Survey on burnout and influencing factors of medical staff for tuberculosis control in Beijing

doi:10.19982/j.issn.1000-6621.20220231

Abstract

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

CLC Number:

R192

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

Figures/Tables 4

References 28

[1]	Maslach, Christina. Job Burnout: New Directions in Research and Intervention. Curr Dir Psychol Sci, 2003, 12(5):189-192. doi: 10.1111/1467-8721.01258. doi: 10.1111/1467-8721.01258 URL
[2]	李超平, 时勘. 分配公平与程序公平对工作倦怠的影响. 心理学报, 2003, 35(5):677-684. doi: 10.3969/j.issn.1673-5218.2009.12.005. doi: 10.3969/j.issn.1673-5218.2009.12.005
[3]	陈曲, 刘旭, 孟开. 北京市三级甲等医院青年医护人员职业倦怠现状及其影响因素分析. 中国全科医学, 2018, 21(2):223-231. doi: 10.3969/j.issn.1007-9572.2017.00.005. doi: 10.3969/j.issn.1007-9572.2017.00.005
[4]	李玲, 许琳. 云南省两市基层疾病预防控制中心结核病防治医务人员职业倦怠的定性研究. 结核病与肺部健康杂志, 2015, 4(4):254-257. doi: 10.3969/j.issn.2095-3755.2015.04.011. doi: 10.3969/j.issn.2095-3755.2015.04.011
[5]	朱鸿雁, 戴俊明, 华钰洁, 等. 上海市闵行区家庭医生职业倦怠状况及影响因素. 环境与职业医学, 2016, 33(8):731-735. doi: 10.13213/j.cnki.jeom.2016.15527. doi: 10.13213/j.cnki.jeom.2016.15527
[6]	Wang Z, Xie Z, Dai J, et al. Physician burnout and its associa-ted factors: a cross-sectional study in Shanghai. J Occup Health, 2014, 56(1):73-83. doi: 10.1539/joh.13-0108-oa. doi: 10.1539/joh.13-0108-oa URL
[7]	朱伟, 娄小平, 王治明. Maslash工作倦怠量表通用版在护理人员中应用的信度与效度评价. 中国行为医学科学, 2007, 16(9):849-851. doi: 10.3760/cma.j.issn.1674-6554.2007.09.031. doi: 10.3760/cma.j.issn.1674-6554.2007.09.031
[8]	何冬冬, 骆善彩, 王颖华, 等. 淮安市基层公共卫生服务人员职业倦怠状况及影响因素分析. 中华劳动卫生职业病杂志, 2019, 37(2):129-132. doi: 10.3760/cma.j.issn.1001-9391.2019.02.010. doi: 10.3760/cma.j.issn.1001-9391.2019.02.010
[9]	李鑫茜, 郭含盟, 肖元梅. 中国医务人员职业倦怠检出率Meta分析. 现代预防医学, 2021, 48(8):1379-1383.
[10]	戴慧芬, 钱桑妮, 魏芳, 等. 医务人员职业倦怠及其影响因素的横断面研究. 中华劳动卫生职业病杂志, 2020, 38(8):594-597. doi: 10.3760/cma.j.cn121094-20200107-00019. doi: 10.3760/cma.j.cn121094-20200107-00019
[11]	苏雪飞, 晏丽娟. 海淀区社区医院青年医务人员职业倦怠状况调查. 中国社区医师, 2017, 33(20):163-164. doi: 10.3969/j.issn.1007-614x.2017.20.102. doi: 10.3969/j.issn.1007-614x.2017.20.102
[12]	彭媛, 潘茜, 张明秋, 等. 成都市四区县基层公共卫生工作人员职业倦怠现状及影响因素. 职业与健康, 2018, 34(3):305-308. doi: CNKI:SUN:ZYJK.0.2018-03-005. doi: CNKI:SUN:ZYJK.0
[13]	许莹, 徐秋月, 闫芳. 北京市基层精神卫生防治人员职业倦怠的调查. 中国心理卫生杂志, 2019, 33(7):559-560. doi: 10.3969/j.issn.1000-6729.2019.07.018. doi: 10.3969/j.issn.1000-6729.2019.07.018
