工作特征模型视角下基层卫生人员内在激励机制研究  

Job Characteristics Model-based Study of the Intrinsic Incentive Mechanism for Primary Health Workers

作　　者：赵世超 平静 朱虹 纪婉婷 王雨燕 王颖 ZHAO Shichao;PING Jing;ZHU Hong;JI Wanting;WANG Yuyan;WANG Ying(School of Public Administration,Shandong Normal University,Jinan 250014,China;School of Management,Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东师范大学公共管理学院,山东省济南市250014 [2]山东中医药大学管理学院,山东省济南市250355

出　　处：《中国全科医学》2023年第25期3118-3126,共9页Chinese General Practice

基　　金：国家自然科学基金青年项目(72204150)。

摘　　要：背景对基层卫生人员的激励关乎新医改“强基层”和分级诊疗目标的实现,研究者大都关注外部激励措施及其对基层卫生人员工作结果的影响,忽视了工作本身所具备的内在激励作用。目的以工作特征模型为研究框架,分析当前基层卫生人员工作特征现状,探究其对基层卫生人员工作结果的内在激励作用,并比较工作特征五维度与收入等外部激励因素对工作结果的作用大小,为提高基层卫生人员的工作动机与绩效提出政策建议。方法采用多阶段抽样法,以山东省三市18家社区卫生服务中心和20家乡镇卫生院为样本来源地,2021年2—6月选取各样本来源地调查当日在岗的基层卫生人员为研究对象,采用自设问卷对其进行调查。采用方便抽样法,从完成调查者中抽取167例基层卫生人员作为访谈对象,对其进行半结构化访谈,了解基层卫生人员对工作特征的认知情况。采用Pearson相关分析工作特征五维度及外部激励因素与基层卫生人员自主动机、工作绩效、职业倦怠、离职意愿之间的相关性,采用多元分层线性回归分析工作特征五维度及外部激励因素对基层卫生人员工作结果的影响及其程度。采用主题框架法对访谈资料进行分析。结果共回收有效问卷870份。工作特征五维度中,基层卫生人员在技能多样性维度上的平均得分最高,为(4.09±0.71)分;在任务完整性维度上的平均得分最低,为(3.18±1.04)分;在任务重要性、工作反馈性、工作自主性3个维度上的平均得分分别为(3.91±0.76)、(3.46±0.83)、(3.43±0.79)分。Pearson相关分析结果显示,基层卫生人员自主动机、工作绩效与工作特征各维度呈正相关(P<0.05),职业倦怠和离职意愿与工作特征各维度呈负相关(P<0.05)。多元分层线性回归结果表明,工作特征五维度对自主动机、工作绩效、职业倦怠、离职意愿4个工作结果变量的贡献率(R2)�Background The incentivation for primary health workers is vital for the realization of two goals of the new healthcare reform in China,namely strengthening primary healthcare and achieving hierarchical diagnosis and treatment.Most previous studies put more emphasis on extrinsic incentive measures and their effect on job outcomes,ignoring the intrinsic motivation effect of job itself.Objective To perform an analysis of the job characteristics of primary health workers using the framework of Job Characteristics Model,assess their intrinsic motivation effect on job outcomes of these workers,and compare the strength of impact of the five dimensions of job characteristics and income and other extrinsic motivators on job outcomes,and put forward policy recommendations for improving work motivation and performance of primary health workers.Methods A survey using a self-developed questionnaire was conducted with primary health workers who were on duty on the day of the survey selected from a multistage sample of healthcare settings(including 18 community health centers and 20 township health centers)in three cities of Shandong Province from February to June 2021.Then,from those who effectively completed the survey,167 cases were selected using convenience sampling to attend semi-structured interviews to understand their views of the characteristics of job as a primary health worker.Pearson correlation was used to analyze the correlations of the five dimensions of job characteristics and extrinsic motivators with autonomous motivation,performance,burnout,and turnover intention.Hierarchical multiple linear regression was used to analyze the strength of impact of the five dimensions of job characteristics and extrinsic motivators on job outcomes.Thematic analysis was used to analyze the interview data.Results A total of 870 cases who handed in effective questionnaires were included for analysis.Among the five dimensions of job characteristics,respondents scored highest and lowest on skill variety(4.09±0.71)and task identi

关 键 词：工作特征模型 基层卫生人员 内在激励 工作结果 工作设计 工作表现 

分 类 号：R197.1[医药卫生—卫生事业管理] R131[医药卫生—公共卫生与预防医学]