云南省结核病防治医生职业倦怠现状及影响因素  

Job burnout and its influencing factors among physicians specialized for tuberculosis prevention and treatment in Yunnan Province

作　　者：李玲[1] 许琳[1] 陈金瓯[1] 杨蕊[1] 

机构地区：[1]云南省疾病预防控制中心结核病防治所,云南昆明650022

出　　处：《环境与职业医学》2017年第10期886-890,共5页Journal of Environmental and Occupational Medicine

摘　　要：[目的]了解云南省不同医疗卫生机构结核病防治(以下简称结防)医生的职业倦怠现状,分析产生职业倦怠的影响因素,提出改善结防医生职业倦怠现状、稳定专业人员队伍建设的对策及建议。[方法]采用自行设计的调查表(包括人口社会学特征、职业基本特征、职业认同感、马斯勒职业倦怠量表)对云南省2所结核病专科医院、3市所辖29个县(区)结核病定点医院及29个县(区)疾病预防控制中心的1 160名结防医生进行调查(有效应答率为95.7%)。采用秩和检验、有序多分类logistic回归分析等方法进行数据分析。[结果]在1 110名结防医生中,774人(70.6%)存在不同程度的职业倦怠,其中轻度、中度和重度职业倦怠的检出率分别为41.2%、22.5%、6.9%。不同职业倦怠分级的结防医生,9个职业认同感项目得分差异均有统计学意义(均P<0.01)。多因素分析显示:与同事相处融洽(OR=0.7,95%CI:0.7~0.9),坦诚自己的结防工作者身份(OR=0.9,95%CI:0.8~1.0)是职业倦怠的保护因素;因害怕传染而对结核病患者有偏见(OR=1.2,95%CI:1.1~1.4),家人希望离开结防岗位(OR=1.2,95%CI:1.0~1.4)是职业倦怠的危险因素;放射人员和临床人员检出职业倦怠的可能性均为管理人员的2.2倍;结防工作年限为20~29年者检出职业倦怠的可能性是<10年者的2.2倍;培训次数为0次和1~2次者,检出职业倦怠的可能性分别是3次及以上者的1.4倍和1.6倍;服务结核病患者数≥200人次/月者,检出职业倦怠的可能性是<100人次/月者的2.2倍。[结论]云南省结防医生职业倦怠检出率高,程度较严重。应通过避免结防医生长期超负荷工作,改善感染控制,制定专项的呼吸道传播疾病防治职业风险保障,提高公众对结防工作的认可和理解,提高结防医生待遇等减少结防医生的职业倦怠。[Objective] To evaluate job burnout situation among physicians specialized for tuberculosis（TB） prevention and treatment in medical institutions in Yunnan Province, analyze related influencing factors, and put forward policy recommendations to relieve their job burnout and facilitate team capacity building.[Methods] Using self-designed questionnaires to collect data on demographic and sociologic features, basic job characteristics, professional identity, and job burnout（Maslach Burnout Inventory） among 1 160 physicians specialized for TB prevention and treatment from 2 specialized TB hospitals, 29 county-or district-designated hospitals, and 29 county-or district-level centers for disease prevention and control of 3 cities in Yunnan, and the valid response rate was 95.7%. Rank sum test and ordinal logistic regression analysis were used for data analysis.[Results] Of the 1 110 physicians specialized for TB prevention and treatment who participated the questionnaire survey, 774（70.6%） showed different levels of job burnout, and the positive rates of mild, moderate, and severe job burnout were 41.2%, 22.5%, and 6.9%, respectively. There were significant differences in 9 professional identity items among different job burnout groups（P〈 0.01）. The multiple logistic regression analysis results showed that getting along well with colleagues（OR=0.7, 95%CI： 0.7-0.9） and admitting they were TB specialized physicians（OR=0.9, 95%CI： 0.8-1.0） were protective factors of job burnout; prejudice to TB patients for fear of infection（OR=1.2, 95%CI： 1.1-1.4） and families＇ expectation on their leaving TB prevention and control work（OR=1.2, 95%CI： 1.0-1.4） were risk factors of job burnout. The odds ratios of job burnout were 2.2 for both radiation physicians and clinical physicians versus managerial staff; 2.2 for those with 20-29 years of seniority versus those with 10 years; 1.4 and 1.6 for those who experienced 0 and 1-2 times of training versus those who did 3 times and above; and 2.2 fo

关 键 词：结核病防治 医生 职业倦怠 现状 影响因素 

分 类 号：R135[医药卫生—劳动卫生]