中国医院消化科医师内在工作动机对职业倦态的影响以及工作压力的中介作用  

The influence of gastroenterologists′intrinsic motivation on work burnout and the mediating effects of work stress

作　　者：袁蓓蓓 杨红[2] 王琨[3] 张莉[3] 王蔚虹[4] 段丽萍[3] Yuan Beibei;Yang Hong;Wang Kun;Zhang Li;Wang Weihong;Duan Liping(China Center for Health Development Studies,Beijing 100191,China;Department of Gastroenterology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Gastroenterology,Peking University Third Hospital,Beijing 100191,China;Department of Gastroenterology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学中国卫生发展研究中心,北京100191 [2]中国医学科学院,北京协和医学院,北京协和医院消化内科,北京100730 [3]北京大学第三医院消化内科,北京100191 [4]北京大学第一医院消化内科,北京100034

出　　处：《中华医学杂志》2022年第41期3321-3327,共7页National Medical Journal of China

摘　　要：目的分析中国医院消化科医师内在工作动机对职业倦态的影响以及工作压力的中介作用。方法2020年调查28个省份331家三级医院消化科医师1655名,采用中介效应模型分析工作压力在内在动机与职业倦态关系中的作用。结果调查收回有效问卷1655份,女1132名,男523名,调查对象平均年龄39.26岁。内在动机对职业倦怠三个维度——情感耗竭、去人性化、低成就感均有降低作用(β=-2.06、-1.77、-4.20,均P<0.001);工作压力在内在动机和职业倦怠三个维度(情感耗竭、去人性化和低成就感)的负相关性中均起部分中介作用,中介效应占比分别为40%、15%和5%(β=-1.58、-0.36、-0.21,均P<0.05);女性医师的内在动机更多地直接降低了职业倦态,特别是在情感耗竭维度,直接效应占比为62%,高于男性医师中46%的直接效应占比。结论加强和利用消化科医师的内在动机既可直接降低职业倦态,也能通过缓解工作压力间接降低职业倦态;在同样环境中,女性医师对工作的内在动机对降低职业倦态有更大和更直接的作用。Objective To analyze the influence of intrinsic motivation on work burnout and the mediating effects of work stress.Methods In 2020,questionnaire survey was conducted in 1655 gastroenterologists working in 28 provinces of China.Mediation model was used to analyze the mediating effects of work stress in the relationship between intrinsic motivation and burnout.Resutls 1655 valid questionnaires were collected,including 1132 women and 523 men,with an average age of 39.26.Intrinsic motivation was related to reduced level of burnout,including emotional exhaustion,dehumanization and low sense of accomplishment(β=-2.06,-1,77 and-4.20;P<0.001).Job stress partially mediated the negative correlation between intrinsic motivation and job burnout in three dimensions,accounting for 40%,15%and 5%(β=-1.58,-0.36 and-0.21;P<0.05),respectively.In female physicians,the intrinsic motivation was more directly related to the reduction of burnout,especially in the dimension"emotional exhaustion"(direct effect accounting for 62%in female gastroenterologists and 46%in male).Conclusions Enhancing the intrinsic motivation of gastroenterologists can directly reduce burnout and indirectly reduce burnout by alleviating work stress.In the same work environment,female physicians′intrinsic motivation had a greater and more direct effect on reducing burnout.

关 键 词：消化科医师 工作动机 工作压力 职业倦怠 

分 类 号：R192.3[医药卫生—卫生事业管理]