成都市家庭医生团队职业认同现状和影响因素研究  

Analysis of occupational identity among family doctor teams and its influencing factors in Chengdu

作　　者：谌金花 张明峰 王意君[1] 杜文 肖竹 伍悦蕾[1] 刘述益[1] CHEN Jinhua;ZHANG Mingfeng;WANG Yijun;DU Wen;XIAO Zhu;WU Yuelei;LIU Shuyi(Department of General Practice,Chengdu First People's Hospital,Chengdu,Sichuan 610041,China)

机构地区：[1]成都市第一人民医院全科医学科,四川成都610041

出　　处：《环境与职业医学》2022年第12期1373-1378,1385,共7页Journal of Environmental and Occupational Medicine

基　　金：成都市医学科研课题(2021280)。

摘　　要：[背景]家庭医生签约服务是落实新医改政策的体现,是基层服务模式的转变。研究表明医务人员职业紧张水平较高。职业认同的提升有利于加强家庭医生团队队伍建设,缓解职业倦怠,减少离职意愿。[目的]了解成都市家庭医生团队职业认同现状,探讨职业认同的影响因素,为促进成都市家庭医生团队的职业发展和队伍建设提供参考依据。[方法]于2021年3月4—26日,采用多阶段分层整群抽样法在成都市23个区市县各随机抽取2家(共46家)已开展家庭医生签约服务的基层卫生医疗机构,采用问卷调查对2681名家庭医生团队的成员进行调查。采用自制问卷进行一般资料采集,采用付出-回报失衡量表调查家庭医生成员的职业紧张,采用职业认同量表调查其职业认同。[结果]本研究回收有效问卷2327份,有效率为86.80%,其中女性1715名(73.7%)、男性612名(26.3%),年龄集中在26~35岁(43.3%)和36~45岁(30.4%),已婚者占比高(82.8%),以大专(36.0%)和本科(47.3%)文凭为主,初级职称(66.0%)为主,无编制者占比高(66.1%)。88.7%家庭医生团队工作者存在职业紧张,其职业认同平均值为(3.68±0.62)分。不同职称、编制、医疗机构、工作年限、收入和付出/回报比值(ERR)组的职业认同得分差异均有统计学意义(P<0.05)。相关性分析显ERR和职业认同呈负相关(rs=-0.495,P<0.05)。多因素分析结果显示:无编制的工作者的职业认同得分低于有编制者(OR=0.429,95%CI:0.299~0.825);副高及以上者的职业认同得分高于无职称者(OR=1.424,95%CI:1.194~2.328);工作年限越长,家庭医生团队工作者的职业认同得分越高,其中工作时间超过20年组的得分是小于5年组的1.820(95%CI:1.342~2.543)倍;收入越高,其职业认同得分越高,9001~12000元·月^(-1)组的得分是1000~3000元·月^(-1)组的1.977(95%CI:0.811~9.696)倍,12000元·月^(-1)以上组是1000~3000元·月^(-1)组的2.283(95%CI:1.199~10.267)倍。[�[Background]The contracted family doctor services are the embodiment of the implementation of the new medical reform policy,and the transformation of the grass-roots health service mode.Studies have proved that the occupational stress in medical staff was at a high level.The enhancement of professional identity will contribute to strengthen team building,alleviate job burnout,and reduce turnover intention of family doctors.[Objective]To investigate the current situation of occupational identity among family doctor teams in Chengdu,to examine potential influencing factors of occupational identity,and to provide a reference for promoting career development and team building of family doctor teams.[Methods]Multi-stage random cluster sampling was adopted to enroll study participants form46 primary healthcare centers where family doctor contract services were implemented among 23 districts and counties in Chengdu between March 4 and 26,2021.A total of 2681 family doctors participated in this survey.A self-reported survey was conducted to collect participants’demographic and occupational data.The Effort-Reward Imbalance(ERI)questionnaire was implemented to assess occupational stress.The Professional Identity Scale was used to appraise occupational identity.[Results]A total of 2327 valid questionnaires were collected,with a valid recovery rate of 86.80%,involving 1715 females(73.7%)and612 males(26.3%),with dominant age groups of 26-35 years(43.3%)and 36-45 years(30.4%),a high proportion of being married(82.8%),having college(36.0%)and undergraduate(47.3%)education,a high proportion of primary titles(66.0%)and informal work contract(66.1%).About 88.7%of family doctor team workers reported occupational stress.The average score of occupational identity was(3.68±0.62)points.There were significant differences in occupational identity scores among different professional title,work contract,working years in medical institutions,income,and effort/reward ratio(EER)groups(P<0.05).ERR was negatively correlated with occupational

关 键 词：家庭医生 医务人员 付出-回报失衡 职业紧张 职业认同 

分 类 号：R132[医药卫生—劳动卫生]