广州市南沙区基层医务人员心理健康和职业倦怠状况及其影响因素分析

Mental Health and Job Burnout and Its Influencing Factors of Grassroots Medical Staff in Nansha District of Guangzhou

目的了解基层医务人员心理健康和职业倦怠状况及其影响因素分析。方法于2020年10月,采用分层随机抽样的方式对广州市南沙区11家区属公立医院和8家社区卫生服务中心医务人员进行调查。采用心理症状自评表、Maslach职业倦怠量表开展网络问卷调查。结果南沙区861名基层医务人员症状自评量表SCL-90总分(160.07±55.23)及各因子均显著高于全国常模(P<0.001),不同岗位得分次序由高至低依次为:其他卫技人员、护士、医生、后勤与行政人员;对影响因素进行逐步回归分析:工作态度、情绪衰竭、缺乏尊重、工作年限、自身安全得不到保障、是否为其他卫技、同事缺乏理解7个指标有正向预测作用,家庭收入和工作环境2个指标有负向预测;职业倦怠发生率42.04%,由高至低依次护士、其他卫技人员、医生、后期与行政人员。职业倦怠总分(45.148±19.656)分,不同类别医务人员总分和个人成就感有差异(P<0.05),对影响因素的逐步回归分析显示:SCL-90总分、工作压力、工作环境、缺乏尊重、遇到压力排解方式、管理者批评过多、家庭收入7个指标对医务人员职业倦怠有正向预测作用,年龄、其他卫技、文化程度有负向预测作用。结论应建立基层医务人员心理健康评估干预长效机制,健全绩效分配机制,注重内部文化内涵建设,引导医务人员宽恕化解矛盾,利用法律武器保障自身权益。

Objective To understand the mental health and job burnout of primary medical staff and analyze the influencing factors.Methods In October 2020,an online questionnaire survey was conducted by using symptom checklist and Maslach Burnout Scale.Results The total score of SCL-90 of 861 grassroots medical staff in Nansha district was(160.07±55.23)and every factor was significantly higher than the national norm(P<0.001).The order of the scores of different positions was other health professionals,nurses,doctors,logistics and administrative personnel from high to low.Results Of stepwise regression analysis showed that work attitude,emotional exhaustion,lacking of respect,working years,lacking of security,whether other health technology,lacking of understanding of colleagues,whether work on time had positive predictive effect,family income and working environment had negative predictive effect.The incidence of job burnout was 42.04%,followed by nurses,other health technicians,doctors,late stage and administrative staff.The total score of job burnout was(45.148±19.656),and the total score and personal accomplishment of different types of medical staff were different(P<0.05).Results of stepwise regression analysis showed that job stress,working environment,lacking of respect,stress relief methods,too much criticism from managers and family income had positive predictive effect on job burnout of medical staff,and age,other health technology,family income and other factors had positive predictive effect on job burnout.Education level had a negative predictive effect.Conclusion We should establish a long-term mechanism of mental health evaluation and intervention for grassroots medical staff,improve the performance distribution mechanism,pay attention to the construction of internal cultural connotation,guide medical staff to forgive and resolve conflicts,and use legal weapons to protect their own rights and interests.