广州市1545名医务人员职业紧张、职业倦怠和抑郁症状的关系研究  

Relation ship among occupational stress,job burnout and depression of 1545 medical staff in Guangzhou

作　　者：黄浪 陈琳[2] 苏艺伟 兰丽琴 黄辉 王雅琪 蔡洁燕 张晋蔚[2] 刘可平 王致[2] 刘移民[2] HUANG Lang;CHEN Lin;SU Yiwei;LAN Liqin;HUANG Hui;WANG Yaqi;CAI Jieyan;ZHANG Jinwei;LIU Keping;WANG Zhi;LIU Yimin(Guangzhou Twelfth People’s Hospital Affiliated to Guangzhou Medical University,Guangzhou,Guangdong 510620,China;Guangzhou occupational disease prevention and control hospital,Guangzhou,Guangdong 510620,China;Guangzhou Hospital of Integrative Medicine,Guangzhou,Guangdong 510800,China;Department of Public Health and Preventive Medicine,School of Basic Medicine,Jinan University,Guangzhou,Guangdong 510632,China;Zhongshan Center for Disease Control and prevention,Zhongshan,Guangdong 528403,China)

机构地区：[1]广州医科大学附属市十二人民医院,广东广州510620 [2]广州市职业病防治院,广东广州510620 [3]广州市中西医结合医院,广东广州510800 [4]暨南大学基础医学院公共卫生与预防医学系,广东广州510632 [5]中山市疾病预防控制中心,广东中山528403

出　　处：《职业卫生与应急救援》2021年第2期129-135,共7页Occupational Health and Emergency Rescue

基　　金：中国疾病预防控制中心职业卫生与中毒控制所中央财政项目(131031109000160008);广州市医学重点学科建设项目(穗卫科教[2016]27号);广州市高水平临床重点专科建设项目(穗卫函[2019]1555号);广州市“121人才梯队工程”后备人才项目(穗人社发[2011]167号)。

摘　　要：目的探讨医务人员职业紧张、职业倦怠和抑郁症状的关系,为促进医务人员身心健康提供理论指导。方法采用整群随机抽样方法,选取广州市三家医院的1545名医务人员为研究对象,应用付出-回报失衡问卷、职业倦怠通用量表和病人健康问卷抑郁量表对其职业紧张、职业倦怠和抑郁症状水平进行自填式问卷调查。采用逐步回归方法,以职业紧张为自变量,职业倦怠为中介,抑郁症状为因变量构建多元线性模型,分析医务人员职业紧张、职业倦怠和抑郁症状的关系。结果1545名医务人员平均年龄(34.2±8.8)岁,平均岗位工作时间(7.6±6.8)年。其职业紧张付出、回报、内在投入维度平均得分分别为(3.0±0.8)分、(3.9±0.6)分、(2.5±0.8)分,付出-回报失衡指数平均得分为0.8±0.4,检出付出-回报失衡模式高职业紧张308人,检出率为19.9%;职业倦怠得分为(1.8±1.1)分,情绪耗竭、人格解体、工作成就感各维度得分分别为(2.2±1.6)分、(1.5±1.4)分、(4.4±1.5)分,检出有职业倦怠感133人,检出率为8.6%;抑郁症状得分为(7.8±4.5)分,检出有抑郁症状者391人,检出率为25.3%。Pearson相关分析显示,医务人员职业倦怠得分与职业紧张的付出、内在投入维度以及抑郁症状得分均呈正相关(r_(s)=0.412、0.542、0.667,P<0.01);抑郁症状得分与职业紧张的付出、内在投入维度得分均呈正相关(r_(s)=0.436、0.542,P<0.01),与职业紧张的回报维度得分呈负相关(r_(s)=-0.514,P<0.01)。多元分层回归分析显示,职业紧张、职业倦怠对抑郁症状的预测作用均有统计学意义(P<0.01),职业紧张和职业倦怠对抑郁症状变化解释量分别为33.2%和13.9%。结论广州市医务人员的职业紧张对其抑郁症状具有直接作用;职业倦怠作为职业紧张的负面结果,在职业紧张影响抑郁症状中发挥部分中介作用;减轻医务人员职业倦怠,有助于改善抑郁症状。Objective To explore the relationship among occupational stress,job burnout and depressive symptoms of medical staff in Guangzhou,and to provide theoretical guidance for promoting their physical and mental health.Methods The occupational stress,the job burnout and the depressive symptoms of 1545 medical staff from 3 hospitals in Guangzhou were surveyed with the Basic Situation Questionnaire,the Pay-Return Imbalance Questionnaire,the General Job Burnout Scale and the Patient Health Questionnaire Depression Scale.A multiple linear model was constructed by the stepwise regression with occupational stress as independent variable,occupational burnout as mediator and depressive symptoms as dependent variable to evaluate their relationship.Results The average age of these medical staff was(34.2±8.8)years old and their employment time was(7.6±6.8)years.The dimensions scores of pay,return and internal input in occupational stress were 3.0±0.8,3.9±0.6,and 2.5±0.8,respectively.The mean of effort-reward imbalance(ERI)index was(0.8±0.4)and 308 medical staff(19.9%)were diagnosed with high occupational stress basing on the ERI model.The job burnout score was 1.8±1.1;the dimension scores of emotional exhaustions,depersonalization,job satisfaction were 2.2±1.6,1.5±1.4,and 4.4±1.5,respectively.There were 133 medical staff(8.6%)suffering from job burnout.The depressive symptoms score was 7.8±4.5,and 391 medical staff(25.3%)with depressive symptoms were detected.Pearson correlation analysis showed that the job burnout was positively correlated with the pay and internal input of the occupational stress and the depressive symptoms(r_(s)=0.412,0.542 and 0.667 respectively,P<0.01).The depressive symptoms were also positively correlated with the pay and internal input of the occupational stress(r_(s)=0.436 and 0.542,respectively,P<0.01),while it was negatively correlated with the reward of the occupational stress(r_(s)=-0.514,P<0.01).Furthermore,multivariate linear model indicated that the occupational stress and the job burno

关 键 词：医务人员 职业紧张 职业倦怠 抑郁症状 中介作用 

分 类 号：B845.66[哲学宗教—心理学]