城市公立医疗机构医生职业倦怠因素结构的探讨及恒等性检验  

A Probe into Factor Structure and Invariance Inspection on Occupational Burnout of Physicians from Urban Public Medical Institutions

作　　者：张宜民[1,2] 冯学山[3,4] 娄继权 浦良发 景湲 

机构地区：[1]上海市浦东卫生发展研究院,200129 [2]复旦大学社会发展与公共政策学院,200433 [3]复旦大学公共卫生学院,200032 [4]教育部公共卫生安全重点实验室,200032

出　　处：《中国卫生统计》2012年第5期670-672,676,共4页Chinese Journal of Health Statistics

基　　金：上海市浦东新区卫生系统优秀青年医学人才培养计划(PWR_q2011-27)

摘　　要：目的探讨城市公立医疗机构医生职业倦怠的潜在结构,并进行测量恒等性检验。方法自编医生职业倦怠问卷(POBQ-PMI)为工具,采用分层整群随机抽样共调查了湖北省三市1451名被试者,借助Amos7.0软件对竞争性模型进行验证性因素分析及多样本比较。结果调整后(允许同一因子内的误差相关)的三因素模型Model3达到拟合标准(GFI、NFI、CFI均>0.9,RMSEA=0.068,RMR=0.047),且在三个地区的样本人群中均得到支持,其因素载荷在不同地区的样本上满足测量恒等特性(⊿CMIN=25.941,⊿DF=16,P>0.05)。结论城市公立医疗机构医生职业倦怠由情感耗竭、人格解体、成就感低落三个因素(11个条目)构成,因素结构与载荷参数具有跨样本稳定性,表明问卷内在信效度较高。Objective To explore latent factor structure of oc- cupational burnout of physicians from urban public medical institutions and inspect measurement invaliance. Methods 1451 physicians from three cities of Hubei province were surveyed, taking advantage of stratified cluster random sampling by self-compiled POBQ-PMI. Competitive models were verified by confirmatory factor analysis and multi-group comparison with the aid of Amos 7.0. Results Adjusted three-factor model 3 could reach the goodness-of-fit standards （GFI,NFI, CFI 〉 0. 9, RMSEA = 0. 068, RMR = 0. 047 ）, and be also supported by three single samples. Meanwhile, factor loadings of model 3 among three different samples met the invariance （ ~ C- MIN = 25. 941, ＆DF = 16, P 〉 0.05 ）. Conclusion Occupational burn- out of physicians from urban public medical institmions is consisted of three factors（ 11 items）, including emotional exhaustion, depersonalization and reduced personal accomplishment. Moreover, its factor structure and load- ing parameters are stable, indicating the POBQ-PMI possessed high struc- ture validity and internal reliability.

关 键 词：医生 职业倦怠 验证性因素分析 多样本恒等性 

分 类 号：R195[医药卫生—卫生统计学]