青岛市两所三甲医院医务人员职业倦怠对生活质量影响的路径分析

A path analysis on the influence of burnout on quality of life among staff in two tertiary hospitals in Qingdao

目的探讨三甲医院医务人员职业倦怠及生活质量的特点并对二者的关系进行路径分析。方法采用随机分层抽样方法选取青岛市两所综合性三甲医院508名医务人员,采用职业倦怠量表(MBI)、生活质量问卷(GQOLI-74)及自编的人口学资料调查表进行调查分析。结果职业倦怠方面,职业倦怠检出率为53.6%;女性MBI得分高于男性(36.05±15.89 vs 30.76±15.67,t=3.351,P<0.01);无管理职务者得分高于有管理职务者(36.11±15.02 vs 30.13±16.94,t=5.435,P<0.01);医生得分(37.04±15.52)、护士得分(35.30±16.20)、医技人员得分(35.01±16.78)均高于职能人员(24.88±12.63),差异有统计学意义(F=15.303,P<0.01)。生活质量方面,工龄<10年者得分(55.14±7.02)低于工龄10~20年(56.32±6.73)、工龄>20年者(57.93±5.86),差异有统计学意义(F=4.455,P<0.05);无管理职务者得分低于有管理职务者(55.50±6.31 vs 59.69±5.12,t=9.815,P<0.01);医生得分(55.64±7.13)、护士得分(55.79±6.50)、医技人员得分(55.53±6.23)均低于职能人员得分(57.75±5.53),差异有统计学意义(F=2.931,P<0.05)。相关、回归与路径分析方面,MBI各因子得分与GQOLI-74心理、躯体及社会功能均呈低度负相关(r=-0.09^-0.35,P<0.05)。MBI的情绪衰竭和成就感低落得分对GQOLI-74总分有负向预测作用(β=-0.126,-0.123,P<0.01)。去人格化、成就感低落对心理、社会和躯体功能的路径均有统计学意义(路径系数为-0.12^-0.17,P<0.05)。情绪衰竭对心理和社会功能的路径有统计学意义(路径系数分别为-0.15,-0.16,P<0.05)。结论三甲医院医务人员有较高的职业倦怠水平,不同质群体医务人员的职业倦怠和生活质量特点各不相同。去人格化与成就感低落可能是影响其心理、社会、躯体生活质量的因素。

Objective To explore the characteristics of burnout and quality of life among staff in two tertiary hospitals,and to analyze the influence of burnout on quality of life.Methods A total of 508 hospital staff in two tertiary hospitals in Qingdao were randomly stratified and surveyed with Maslach Burnout Inventory(MBI),Quality of Life Questionnaire(GQOLI-74)and a self-developed demographic inventory.Results MBI:The rate of burnout was 53.6%;female staff got higher MBI score than male[(36.05±15.89)vs(30.76±15.67),t=3.351,P<0.01];staff without a managerial position displayed more serious burnout compared with those with managerial position[(36.11±15.02)vs(30.13±16.94),t=5.435,P<0.01);burnout in doctors(37.04±15.52),nurses(35.30±16.20)and technicians(35.01±16.78)were all higher than that in functional personnel(24.88±12.63)(F=15.303,P<0.01).GQOLI-74:Staff with less than 10 years of service(55.14±7.02)had reduced GQOLI-74 score than those with more than 10-20 years of service(56.32±6.73)and 20 years of service(57.93±5.86)(F=4.455,P<0.05);staff without a managerial position got lower GQOLI-74 score than those with a managerial position[(55.50±6.31)vs(59.69±5.12),t=9.815,P<0.01)];GQOLI-74 score of doctors(55.64±7.13),nurses(55.79±6.50)and technicians(55.53±6.23)were lower than that of functional personnel(57.75±5.53),(F=2.931,P<0.05).Correlation,regression and path analysis:All MBI factors demonstrated a negative correlation with mental,physical and social functions in GQOLI-74(r=-0.09--0.35,P<0.05);emotional exhaustion and reduced sense of accomplishment in MBI were negative predictors of GQOLI-74(β=-0.126,-0.123,P<0.01);depersonalization and reduced sense of accomplishment in MBI showed statistical significance on the path of psychological,social and physical functions in GQOLI-74(path coefficient:-0.12--0.17,P<0.05);emotional exhaustion in MBI displayed statistical significance on the path of psychological and social functions in GQOLI-74(path coefficient was respective-0.15 and-0.16,P<0.05).Conclusion There is a high level of burnout among hospital staff in tertiary hospitals.Characteristics of burnout and quality of life among hospital staff are different in heterogenous subgroups.Depersonalization and reduced sense of accomplishment may be the factors influencing psychological,social and physical functions in quality of life.