重大突发公共卫生事件下医务人员职业紧张影响因素分析

Analysis on influencing factors on occupational stress of medical staff during major public health emergencies

目的分析重大突发公共卫生事件下医务人员职业紧张现状及其影响因素。方法采取方便抽样方法,选择广州市491名医务人员作为研究对象,采用《工作内容问卷》《工作付出-回报失衡紧张量表》联合评估研究对象的工作要求-自主(JDC)和付出-回报失衡(ERI)模式职业紧张水平。结果研究对象的JDC、ERI模式职业紧张检出率分别为50.1%和52.5%;2种模式职业紧张检出率比较,差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,个人月收入越低、周工作时间越长者,检出JDC和ERI模式职业紧张的风险均越高(P值均<0.05);夜班、睡眠时间<6 h/d者、对单位提供的防护措施不满意者检出JDC和ERI模式职业紧张的风险分别高于无夜班、睡眠时间≥6 h/d、对单位提供的防护措施满意者(P值均<0.01);接触过新型冠状病毒感染病例或疑似病例的人员检出ERI模式职业紧张的风险高于无接触者(P<0.05)。结论重大突发公共卫生事件下,医务人员存在一定程度的JDC和ERI模式职业紧张;主要影响因素包括个人月收入、周工作时间、夜班、睡眠时间、对防护措施的满意度和职业暴露等。

Objective To analyze the current status and influencing factors of occupational stress among medical staff during major public health emergencies.Methods A total of 491 medical staff in Guangzhou City was selected as the research subjects using a convenient sampling method.The Job Content Questionnaire and Effort-Reward Imbalance Questionnaire were used to evaluate the occupational stress level in the job demand-control(JDC)and effort-reward imbalance(ERI)models among the staff.Results Among the research subjects,the detection rates of occupational stress in JDC and ERI models were 50.1%and 52.5%,respectively.There was no significant difference in the detection rates of occupational stress between the two models(P>0.05).The result of multivariate logistic regression analysis showed that individuals with lower monthly income and longer weekly working hours had a higher risk of occupational stress in both JDC and ERI models(all P<0.05).Staff with night shift,daily sleep time less than six hours,and dissatisfaction with the protective measures provided by the hospital had higher risk of occupational stress than those with no night shift,daily sleep time at least six hours,and satisfaction with the protective measures provided by the work place in JDC and ERI models(all P<0.01).The risk of ERI model occupational stress of personnel who had been exposed to COVID-19 cases or suspected cases was higher than that in those who had not been exposed(P<0.05).Conclusion Medical staff experience a certain level of occupational stress,characterized by both JDC and ERI models,during major public health emergencies.The main influencing factors included personal monthly income,weekly working hours,night shift,sleep time,satisfaction with protective measures and occupational exposure.