上海市某区基层卫生工作者职业紧张现状及相关因素分析

Analysis on current situation of occupational stress and the related factors among primary health workers in a district of Shanghai

目的 了解上海市某区社区卫生服务中心卫生工作者职业紧张现状,分析该群体职业紧张影响因素,为缓解职业紧张提供干预建议。方法 2020年6—10月采用方便抽样方法,以该区全体基层卫生工作者为调查对象,对职业紧张情况进行logistic回归分析。结果 本次共发放调查问卷1 816份,能独立完成知情同意的有效调查人数为1 515名,应答率为83.43%。职业紧张阳性175人,阳性率为11.55%。调查对象付出维度得分为(14.24±5.56)分,回报维度得分为(47.23±9.19)分,内在投入维度得分为(12.65±5.93)分,付出-回报不平衡指数平均总分为(0.63±0.50)分,其中职业紧张组付出、投入得分均高于正常组,回报得分低于正常组(均P<0.01)。多因素回归分析显示,35~<45年龄组(OR=2.095,95%CI:1.120~3.916)、工种数量≥3种(OR=2.320,95%CI:1.355~3.972)、加班强度>1次/周(OR=2.066,95%CI:1.414~3.020)、带教任务>1次/周(OR=1.749,95%CI:1.005~3.046)、值班频率>1次/周(OR=2.049,95%CI:1.182~3.551)是基层卫生工作者职业紧张的危险因素(均P<0.05)。结论 该区基层卫生工作者职业紧张发生率较高,需增加高付出员工的回报以防止过度投入,同时加强职工心理弹性培训。

Objective To investigate the current situation of occupational stress among health workers in a community health service center in Shanghai,analyze the influencing factors of occupational stress in this group,so as to provide intervention suggestions for alleviating occupational stress. Methods From June to October 2020,the convenience sampling method was used to collect all the grassroots health workers in the area,and the logistic regression analysis was used to analyze the occupational stress. Results A total of 1 816 questionnaires were issued in this study,of which 1 515 were able to independently complete informed consent,and the response rate was 83.43%. The positive rate of occupational stress was 11.55% in 175 patients. The participants scored(14.24±5.56)points in the effort dimension,(47.23 ±9.19)points in the reward dimension,(12.65 ±5.93)points in the intrinsic investment dimension,and(0.63±0.50)points in the effort-reward lopsided index. The scores of effort and input in the occupational stress group were higher than those in the normal group,and the scores of reward were lower than those in the normal group(all P <0.01).Multivariate logistic regression analysis showed that 35-<45 age group(OR=2.095,95%CI:1.120-3.916),number of types of work≥3(OR=2.320,95%CI:1.355-3.972),overtime intensity >1 time/week(OR=2.066,95%CI:1.414-3.020),teaching task >1 time/week(OR=1.749,95%CI:1.005-3.046),duty frequency >1 time/week(OR=2.049,95%CI:1.182-3.551) were risk factors for occupational stress among primary health workers. Conclusion The incidence of occupational stress among primary health workers in this area is high,and it is necessary to increase the reward of high-paying employees to prevent over-investment and strengthen the training of mental resilience of employees.