山西省乡村医生心理健康现状及影响因素分析

Status quo and influencing factors of rural doctors’mental health in Shanxi Province

目的调查山西省乡村医生的心理健康现状及其影响因素。方法采用多阶段分层抽样的方法,选择2019年1月—2019年10月在山西省执业的乡村医生作为研究对象。收集研究对象的基本信息,采用自行编制的《乡村医生工作现状问卷》调查其工作现状,SCL-90症状自评量表调查其心理健康。用二元Logistic回归模型分析心理健康的影响因素。结果该次共调查523名乡村医生,共发现可能存在心理问题医生158人(30.21%),其中,焦虑、偏执、抑郁、人际关系紧张、躯体化的检出率高于20%。t检验结果显示:研究对象与国内常模相比,SCL-90总得分〔(136.59±22.73)分vs(129.96±38.76)分〕、躯体化〔(1.44±0.31)分vs(1.37±0.48)分〕、人际关系〔(1.77±0.30)分vs(1.65±0.51)分〕、抑郁〔(1.56±0.35)分vs(1.50±0.59)分〕、焦虑〔(1.53±0.41)分vs(1.39±0.43)分〕、偏执〔(1.59±0.37)分vs(1.43±0.57)分〕,研究对象的得分均高于国内常模,差异有统计学意义(P<0.05)。二元Logistic回归模型结果显示:年龄<30岁、不在本乡长大、从事乡村医生年限<5年、平均每天医疗服务时间≥12小时、工作环境评价为较差、工作评价为不满意、硬件设施评价为较差、平均服务≥100人次/周是可能产生心理问题的影响因素(P<0.05)。结论山西省乡村医生的心理健康水平低于一般职业人群,应积极增加投入,改善乡村医生的工作环境和村卫生室的设施配置,积极开展乡村医生身心疾病的筛查,提高乡村医生的心理健康水平和生活质量。

Objective To explore the status quo of rural doctors’mental health in Shanxi Province and the influencing factors.Methods Multistage stratified sampling was used to select rural doctors who licensed in Shanxi Province from January 2019 to October 2019 as the objects of this study.Basic information of the rural doctors was collected and a self-made questionnaire was used for exploring the work status of rural doctors and symptom check list-90(SCL-90)was used to explore their mental health.Binary Logistic regression was used for analyzing the influencing factors of their mental health.Results Totally 523 rural doctors were included in the study,158(30.21%)of whom were likely to have mental problems.The detection rate of anxiety,stubborn,depression,interpersonal relationship tension,and somatization was higher than 20%.And t test results showed that in comparison with the national norm,the total scores of SCL-90〔(136.59±22.73)vs.(129.96±38.76)〕,somatization〔(1.44±0.31)vs.(1.37±0.48)〕,interpersonal relationship tension〔(1.77±0.30)vs.(1.65±0.51)〕,depression〔(1.56±0.35)vs.(1.50±0.59)〕,anxiety〔(1.53±0.41)vs.(1.39±0.43)〕,and stubborn〔(1.59±0.37)vs.(1.43±0.57)〕of rural doctors were higher than the national norm with statistically significant difference(P<0.05).Binary Logistic regression model showed that age younger than 30 years,growing up in another county,being a rural doctor shorter than 5 years,averaged health service time equal to or above 12 hours per day,work environment evaluated as poor,job evaluated as dissatisfied,hardware facility evaluated as worse,and averaged health services equal to or above 100 person-time per week were the factors which might lead to mental problems among rural doctors(P<0.05).Conclusions The mental health of rural doctors in Shanxi Province is poorer than general occupational population.It is necessary to actively increase input to improve the working environment of rural doctors and the facility allocation for village clinics,and to actively carry out the screening of physical and mental diseases for rural doctors,so as to improve the mental health and quality of life of rural doctors.