医务社会工作者职业紧张、组织支持与离职意愿的关系研究

Study On the Relationship Between Ocupational Stress,Organizational Support and Turnover Intention of Medical Social Workers

本研究使用“中国社会工作动态数据(CSWLS2019)”中220份医务社会工作者群体数据,以社会交换理论和组织支持理论为指导,实证研究了职业紧张和组织支持对医务社会工作者离职意愿的影响。研究发现,职业紧张中的付出—回报失衡和超负荷均对离职倾向有显著影响,且付出—回报失衡比超负荷作用更显著;组织支持在职业紧张与离职意愿之间存在部分中介效应。由此提出通过明确考核指标和提升组织支持感来解决医务社会工作者的离职倾向问题。

As the reform of China’s medical market services advanced in the 1980s,the issues of the doctor-patient trust and doctor-patient relationship became increasingly prominent,and hospitals launched innovations in management level and service quality to improve patient satisfaction and reduce disputes,and the reconstruction of medical social work came into being.Nowadays,medical social workers(hereinafter referred to as medical social workers)play positive functions in the hospital system,such as providing emotional guidance to patients,assisting in establishing support networks,balancing information asymmetry between doctors and patients,and coordinating doctor-patient relationships,therefore,the stability of the medical social work team is of great significance to the hospital system.Based on organizational support theory and social exchange theory,this study will examine whether organizational support perceptions from within the institution,between institutional cultures,and across the system mediate the relationship between MSWs’occupational stress and willingness to leave.Statistical data were obtained from the national baseline data of the China Social Work Dynamics Survey 2019(CSWLS2019)organized by the East China University of Science and Technology.220 cases of data participating in the medical social worker module survey were selected,and the data were processed and analyzed using SPSS22.0 software,and the factors influencing medical social workers’propensity to leave were explored based on this survey data.The propensity to leave medical social workers was the dependent variable.Sense of organizational support and professional tension were the independent variables.The sense of organizational support included three dimensions,namely,intra-organizational support,organizational culture support,and cross-system support.Professional tension included three dimensions,i.e.,give and take,reward,and overload.This study found that:first,the basic demographic variable of“age”was significantly affected in the model of social workers’propensity to leave;Second,among the career tension factors,“give-and-reward ratio”and“overload”had a positive effect on the propensity to leave.Third,among the organizational support factors,organizational culture support,as the core factor of organizational support factors,has a negative effect on separation.Social workers consider various factors before separation behavior occurs,and use the two main factors of career tension and organizational support as the main measure.Based on the above analysis,this study concludes that the current concern and intervention of medical social workers’professional tension phenomenon should be strengthened,and the intervention of medical social workers’professional tension can be carried out at both external and internal levels:(1)Individuals should strengthen mental health education and consciously regulate the sense of imbalance.Medical social workers should truly understand the characteristics of their profession,and should realize that social work is often an implicit,inner payment,and sometimes the payment is timely,while the return is delayed,and the psychological gap is likely caused by this imbalance,therefore,medical social workers should correctly evaluate the payment and return in their profession,rationally view the payment-reward imbalance,and consciously self-regulate.(2)Social work institutions and hospital systems should optimize assessment indexes,reduce work burden and consider adding reasonable material and spiritual reward mechanisms.On the part of social work institutions and hospitals,they should establish reasonable assessment indexes,so that medical social workers can clearly understand their work responsibilities and goals,comprehensively assess their work,make the ratio of medical social workers’pay and reward more open and transparent,and reduce additional cases of overload work.Through the establishment of a material or spiritual reward mechanism,the imbalance of pay and reward of medical social workers can be alleviated,which can further enhance their work commitment and effectiveness,and patients and their families can also benefit from it.At the same time,social work organizations and hospitals should strengthen their culture and build a supportive leadership team,which can be built from the following aspects:(1)Social work organizations should improve the organizational culture that matches their own characteristics,and an organizational culture that combines their own characteristics and professional values will be recognized by medical social workers in the organizations.(2)Hospitals should clarify the scope of responsibilities of medical social workers and smooth the exchange of information between medical and nursing teams and medical social workers,so that medical social workers can carry out helping services based on good interdisciplinary cooperation and make medical social workers better play the role of“bridge”and“mediator”in the development of China’s health career.These measures can make medical social workers feel fully supported,so that they can carry out their work of helping people more passionately and reduce burnout and work stress,which in turn will reduce their willingness to leave their positions as medical social workers.