中国全科医生对工作场所患者源暴力的感知、心理资本与职业认同的关系研究

Relationships between Perceived Workplace Violence by Patients,Psychological Capital,and Professional Identity among General Practitioners in China

背景社会环境和心理因素会对职业认同产生明显影响,目前尚无关于中国全科医生对工作场所患者源暴力的感知、心理资本与职业认同关系的研究。目的了解中国全科医生对工作场所患者源暴力的感知、心理资本与职业认同现状及三者之间的关系。方法于2021年3—5月,在中国东、中、西部地区采用多阶段分层随机抽样的方法抽取4632例全科医生进行电子问卷调查,调查问卷内容主要包括全科医生的基本情况、工作场所患者源暴力、心理资本、职业认同。采用Spearman秩相关分析工作场所患者源暴力、心理资本与职业认同的关系;采用多元分层回归分析工作场所患者源暴力、心理资本对职业认同的影响。结果共回收4376份有效问卷(94.47%)。4376例全科医生中,624例(14.26%)过去1年中遭受过工作场所患者源暴力,全科医生心理资本总得分为(102.89±16.94)分,职业认同总得分为(33.93±8.95)分。Spearman秩相关分析结果显示,全科医生工作场所患者源暴力与心理资本及其各维度、职业认同呈负相关,心理资本及其各维度与职业认同呈正相关(P<0.01)。多元分层回归分析结果显示,工作场所患者源暴力对职业认同有负向预测作用(低频度,b=-0.071;中频度,b=-0.054;高频度,b=-0.042;P均<0.001),心理资本对职业认同有正向预测作用(b=0.330,P<0.001),心理资本在工作场所患者源暴力与职业认同之间起部分中介作用。结论中国全科医生工作场所患者源暴力、心理资本与职业认同之间存在相关关系,心理资本在工作场所患者源暴力和职业认同之间起部分中介作用,未来应重视全科医生的职业环境、职业现状和心理健康。

Background Social environment and psychological factors have a notable impact on professional identity.Currently,there are no available studies on relationships between perception of workplace violence(WPV)by patients,psychological capital(PsyCap),and professional identity among general practitioners(GPs)in China.Objective To investigate the relationships between perceived WPV by patients,PsyCap,and professional identity among GPs in China.Methods A self-administered electronic questionnaire survey was conducted with 4632 GPs selected by use of stratified multistage random sampling from eastern,central,and western China between March and May 2021.The survey was used for collecting data mainly consisting of GPs'basic demographics,perceived WPV by patients,PsyCap,and professional identity.Spearman's correlation was used to analyze relationships between perceived WPV by patients,PsyCap,and professional identity.Hierarchical multiple regression analysis was used to analyze the effects of perceived WPV by patients and PsyCap on professional identity. Results Altogether,94.47% of the GPs(4 376/4 632) who handed in responsive questionnaires were included for analysis. Six hundred and twenty-four(14.26%) GPs had experienced WPV by patients in the past year. The average total scores of PsyCap and professional identity were(102.89±16.94) and (33.93±8.95),respectively. The increase in the score of perceived WPV by patients was correlated with a decrease in the scores of PsyCap and its dimensions,and in the score of professional identity(P<0.01). The increase in the scores of PsyCap and its dimensions was correlated with increased score of professional identity(P<0.01). Hierarchical multiple regression analysis showed that the frequency of WPV by patients had a negative predictive effect on professional identity(low frequency,b=-0.071;intermediate frequency,b=-0.054;high frequency,b=-0.042;P<0.001). PsyCap had a positively predicted effect on professional identity(b=0.330,P<0.001),and it played a partial mediating role between perceived WPV by patients and professional identity. ConclusionThe GPs' perceived WPV by patients,PsyCap,and professional identity are interrelated,and PsyCap plays a partial mediating role between perceived WPV by patients and professional identity. Great importance should be attached to the professional work environment,occupational status,and mental health among Chinese GPs.