[14]	刘美星, 丁静, 季燕, 等. 北京市西城区家庭医生职业倦怠现状及影响因素研究. 中国全科医学, 2021, 24(13):1656-1664. doi: 10.12114/j.issn.1007-9572.2020.00.537. doi: 10.12114/j.issn.1007-9572.2020.00.537
[15]	Shenoi AN, Kalyanaraman M, Pillai A, et al. Burnout and Psychological Distress Among Pediatric Critical Care Physicians in the United States. Crit Care Med, 2018, 46(1):116-122. doi: 10.1097/CCM.0000000000002751. doi: 10.1097/CCM.0000000000002751 pmid: 29016364
[16]	付莉, 赵霞, 肖旭珏, 等. 结核病护理人员心理一致感与职业倦怠及其相关性研究. 中国防痨杂志, 2018, 40(6):622-627. doi: 10.3969/j.issn.1000-6621.2018.06.014. doi: 10.3969/j.issn.1000-6621.2018.06.014
[17]	李玲. 云南省不同医疗卫生机构结核病防治医务人员职业倦怠及其影响因素研究. 昆明: 昆明医科大学, 2016.
[18]	曹蕾, 曾德唯, 曾艺, 等. 基层疾控公共卫生人员职业倦怠现状及影响因素. 现代医药卫生, 2021, 37(17):2893-2898. doi: 10.3969/j.issn.1009-5519.2021.17.004. doi: 10.3969/j.issn.1009-5519.2021.17.004
[19]	Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol, 2001, 52:397-422. doi: 10.1146/annurev.psych.52.1.397. doi: 10.1146/annurev.psych.52.1.397 pmid: 11148311
[20]	王洋, 任丽苗, 刘虹. 中医医院青年护士职业期望与职业倦怠相关性研究. 护理研究, 2017, 31(16):2012-2014. doi: 10.3969/j.issn.1009-6493.2017.16.026. doi: 10.3969/j.issn.1009-6493.2017.16.026
[21]	张会方, 高强, 罗翔予, 等. 公立医院医生职称晋升满意度现状及影响因素分析. 中华医院管理杂志, 2021, 37(7):529-533. doi: 10.3760/cma.j.cn111325-20201218-02234. doi: 10.3760/cma.j.cn111325-20201218-02234
[22]	Chopra M, Munro S, Lavis JN, et al. Effects of policy options for human resources for health: an analysis of systematic reviews. Lancet, 2008, 371(9613):668-674. doi: 10.1016/S0140-6736(08)60305-0. doi: S0140-6736(08)60305-0 pmid: 18295024
[23]	梁婕, 田凌云, 杨秋红, 等. 应对方式在重症医学科护士社会支持和职业倦怠间的中介作用. 中国护理管理, 2022, 22(1):106-110. doi: 10.3969/j.issn.1672-1756.2022.01.022. doi: 10.3969/j.issn.1672-1756.2022.01.022
[24]	胡丹, 唐卫卫, 朱珠, 等. 基于激励相容理论的基层医疗机构医务人员工作满意度提升策略研究. 广西医学, 2021, 43(21):2584-2589. doi: 10.11675/j.issn.0253-4304.2021.21.16. doi: 10.11675/j.issn.0253-4304.2021.21.16
[25]	王颖, 倪超, 刘秋燕. 中国公务员职业倦怠的产生过程:社会支持与应对方式的调节效应. 中国行政管理, 2015(4):118-122. doi: 10.3782/j.issn.1006-0863.2015.04.22. doi: 10.3782/j.issn.1006-0863.2015.04.22
[26]	张学谦. Z县乡镇青年公务员职业倦怠问题研究. 济南:山东大学, 2021.
[27]	王军, 张娜芹, 苏世云, 等. 神经外科护士职业倦怠与睡眠质量的相关性研究. 中华现代护理杂志, 2022, 28(6):788-792. doi: 10.3760/cma.j.cn115682-20210420-01727. doi: 10.3760/cma.j.cn115682-20210420-01727
[28]	刘志军, 罗念, 国敏, 等. 医务人员职业倦怠、睡眠质量对其主观幸福感的影响. 中国卫生事业管理, 2018, 35(11):866-869. doi: CNKI:SUN:ZWSG.0.2018-11-019. doi: CNKI:SUN:ZWSG.0.2018-11-019

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