业倦怠水平普遍较高,建议严格控制每周工作时长和加班频次,实行弹性排班制度,定期开展培训及心理辅导,提高其应对压力的能力及沟通技巧,规避职业倦怠风险。

Objective To investigate the job burnout status of emergency medical staff and its related factors,to explore the measures of prevention.Methods Using job burnout scale,250 emergency medical staff from 15 comprehensive hospitals in Chongqing were randomly selected to investigate the job burnout,and 249 of them were included in the final statistics.Descriptive statistics,χ^2 test and multivariate Logistic regression analysis were used for data analysis.Results Among the 249 emergency medical staff,69 cases(27.71%)suffered from severe emotional failure,87 cases(34.94%)suffered from severe depersonalization,69 cases(27.71%)suffered from severe personal achievement depression,and the comprehensive burnout rate was 44.98%(112/249).The rate of severe emotional failure of emergency medical staff in different education background,working hours and working overtime frequency groups was different,and the difference was statistically significant(χ^2=7.89,8.77,14.45,all P<0.05);the rate of severe depersonalization was different in different working age groups,and the difference was statistically significant(χ^2=4.05,P<0.05);the rate of severe personal achievement depression was different in different working age groups and working hours groups,the difference was statistically significant(χ^2=4.55,10.34,both P<0.05).Multivariate Logistic regression analysis of job burnout showed that 40—60 h of work per week(OR=3.30,P<0.01),3 times of overtime per week(OR=4.97,P=0.01)were the risk factors of severe emotional failure,and the working age≥10 years(OR=0.28,P=0.04),40—60 h of work per week(OR=0.20,P<0.01)were the protective factors of severe personal achievement depression.Conclusion The level of burnout of emergency medical staff is generally high.It is suggested to strictly control the working hours and overtime frequency every week,implement flexible shift arrangement system,carry out regular training and psychological guidance,improve their ability to cope with stress and communication skills,and avoid the risk of burnout.