知觉压力和职业不确定感在外科医务人员工作场所韧性与健康生产力受损间的链式中介作用

Chain mediating effect of perceived stress and occupational uncertainty on workplace resilience and the impairment of health productivity among surgical medical staff

目的探讨知觉压力、职业不确定性在工作场所韧性对外科医务人员健康生产力受损影响机制中的多重中介作用。方法2023年3—5月,采用便利抽样法,选取四川省6所三级甲等医院342名外科医务人员为调查对象,采用一般资料调查表、知觉压力量表、职业不确定性量表、工作场所韧性量表和健康生产力受损量表进行调查。构建并检验知觉压力和职业不确定性的链式中介模型。结果四川省6所342名三级甲等医院外科医务人员知觉压力得分为(32.92±10.85)分,职业不确定性得分为(98.92±27.93)分,工作场所韧性得分为(64.01±16.52)分,健康生产力受损得分为(14.33±4.35)分。外科医务人员健康生产力受损与工作场所韧性呈负相关(r=-0.667,P<0.05),与知觉压力和职业不确定性均呈正相关(r=0.687、0.692,均P<0.05)。工作场所韧性对隐性缺勤的总间接效应为0.317,占总效应的41.93%,其中知觉压力和职业不确定性对健康生产力受损的特定中介效应分别占18.39%和15.74%,两者的链式中介作用占7.80%。结论四川省三级甲等医院外科医务人员健康生产力受损处于中等偏上水平,知觉压力和职业不确定性在工作场所韧性对外科医务人员隐性健康生产力受损影响机制中的多重中介作用成立。医疗管理者应关注健康生产力受损水平高的医务人员,降低其知觉压力和职业不确定性,以进一步改善医务人员身心健康。

Objective To explore the multiple mediating effects of perceived stress and occupational uncertainty in the influence mechanism of workplace resilience on the impairment of health productivity among surgical medical staff.Methods From March to May 2023,a convenience sampling method was used to select 342 surgical medical staff from 6 grade-A tertiary hospitals in Sichuan Province as the survey subjects.The survey was conducted using a general information questionnaire,perceived stress scale,occupational uncertainty scale,workplace resilience scale,and health productivity impairment scale.Construct and test the chain mediation model of perceived stress and occupational uncertainty.Results The scores of perceived stress,occupational uncertainty,workplace resilience and health productivity impairment of 342 surgical medical staff in 6 grade-A tertiary hospitals in Sichuan Province were(32.92±10.85),(98.92±27.93),(64.01±16.52)and(14.33±4.35)points,respectively.The impaired health productivity of surgical medical staff was negatively correlated with workplace resilience(r=-0.667,P<0.05),and positively correlated with perceived stress and occupational uncertainty(r=0.687,0.692,both P<0.05).The total indirect effect of workplace resilience on hidden absence was 0.317,accounting for 41.93%of the total effect.Among them,the specific mediating effects of perceived stress and occupational uncertainty on health productivity impairment accounted for 18.39%and 15.74%,respectively,and the chain mediating effect of the two accounted for 7.80%.Conclusion The impaired health productivity of surgical medical staff in grade-A tertiary hospitals in Sichuan Province is at a moderate to high level,and the multiple mediating effects of perceived stress and occupational uncertainty in the mechanism of workplace resilience on the impaired hidden health productivity of surgical medical staff are established.Medical managers should pay attention to medical staff with high levels of health productivity impairment,reduce their perceived stress and occupational uncertainty,so as to further improve their physical and mental health.