新型冠状病毒感染疫情期间不同职业类别的基层卫生人员留职意愿调查及其影响因素分析  

A survey on the intention to stay and its influencing factors among primary health care workers during COVID-19 epidemic

作　　者：顾杰 席彪[3] 冯玫 顾申红 潘志刚[1] 任菁菁 肖雪[7] 谭伟 黄姣灵[9] 杜兆辉 顾晓青 祝墡珠 Gu Jie;Xi Biao;Feng Mei;Gu Shenhong;Pan Zhigang;Ren Jingjing;Xiao Xue;Tan Wei;Huang Jiaoling;Du Zhaohui;Gu Xiaoqing;Zhu Shanzhu(Department of General Practice,Zhongshan Hospital,Fudan University,Shanghai 200032,China;International Medical Center,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Medical Education Collaboration and Medical Education Research Center,Hebei Medical University,Shijiazhuang 050017,China;Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Third Hospital of Shanxi Medical University,Tongji Shanxi Hospital,Taiyuan 030032,China;College of General Practice and Continuing Education,Hainan Medical University,Haikou 570102,China;Department of General Practice,First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Department of General Practice,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Department of General Practice,Wuhan University of Science and Technology Hospital,Wuhan 430065,China;School of Public Health,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Shanggang Community Health Service Center of Pudong New Area,Shanghai 200126,China;Xidu Community Health Service Center of Fengxian District,Shanghai201401,China)

机构地区：[1]复旦大学附属中山医院全科医学科,上海200032 [2]复旦大学附属中山医院国际医疗部,上海200032 [3]河北医科大学医教协同与医学教育研究中心,石家庄050017 [4]山西白求恩医院(山西医学科学院)、山西医科大学第三医院、同济山西医院全科医疗科,太原030032 [5]海南医学院全科医学与继续教育学院,海口570102 [6]浙江大学医学院附属第一医院全科医学科,杭州310003 [7]遵义医科大学附属医院全科医学科,遵义563000 [8]武汉科技大学医院全科医学科,武汉430065 [9]上海交通大学医学院公共卫生学院,上海200025 [10]上海市浦东新区上钢社区卫生服务中心,上海200126 [11]上海市奉贤区西渡街道社区卫生服务中心,上海201401

出　　处：《中华全科医师杂志》2024年第8期839-847,共9页Chinese Journal of General Practitioners

基　　金：上海市教育科学研究项目(C2021027);全国全科医学教育教学研究课题(B-YXGP20210401-01)。

摘　　要：目的调查新型冠状病毒感染疫情(简称为新冠疫情)期间我国不同职业类别的基层卫生人员的留职意愿,并探讨其影响因素。方法该研究为横断面研究。采取多阶段整群随机抽样的方法,于2022年5—10月对中国31个省、自治区、直辖市的62家基层卫生机构的工作人员进行线上问卷调查。根据工作岗位将基层卫生人员分为全科医师、护士、公共卫生医师(简称为公卫医师)、管理人员和辅助人员5种职业类别。使用中文版留职意愿问卷定量评估留职意愿。调查的内容包括个人因素、工作因素、新冠疫情相关因素和心理反应等。采用多元线性回归模型分析新冠疫情期间不同职业类别基层卫生人员留职意愿的影响因素。结果27个省/自治区、4个直辖市的44家社区卫生服务中心、18家乡镇卫生院参与了本次调查,3769人填写了问卷。入选基层卫生人员的年龄为(37.4±9.2)岁,其中女性2971名(78.8%),留职意愿得分为(21.7±4.1)分。以全科医师为参照,管理人员留职意愿较低(P=0.004)。年龄、女性、已婚、本人月收入、基层服务年限、单位支持功能自评、明尼苏达满意度量表简表(MSQ-SF)得分、个人成就感(PA)得分均与留职意愿得分呈正向关联(均P<0.05),而9项患者健康问卷(PHQ-9)得分、情感耗竭(EE)得分、去人格化(DP)得分均与留职意愿得分呈负向关联(均P<0.05)。各职业类别人员的MSQ-SF得分均与留职意愿得分呈正向关联(均P<0.01)。此外,在全科医师中,本人月收入、基层服务年限、单位支持功能自评、PA得分均与留职意愿得分呈正向关联(均P<0.05),而PHQ-9得分、EE得分均与留职意愿得分呈负向关联(均P<0.05)。在护士中,年龄、女性、本人月收入、单位支持功能自评、PA得分与留职意愿得分呈正向关联(均P<0.05);而EE得分与留职意愿得分呈负向关联(P<0.001)。在公卫医师中,已婚与留职意愿得分呈正�Objective:To investigate the intention to stay on among primary health care workers(PHWs)during the COVID-19 epidemics and its influencing factors.Methods:An online questionnaire survey was conducted among PHWs from 62 primary health institutions in 31 provinces,autonomous regions and municipalities across China selected by multi-stage whole cluster random sampling method between May and October 2022.According to the job position,the PHWs were divided into 5 categories:general practitioners(GPs),nurses,public health doctors,managers and support staff.Intention to stay was measured using the Chinese version of the Intention to Stay Questionnaire.Multiple linear regression model was used to analyze the influencing factors of the intention to stay in PHWs of different occupational categories,including personal factors,work factors,factors related to the COVID-19 and psychological reactions.Results:A total of 3769 PHWs from 44 community health service centers,18 township hospitals of 27 provinces/autonomous regions and 4 municipalities participated in this survey.The mean age of participants was(37.4±9.2)years,including 2971(78.8%)women.The mean score of intention to stay of participants was 21.7±4.1.Compared with GPs,managers had lower intention to stay(P=0.004).Age,female,in marriage,monthly income,years of primary care service,self-evaluation of unit support function,MSQ-SF score,and PA score were positively correlated with the score of intention to stay(all P<0.05),while PHQ-9 score,EE score,and DP score were negatively correlated with the score of intention to stay(all P<0.05).The MSQ-SF scores of all occupational categories were positively correlated with the scores of intention to stay(all P<0.01).In addition,among GPs,monthly income,years of service in primary care,self-evaluation of unit support function,and PA scores were positively correlated with the score of intention to stay(all P<0.05),while PHQ-9 scores and EE scores were negatively correlated with the score of intention to stay(all P<0.05).Among nu

关 键 词：影响因素 留职意愿 基层医疗 新型冠状病毒感染 

分 类 号：R192[医药卫生—卫生事业管理]