山东省西南地区乡村全科医生离职倾向及其影响因素研究

Turnover intention and its influencing factors in rural general practitioners

目的了解山东省西南地区乡村全科医生离职倾向及其影响因素,为维持我国基层医疗队伍的稳定性提供合理建议。方法2020年5月,利用多阶段随机抽样的方法对山东省西南地区2805名乡村全科医生进行问卷调查。采用Pearsonχ2检验和多因素二元logistic回归方法分析乡村全科医生离职倾向的影响因素。结果共发放2805份问卷,回收问卷2693份,有效问卷2272份,有效率为84.4%。有1076名(47.4%)乡村全科医生存在中高离职倾向。二元logistic回归结果显示,兼职(OR=1.443,95%CI:1.105~1.884,P<0.01)、平均每月夜班次数≥20次(OR=1.340,95%CI:1.106~1.623,P<0.01)、接诊时长≥13 h(OR=1.358,95%CI:1.107~1.666,P<0.01)、存在失眠症状(OR=2.075,95%CI:1.755~2.454,P<0.01)、工作中感到沮丧(OR=2.987,95%CI:2.516~3.546,P<0.01)、有情感衰竭(OR=3.801,95%CI:3.188~4.533,P<0.01)、有去人格化倾向(OR=2.493,95%CI:2.086~2.981,P<0.01)的乡村全科医生更易产生离职倾向。结论山东省西南地区乡村全科医生具有较高的离职倾向,兼职、平均每月夜班次数多、接诊时间长、失眠、感到沮丧、职业倦怠是离职倾向的影响因素。政府部门应加强对基层医疗服务的资金投入,提高乡村全科医生的工资待遇,降低工作负荷,增强乡村全科医生队伍的稳定性。

Objective To investigate the turnover intention and its influencing factors in rural general practitioners in southwest Shandong province.Methods In May 2020,a survey with self-designed questionnaire was conducted among 2805 rural general practitioners in southwest Shandong province selected by multi-stage sampling method.Pearson chi square test(χ²)and binary logistic regression were used to analyze the factors influencing the turnover intention of rural general practitioners.Results A total of 2805 questionnaires were sent out,2693 were collected and 2272 were valid,with an effective rate of 84.4%.Among 2272 participants,1076(47.4%)had medium to high level turnover intention.Binary logistic regression showed that part-time job(OR=1.443,95%CI:1.105-1.884,P<0.01),average monthly night shifts≥20 times(OR=1.340,95%CI:1.106-1.623,P<0.01),daily working time≥13 hours(OR=1.358,95%CI:1.107-1.666,P<0.01),insomnia(OR=2.075,95%CI:1.755-2.454,P<0.01),feeling depressed at work(OR=2.987,95%CI:2.516-3.546,P<0.01),degree of emotional exhaustion(OR=3.801,95%CI:3.188-4.533,P<0.01)and degree of de-personalization tendencies(OR=2.493,95%CI:2.086-2.981,P<0.01)were the significant factors influencing the turnover intention of rural general practitioners.Conclusions Rural general practitioners in southwest Shandong have a high-level turnover intention,part-time jobs,average number of night shift per month,working time,insomnia,depression and job burnout are the main factors affecting the turnover intention.Necessary measures should be taken by relevant departments to enhance the stability of rural general practitioners.