基于员工援助计划的医务人员职业压力管理体系构建

Construction of an occupational stress management system for medical staff based on employee assistant program

目的构建医务人员职业压力管理体系,为管理部门实施职业压力管理提供科学依据。方法2019年1月至2020年7月,以员工援助计划为基础,结合"评估-预防-控制-善后"组织压力管理模型,选择职业压力突出的儿科为切入点,通过查阅文献及对儿童医院管理岗位和临床一线医护人员的半结构式访谈,了解其职业压力管理现状,形成压力管理体系初稿。采用德尔菲法对儿科领域专家进行函询,最终确立医务人员职业压力管理体系。采用百分权重法确定权重。结果共对8名医院行政管理人员及8名临床一线医护人员进行了访谈,提炼出4个主题。共有20名专家参与了两轮函询,有效回收率分别为91%和100%,权威系数分别为0.78和0.80,肯德尔协调系数分别为0.17和0.14(均P<0.01)。最终形成的职业压力管理体系包含组织体系、压力评估、压力预防、压力控制和效果评价5个一级条目,21个二级条目和71个三级条目。结论构建的医务人员职业压力管理体系具有较好的科学性与可靠性,内容全面,可为医院管理部门系统开展职业压力管理提供参考。

Objective To develop an occupational stress management system for medical staff,in order to provide scientific reference for management actions.Methods From January 2019 to July 2020,a stress management system initially took shape based on employee assistant program(EAP)and the assessment-prevention-control-evaluation organizational stress management model,pinpointing pediatrics featuring high occupational stress as the breakthrough point.Other means called into play include literature review and semi-structured interviews of pediatric managers and staff,for the purposes of learning the status of stress management.Delphi method was also used to learn by correspondence the occupational stress management system as seen by pediatric experts.The weight of items was determined by percentage method.Results Eight managers and eight pediatric staff were interviewed,with four topics identified.Twenty experts participated in 2 rounds of Delphi inquiry by correspondence,and the recovery rates were 91%and 100%respectively.The authority coefficients were 0.78 and 0.80,and the Kendall coordination coefficients were 0.17 and 0.14(both P<0.01).The finalized occupational stress management system consists of 5 level-1 indicators,including organization system,stress assessment,stress prevention,stress control and effect evaluation,as well as 21 level-2 indicators and 71 level-3 indicators.Conclusions The occupational stress management system of medical staff is scientific,reliable and comprehensive,serving as a useful reference for the hospital management in their occupational stress management work.