社区卫生服务员工中职业紧张与倦怠的调查分析  

Survey and Analysis of Occupational Stress and Job Burnout among Community Health Service Workers in Shanghai

作　　者：葛文珍[1] 戴俊明[1] 玄泽亮 谢震宇[3] 傅华[1] 

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]上海市徐汇区卫生局,上海200030 [3]上海市浦东新区疾病预防控制中心,上海200133

出　　处：《工业卫生与职业病》2010年第2期69-73,共5页Industrial Health and Occupational Diseases

基　　金：上海医学研究发展基金(2006021);上海市公共卫生重点学科建设项目(08GWZX1001)

摘　　要：目的弄清社区卫生服务员工职业紧张与职业倦怠的现状,探讨两者之间的关联。方法采用依据工作要求-自主模式与付出-回报失衡模式理论开发的简明职业紧张问卷和Maslach的职业倦怠问卷的修订版,对上海市的1397名社区卫生服务员工进行调查。运用多元Logistic回归分析不同职业紧张因子与职业倦怠的关联。结果有77.1%人被评定为职业紧张,有19.3%人呈现付出回报失衡,职业倦怠阳性率高达77.3%。职业倦怠均分为2.17±0.91,其3个维度情感耗竭均分为2.23±1.46,人格解体为1.04±1.15,个体成就感得分为3.78±1.36。高要求低自主是个体成就感降低的保护因子,以低D/C组为对照,中等与高组的OR值分别为0.54（95%CI=0.37-0.78）和0.42（95%CI=0.25-0.72）。社会支持是职业倦怠的保护因子,以低社会支持组为对照组,中、高社会支持组OR值分别为0.69（95%CI=0.47-1.00）和0.52（95%CI=0.35-0.77）;付出回报失衡是职业倦怠的危险因子,以低付出回报失衡为对照,中等组的OR值为2.48（95%CI=1.33-4.62）;高失衡组OR值为4.91（95%CI=1.78-13.6）。内在投入是情感耗竭和人格解体的危险因子。结论预防职业倦怠需要降低职业紧张程度,缓解付出回报失衡,同时增加社会支持。Objective To identify the situation of occupational stress and job burnout among community health care workers.MethodsA survey on occupational stress and job burnout was carried out among 1397 community health care workers in Shanghai.Self-administered questionnaire was used to assess job burnout and occupational stress based on Maslach Burnout Inventory and the Job Demand-Control model as well as Effort-Reward Imbalance Model.Multiple logistic regressions were used to analyze the association between occupational stress and job burnout.Results77.1% participants were assessed having occupational stress,19.3% subjects showed effort-reward imbalance and the positive rate of job burnout occupied as high as 77.3%.The mean of job burnout was 2.17±0.91 and the mean of its three dimensional emotional exhaustion was 2.23±1.46.Depersonalization was 1.04±1.15 and the sense of personal accomplishment was 3.78±1.36.High demand-low self-control was a protective factor for personal accomplishment.With low D/C group as control,odd ration equaled to 0.54（95%CI=0.37~0.78） for the middling D/C group,and 0.42（95%CI=0.25~0.72） for high D/C group.Social support was a protective factor of job burnout.With low social support group as control,odd ration equaled to 0.69（95%CI=0.47~1.00）or 0.52（95%CI=0.35~0.77） for medium or high social support groups.Effort-reward imbalance was a protective factor of personal accomplishment.In comparison with low effort-reward imbalance group,OR of the medium effort-reward imbalance group was 2.48（95%CI=1.33~4.62）,the OR of the high effort-reward imbalance group was 0.52（95%CI=0.35~0.77）.Over-commitment was a risky factor of emotional exhaustion and depersonalization.ConclusionsIn order to prevent job burnout,it＇s better to control occupational stress,improve effort-reward imbalance and increase social support.

关 键 词：社区卫生服务 职业紧张 付出回报失衡 职业倦怠 

分 类 号：R135[医药卫生—劳动卫生]