公立大型医院职工心理健康现况及其与社会支持等因素的相关性

Mental health status of employees in large public hospitals and its correlation with social support and other factors

目的分析公立大型医院职工心理健康现况及其与社会支持等因素的相关性。方法采用横断面设计,于2023年11月通过整群抽样方法,抽取北京医院、中日友好医院、中国医学科学院肿瘤医院三家公立大型医院的部分职工进行调查。采用电子问卷收集心理健康相关指标,通过心理健康自评问卷评估心理健康现况,≤6分为心理良好组,≥7分为心理需关注组。共发问卷3828份,收回有效问卷3803份纳入最终分析。分析心理健康现况及其与社会支持等因素的相关性。社会支持相关指标包括独居、与亲戚或朋友的来往人数和参加集体活动,此外还包括医师、护士、医技与科研人员以及行政与后勤人员这四类岗位和性别、职称、学历、对单位福利满意度等信息。结果纳入的3803名调查对象中男性874名(23.0%),女性2929名(77.0%);≤30岁743名(19.5%),31~45岁2177名(57.2%),>45岁883名(23.2%);其中心理需关注者1238名(32.6%)。女性、护士、未婚、研究生以下学历及对单位福利满意度较低的职工心理健康需要关注(均P<0.05),其社会支持总分(t=138.59,P<0.001)和分级(χ^(2)=255.25,P<0.001)均相对更低;社会支持因素方面,非独居、与亲戚朋友经常来往和参加集体活动是心理健康的独立保护因素(均P<0.05);女性职工的学历与心理健康之间的保护性关联较男性职工更强(女性:OR=0.348,95%CI:0.198~0.614;男性:OR=0.653,95%CI:0.430~0.994);非独居是护士心理健康的保护性因素(OR=0.515,95%CI:0.367~0.723),而高职称(OR=0.362,95%CI:0.182~0.720)和学历(OR=0.365,95%CI:0.175~0.758)是医师心理健康的保护因素(均P<0.05)。结论公立大型医院职工心理健康在性别、岗位、学历等不同亚组间存在分化,总体上需要得到关注;社会支持因素方面,非独居、与亲戚朋友经常来往和参加集体活动与良好的心理健康状态相关;医院工会等部门应进行针对性更强的帮助和支持,为职工塑造更好的心理健康环境。

Objective To analyze the current mental health status of employees in large public hospitals and its correlation with factors such as social support.Methods A cross-sectional study was conducted in November 2023.Using cluster sampling,employees from Beijing Hospital,China-Japan Friendship Hospital,and the Cancer Hospital of the Chinese Academy of Medical Sciences were surveyed.An electronic questionnaire was used to collect indicators related to mental health.Mental health status was assessed using a self-evaluation questionnaire,with scores≤6 indicating good mental health and scores≥7 indicating the need for attention.A total of 3828 questionnaires were distributed,and 3803 valid responses were included in the final analysis.The study analyzed the current mental health status and its correlation with factors such as social support among the included employees.Social support indicators included living alone,frequency of contact with relatives or friends,and participation in group activities.Other factors included job type(physicians,nurses,medical technicians and researchers,and administrative and logistical employees),gender,professional title,education level,and satisfaction with workplace benefits.Results The study included 3803 respondents,comprising 874(23.0%)males and 2929(77.0%)females;743(19.5%)aged≤30 years,2177(57.2%)aged 31-45 years,and 883(23.2%)aged>45 years.Among them,1238(32.6%)employees needed attention for their mental health.The female,nurse,unmarried,post-graduate degree or less,and employees with low satisfaction with unit welfare need to pay attention to their mental health(all P<0.05),their total social support score(t=138.59,P<0.001)and grade(χ^(2)=255.25,P<0.001)are lower.In terms of social support factors,non-living alone,frequent communication with relatives and friends and participation in group activities were independent protective factors for mental health(all P<0.05).The protective association between education and mental health of female workers was stronger than that of male workers(female OR=0.348,95%CI:0.198-0.614 vs male OR=0.653,95%CI:0.430-0.994).Non-living alone was the only protective factor for nurses′mental health(OR=0.515,95%CI:0.367-0.723);However,high professional title(OR=0.362,95%CI:0.182-0.720)and educational background(OR=0.365,95%CI:0.175-0.758)were only protective factors for physicians′mental health(all P<0.05).Conclusions The mental health of employees in large public hospitals is differentiated among different subgroups,such as gender,position and educational background,which needs attention in general.In terms of social support factors,non-living alone,frequent communication with relatives and friends,and participation in group activities were associated with good mental health.Hospital trade unions and other departments should carry out more targeted help and support to create a better mental health environment for employees.