临床专硕生情绪劳动、医患关系及职业认同的相关分析

Correlation analysis of emotional labor,doctor-patient relationship and professional identity of clinical graduate students

目的探讨在读临床医学专业硕士学生(临床专硕生)医患关系体验及情绪劳动对职业认同的影响,为培养医学生情绪管理能力,提升从医积极性提供参考。方法2020年11月,采用整群抽样的方法,对北京市某医学院校405位临床专硕生展开问卷调查,包括一般资料问卷、困难医患关系感知量表、情绪劳动量表和职业认同量表。结果405位临床专硕生的困难医患关系感知平均得分为2.73±0.50;情绪劳动的3个策略维度得分从高到低依次为深层表现(3.93±0.55)、自然表现(3.79±0.70)、浅层表现(3.35±0.61);职业认同得分为3.66±0.48,6个维度得分从高到低依次为职业行为(4.11±0.54)、职业情感(3.86±0.63)、职业承诺(3.80±0.69)、职业价值观(3.77±0.56)、职业期望(3.72±0.62)、职业认知(2.95±0.52)。临床专硕生困难医患关系感知与浅层表现呈正相关(r=0.358,P<0.01),与深层表现、自然表现及职业认同呈负相关(r=-0.357、-0.341、-0.328,均P<0.01);深层表现和自然表现与职业认同呈正相关(r=0.433、0.424,均P<0.01)。深层表现、自然表现在医患关系与职业认同之间存在部分中介效应,深层表现的中介效应占总效应的20.3%,自然表现的中介效应占总效应的31.1%。结论可以通过增加医患沟通和情绪智力培训等人文教育课程,指导医学生正确看待医患关系,改善情绪耗竭,提升职业认同与综合素质。

Objective To explore the impact of the experience of the doctor-patient relationship and emotional labor on professional identity of clinical medical graduate students of master degree(hereafter referred to as clinical graduate students),provide references for cultivating medical students’emotional management ability and improving their motivation to practice medicine.Methods In November 2020,a cluster sampling method was used to conduct a questionnaire survey of 405 clinical graduate students from a medical college in Beijing,including the general information questionnaire,the questionnaire on the perception of difficult doctorpatient relationship,the emotional labor scale,and the occupational identity scale.Results The average score of difficult doctorpatient relationship perception among 405 clinical graduate students was 2.73±0.50.The scores of three strategic dimensions of emotional labor from high to low were deep acting(3.93±0.55),natural acting(3.79±0.70),and surface acting(3.35±0.61).The occupational identity score was 3.66±0.48,and the scores of six dimensions from high to low were professional behavior(4.11±0.54),professional emotion(3.86±0.63),professional commitment(3.80±0.69),professional values(3.77±0.56),professional expectations(3.72±0.62)and professional cognition(2.95±0.52).The difficult doctor-patient relationship perception in clinical graduate students was positively correlated with surface acting(r=0.358,P<0.01),and negatively correlated with deep acting,natural acting and professional identity(r=-0.357,-0.341,-0.328,all P<0.01).The deep acting and natural acting were positively correlated with professional identity(r=0.433,0.424,both P<0.01).The deep acting and natural acting had partial mediating effects between the doctor-patient relationship and occupational identity.The mediating effect of deep acting accounted for 20.3%of the total effect,and the effect of natural acting accounted for 31.1%.Conclusion Humanistic education courses such as doctor-patient communication and emotional intelligence training can be used to guide students treat doctor-patient relationship correctly,so as to improve emotional exhaustion,and enhance both of their professional identity and comprehensive quality.