广州市基层医疗卫生机构与基层政府的卫生服务人员职业倦怠差异及其影响因素  

Differences in burnout among health service workers in primary healthcare organizations and primary government and influencing factors in Guangzhou city

作　　者：张玉仙 李兵[2,3] ZHANG Yu-xian;LI Bing(Baiyun District Maternal and Child Health Hospital,Guangzhou city,Guangdong 510405,China;School of Basic Medicine and Public Health,Jinan University;Promotion and Education Section,Guangdong Maternal and Child Health Hospital)

机构地区：[1]广州市白云区妇幼保健院保健部,广东510405 [2]广东省妇幼保健院宣教科 [3]暨南大学基础医学与公共卫生学院

出　　处：《预防医学论坛》2023年第9期677-683,共7页Preventive Medicine Tribune

摘　　要：目的 对比广州市基层医疗卫生机构与基层政府卫生服务人员职业倦怠情况,分析基层卫生服务人员职业倦怠的影响因素。方法 对广州市205名基层医疗卫生机构和105名基层政府的卫生服务人员进行抑郁-焦虑-压力量表、马氏工作倦怠量表问卷调查,比较两组职业倦怠、情感衰竭、去人格化、低成就感发生率,采用logistics回归分析基层卫生服务人员职业倦怠及其各维度的影响因素。结果 广州市基层卫生服务人员中,出现职业倦怠、情感衰竭、去人格化、低成就感的分别占67.1%(208/310)、32.9%(102/310)、30.0%(93/310)、85.8%(266/310),其中基层政府卫生服务人员职业倦怠、情感衰竭、去人格化发生率分别为82.9%(87/105)、50.5%(53/105)、46.7%(49/105),基层医疗卫生机构分别为59.0%(121/205)、23.9%(49/205)、21.5%(44/205),基层政府卫生服务人员各指标均高于基层医疗卫生机构(χ^(2)值分别为7 401.0、33.743、22.249,P<0.001)。基层政府低成就感发生率87.6%(92/105),基层医疗卫生机构为84.9%(174/205),两者比较差异无统计学意义(χ^(2)=1.139,P=0.513)。logistics回归结果提示,防疫工作比重100%(O R=3.386,95%CI:1.299~8.825,P=0.013)、抑郁(O R=8.625,95%CI:2.372~31.356,P=0.001)、焦虑(O R=4.263,95%CI:1.919~9.470,P<0.001)是职业倦怠的危险因素;防疫工作比重80%~<100%(O R=3.516,95%CI:1.325~9.332,P=0.012)、防疫工作比重100%(O R=5.179,95%CI:1.872~14.332,P=0.002)、抑郁(O R=2.859,95%CI:1.328~6.154,P=0.007)、焦虑(O R=3.294,95%CI:1.570~6.912,P=0.002)、压力(O R=3.250,95%CI:1.447~7.298,P=0.004)是情感衰竭的危险因素;防疫工作比重80%~<100%(O R=2.956,95%CI:1.160~7.532,P=0.023)、防疫工作比重100%(O R=4.207,95%CI:1.630~10.683,P=0.003)、抑郁(O R=11.446,95%CI:6.193~21.156,P<0.001)是去人格化的危险因素;防疫工作比重80%~<100%(O R=3.852,95%CI:1.386~10.704,P=0.010)、焦虑(O R=3.124,95%CI:1.361~7.172,P=0.007)是低成就感的危险因素,年龄≥40�Objective To compare the burnout status of primary health care institutions and primary government health service workers(HSWs) in Guangzhou city, and analyze the influencing factors of burnout of primary HSWs. Methods A survey was conducted on 205 primary health care institutions HSWs and 105 primary government HSWs in Guangzhou city using the Depression-Anxiety-Stress-Scale and the Maslach Burnout Scale.The incidence rates of burnout, emotional exhaustion(EE),depersonalization(DP),and low personal achievement(LPA) were compared between the 2 groups.Logistic regression analysis was used to analyze the burnout and its influencing factors in various dimensions of primary HSWs. Results Among primary HSWs in Guangzhou city, 67.1%(208/310),32.9%(102/310),30.0%(93/310),and 85.8%(266/310) experienced burnout, EE, DP and LPA,respectively, with 82.9%(87/105),50.5%(53/105),46.7%(49/105) incidence of burnout, EE, and DP among primary government HSWs, all of which were higher than those of primary health care institutions at 59.0%(121/205),23.9%(49/205),and 21.5%(44/205)(χ^(2)=7 401.0,33.743,22.249,P<0.001);and the incidence of LPA was 87.6%(92/105) and 84.9%(174/205) in primary HSWs, with no statistically significant differences(χ^(2)=1.139,P=0.513).The logistics regression results suggested that 100% of the proportion of epidemic prevention work(O R=3.386,95%CI:1.299-8.825,P=0.013),depression(O R=8.625,95%CI:2.372-31.356,P=0.001),and anxiety(O R=4.263,95%CI:1.919-9.470,P<0.001) were risk factors for burnout.80% to less than 100% of the proportion of epidemic prevention work(O R=3.516,95%CI:1.325-9.332,P=0.012),100% of the proportion of epidemic prevention work(O R=5.179,95%CI:1.872-14.332,P=0.002),depression(O R=2.859,95%CI:1.328-6.154,P=0.007),anxiety(O R=3.294,95%CI:1.570-6.912,P=0.002),and stress(O R=3.250,95%CI:1.447-7.298,P=0.004) were risk factors for EE;80% to less than 100% of the proportion of epidemic prevention work(O R=2.956,95%CI:1.160-7.532,P=0.023),100% of the proportion of epidemic prevention work(O R=4.

关 键 词：职业倦怠 卫生服务人员 基层医疗卫生机构 基层政府 

分 类 号：R195[医药卫生—卫生统计学]