北京市结核病防治医务人员职业倦怠状况及影响因素调查

doi:10.19982/j.issn.1000-6621.20220231

摘要/Abstract

摘要：

目的:调查北京市结核病防治医务人员职业倦怠情况,探讨低成就感、人格解体及情感衰竭3个不同维度的职业倦怠影响因素,提出减轻职业倦怠产生的建议和对策,提高结核病防治工作质量。方法:2021年4月25日至5月10日,采用现况调查的方法,运用结构型自填问卷对北京结核病控制研究所及北京市16个区的结核病防治机构从事诊疗、防控岗位的医务人员进行在线匿名问卷调查。调查内容包括马斯勒职业倦怠调查普适量表(MBI-GS)以及自行设计的一般信息表。采用logistic逐步回归,分别分析职业倦怠3个维度的影响因素。结果:共发放问卷313份,收回有效问卷311份,有效率为99.36%。311名结核病防治医务人员中,男性 81名(26.05%),女性230名(73.95%),平均年龄(41.12±9.84)岁,检出职业倦怠195名(62.70%),低成就感202名(64.95%),人格解体144名(46.30%),情感衰竭192名(61.74%)。3个维度影响因素的logistic回归分析显示:从事防控岗位(OR=2.12,95%CI:1.26~3.55) 的医务人员在工作中更容易体会到低成就感;从事结核病防治工作时间≥10年(OR=2.21,95%CI:1.34~3.64)、每周累计运动时间<3h(OR=1.71, 95%CI:1.04~2.82)、职称晋升没达到期望(OR=3.09,95%CI:1.79~5.33)、与同事相处不融洽(OR=2.70,95%CI:1.43~5.08)的医务人员更容易出现人格解体现象;每天睡眠时间<6h(OR=1.85,95%CI:1.02~3.37)、职称晋升没达到期望(OR=1.84,95%CI:1.11~3.05)、与同事相处不融洽(OR=2.68,95%CI:1.34~5.35)的医务人员更容易发生情感衰竭。结论:北京市结核病防治医务人员职业倦怠检出率较高,从事防控岗位的人员更容易出现低成就感,应增加结核病防治医务人员职称晋升机会、开展团体心理建设、共同建立良好的工作氛围,多措并举提高工作成就感,从而减轻职业倦怠的发生。

关键词: 结核, 医务人员, 厌倦,职业性, 因素分析,统计学

Abstract:

Objective:To overview burnout of medical staff for tuberculosis control in Beijing and explore the risk factors of the three different dimensions which are reduced personal accomplishment, depersonalization and emotional exhaustion. Thus to make recommendations to reduce burnout, then to improve the quality of tuberculosis prevention and control. Methods:Cross-sectional surveys were conducted during April 25 to May 10, 2021. All the medical staff in Beijing Institute of Tuberculosis Control and prevention and tuberculosis control agencies in 16 districts of Beijing completed the anonymous online structured self-filled questionnaire. The questionnaire included the Maslach Burnout Survey Generalized Scale (MBI-GS) and general information. Logistic stepwise regression was used to analyze the influencing factors of its three dimensions of burnout. Results:A total of 313 questionnaires were distributed, and 311 were valid, with an effective rate of 99.36%. Among 311 practitioners, 81 (26.05%) were male and 230 (73.95%) were female, with an average of (41.12±9.84) years old, 195 (62.70%) positive cases of burnout, 202 (64.95%) cases of reduced personal accomplishment, 144 (46.30%) cases of depersonalization, 192 (61.74%) cases of emotional exhaustion. The logistic multiple regression analysis of three dimensions of burnout among the practitioners showed that medical staff in prevention and control positions (OR=2.12, 95%CI: 1.26-3.55) were more likely to experience reduced personal accomplishment in their work; medical staff who working in TB for ≥10 years (OR=2.21,95%CI:1.34-3.64), exercising less than 3 hours per week (OR=1.71, 95%CI:1.04-2.82), not meeting expectations for promotion (OR=3.09,95%CI:1.79-5.33), and not getting along well with colleagues (OR=2.70, 95%CI:1.43-5.08) were more likely to experience depersonalization; those who sleep <6 hours per day (OR=1.85, 95%CI: 1.02-3.37), did not meet expectations for title promotion (OR=1.84, 95%CI: 1.11-3.05), did not get along with colleagues (OR=2.68, 95%CI: 1.34-5.35) more likely to experience emotional exhaustion among medical staff. Conclusion:High burnout rate was detected in medical stall for tuberculosis control in Beijing. Those in prevention and control positions are more likely to have reduced personal accomplishment. It is necessary to increase the opportunities for the promotion, carry out group psychological construction, create a good working atmosphere, and various measures should be taken to improve the sense of work achievement, and to reduce the occurrence of burnout.

Key words: Tuberculosis, Medical staff, Burnout,professional, Factor analysis,statistical

中图分类号:

R192

张红伟, 孙闪华, 许琰, 高志东, 李艳圆, 陶荔莹, 赵瑶, 赵鑫, 陈曦. 北京市结核病防治医务人员职业倦怠状况及影响因素调查[J]. 中国防痨杂志, 2022, 44(10): 1063-1070. doi: 10.19982/j.issn.1000-6621.20220231

Zhang Hongwei, Sun Shanhua, Xu Yan, Gao Zhidong, Li Yanyuan, Tao Liying, Zhao Yao, Zhao Xin, Chen Xi. Survey on burnout and influencing factors of medical staff for tuberculosis control in Beijing[J]. Chinese Journal of Antituberculosis, 2022, 44(10): 1063-1070. doi: 10.19982/j.issn.1000-6621.20220231

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编码	变量	赋值	编码	变量	赋值
Y₁	低成就感	0=无,1=有	X₄	月收入(元)	0=<7000,1=≥7000
Y₂	人格解体	0=无,1=有	X₅	每周累计运动时间(h)	0=≥3,1=<3
Y₃	情感衰竭	0=无,1=有	X₆	每天睡眠时间(h)	0=≥6,1=<6
X₁	婚姻	0=其他,1=已婚	X₇	同事相处	0=融洽,1=不融洽
X₂	岗位	0=诊疗,1=防控	X₈	职称晋升期望	0=达到,1=未达到
X₃	结防工作时间(年)	0=<10,1=≥10

维度	因素	β值	s$\bar{x}$值	Wald χ²值	OR(95%CI)值	P值
低成就感	岗位
	诊疗				1.00
	防控	0.751	0.264	8.085	2.12(1.26~3.55)	0.004
人格解体	结防工作总时间(年)
	<10				1.00
	≥10	0.794	0.255	9.737	2.21(1.34~3.64)	0.002
	每周累计运动时间(h)
	≥3				1.00
	<3	0.539	0.255	4.481	1.71(1.04~2.82)	0.034
	职称晋升期望
	达到				1.00
	未达到	1.127	0.278	16.392	3.09(1.79~5.33)	<0.001
	与同事相处融洽
	是				1.00
	否	0.992	0.323	9.402	2.70(1.43~5.08)	0.002
情感衰竭	睡眠时间(h)
	≥6				1.00
	<6	0.617	0.305	4.084	1.85(1.02~3.37)	0.043
	职称晋升达到期望
	是				1.00
	否	0.610	0.257	5.636	1.84(1.11~3.05)	0.018
	与同事相处融洽
	是				1.00
	否	0.984	0.353	7.771	2.68(1.34~5.35)	0.005