三甲医院医务人员长工时、轮班与职业紧张的关联研究

Association of long working hours and shift work with occupational stress in level A tertiary hospitals

目的探讨三甲医院医务人员长工时、轮班与职业紧张的关联,为促进医务人员身心健康提供依据。方法采用分层整群抽样方法,从新疆维吾尔自治区南疆、北疆各抽取1家三甲医院的医务人员为调查对象。通过问卷调查收集人口学信息、工作时长和轮班情况等资料,采用中国疾病预防控制中心职业卫生所制定的职业紧张测量核心量表调查职业紧张情况;采用多重线性回归模型分析长工时(周工作时长>40 h)、轮班与职业紧张的关联。结果发放问卷2529份,回收有效问卷2262份,问卷有效率为89.44%。调查的医务人员年龄为(35.12±8.71)岁;女性1696人,占74.98%;医生722人,占31.92%;护士1033人,占45.67%;医技或药技人员361人,占15.96%。长工时暴露1808人,占79.93%。轮班1264人,占55.88%。职业紧张评分为(44.79±8.49)分;检出职业紧张649人,检出率为28.69%。多重线性回归分析结果显示,校正年龄、婚姻状况、工龄、岗位、吸烟和体育锻炼等混杂因素后,长工时(>40 h~,β'=0.124;>48 h~,β'=0.175;≥55 h,β'=0.323)、轮班(β'=0.203)是医务人员职业紧张的影响因素(P<0.05);长工时和轮班对职业紧张的影响不存在交互作用(P>0.05)。结论长工时和轮班可增加三甲医院医务人员发生职业紧张的风险。

Objective To examine the association of long working hours and shift work with occupational stress among medical staff in level A tertiary hospitals,so as to provide insights into promotion of physical and mental health among medical personnel.Methods One level A tertiary hospital was sampled using a stratified cluster sampling method from southern and northern Xinjiang Uygur Autonomous Region,and all medical personnel were recruited from these two hospitals.Participants'demographics,working duration,and working in shifts were collected using questionnaires,and occupational stress was measured using the Core Scale for Measurement of Occupational Stress proposed by National Institute for Occupational Health and Poison Control,Chinese Center for Disease Control and Prevention.The associations of long working hours(weekly working duration of>40 hours)and shift work with occupational stress were examined using a multiple linear regression model.Results A total of 2529 questionnaires were allocated,and 2262 were valid,with an effective rate of 89.44%.The respondents had a mean age of(35.12±8.71)years,and included 1696 women(74.98%).Of all respondents,there were 722 doctors(31.92%),1033 nurses(45.67%),361 medical or pharmaceutical technicians(15.96%),1808 with long working hours(79.93%)and 1264 with shift work(55.88%).The score of occupational stress was(44.79±8.49)points,and the prevalence of occupational stress was 28.69%among respondents.Multiple linear regression analysis showed that after adjustment for age,marital status,length of service,position,smoking and physical exercise,long working hours(>40 h,β'=0.124;>48 h,β'=0.175;≥55 h,β'=0.323)and shift work(β'=0.203)were influencing factors for occupational stress among medical personnel(P<0.05);however,there was no interaction between long working hours and shift work(P>0.05).Conclusion Long working hours and shift work may increase the risk of occupational stress among medical personnel in level A tertiary hospitals.