中国全科医学 ›› 2024, Vol. 27 ›› Issue (19): 2305-2311.DOI: 10.12114/j.issn.1007-9572.2023.0251

• 中国全科医疗/社区卫生服务工作研究 • 上一篇    下一篇

基层医务人员付出-回报失衡与职业倦怠的关系研究

关彦, 林泽华, 罗桢妮*()   

  1. 510000 广东省广州市,广州医科大学卫生管理学院
  • 收稿日期:2023-10-24 修回日期:2023-11-24 出版日期:2024-07-05 发布日期:2024-04-28
  • 通讯作者: 罗桢妮

  • 作者贡献:
    关彦、罗桢妮、林泽华负责文章的构思与设计、论文撰写;关彦负责数据校对、文章修订;林泽华负责问卷设计、数据分析;关彦、林泽华负责文献及相关资料的收集与整理;罗桢妮负责文章的修订、审校,并对文章进行整体把握,监督管理,对文章负责。
  • 基金资助:
    国家自然科学基金资助项目(71503057); 广东省自然科学基金资助项目(2015A030310475); 广州医科大学科研能力提升目(02-410-2405026)

Relationship between Effort-reward Imbalance and Job Burnout among Primary Healthcare Workers

GUAN Yan, LIN Zehua, LUO Zhenni*()   

  1. School of Health Management, Guangzhou Medical University, Guangzhou 510000, China
  • Received:2023-10-24 Revised:2023-11-24 Published:2024-07-05 Online:2024-04-28
  • Contact: LUO Zhenni

摘要: 背景 当前基层医务人员压力较大,容易出现付出-回报失衡情况和职业倦怠,阻碍基层卫生服务发展,未得到充分重视。目的 研究基层医务人员付出-回报失衡情况和职业倦怠情况,并探讨两者的关系,为改善基层医务人员职业倦怠提供参考。方法 2022年3—5月采用便利抽样法选取广东省东莞市4个街道、28个镇基层医疗卫生机构(包括社区卫生服务机构和乡镇卫生院)的基层医务人员为调查对象,采用一般情况问卷、职业倦怠通用量表(MBI-GS)和付出-回报失衡量表进行问卷调查。以MBI-GS得分为因变量,以付出-回报失衡模型中的付出-回报比和超负荷程度为自变量,采用分层回归分析探讨付出-回报失衡模型对职业倦怠的影响。结果 共纳入347名基层医务人员。基层医务人员MBI-GS量表总得分为(3.72±1.25)分。职业倦怠现象发生率为93.4%,有76.7%被调查者处于付出-回报失衡状态,有35.2%被调查者处于高负荷状态;处于付出-回报失衡状态的基层医务人员的MBI-GS量表总得分高于处于付出-回报平衡状态的基层医务人员(t=-5.20,P<0.001);处于高负荷状态基层医务人员的MBI-GS量表总得分高于处于正常负荷或低负荷状态的基层医务人员(t=8.08,P<0.001)。多元分层回归分析结果提示,付出-回报失衡、超负荷程度对职业倦怠有正向预测作用(b=0.414、0.109,P<0.05)。结论 基层医务人员付出-回报失衡情况严重,职业倦怠状况普遍,付出-回报失衡模型对职业倦怠有正向预测作用,建议适当减轻基层医务人员工作负荷,提高其工作回报,重视其心理健康。

关键词: 医务人员, 医院, 心理倦怠, 基层医务人员, 付出-回报失衡, 职业倦怠, 心理健康

Abstract:

Background

Currently, primary healthcare staff are under high pressure and prone to effort-reward imbalance and burnout, which hinders the development of primary health services and has not been sufficiently emphasized.

Objective

To study the situation of effort-reward imbalance and burnout among primary healthcare workers, and explore the relationship between the two, so as to provide reference for improving burnout among primary healthcare workers.

Methods

Primary healthcare workers from primary healthcare institutions (including community health service institutions and township health centers) in 4 streets and 28 townships in Dongguan City, Guangdong Province, were selected for the survey from March to May 2022 using the convenience sampling method. The questionnaire included general information, the Maslach Burnout Inventory-General Survey (MBI-GS) and the Effort-Reward Imbalance (ERI) . With MBI-GS score as the dependent variable, the effort-reward ratio and degree of overload in the effort-reward imbalance model as the independent variables, stratified regression analysis was used to explore the effects of the effort-reward imbalance model on burnout.

Results

A total of 347 primary healthcare workers were included, the total score of MBI-GS for primary healthcare workers was (3.72±1.25) . Of the 347 primary healthcare workers, 93.4% were burnout, 76.7% were in effort-reward imbalance, and 35.2% were under a heavy workload. The total MBI-GS score of primary healthcare workers in effort-reward imbalance was higher than those in effort-reward balance (t=-5.20, P<0.001) ; the total MBI-GS score of primary healthcare workers under heavy workload was higher than those under normal or low workload (t=8.08, P<0.001) . The results of multivariate regression analysis showed positive predictive effects of effort-reward imbalance and heavy workload on burnout (b=0.414, 0.109, P<0.05) .

Conclusion

The condition of effort-reward imbalance is serious and job burnout is common among primary healthcare workers. The effort-reward imbalance model positively predicts burnout, it is recommended to reduce the workload of primary healthcare workers, improve their work reward and emphasize their psychological health.

Key words: Medical staff, hospital, Burnout, psychological, Primary healthcare staff, Effort-reward imbalance, Job burnout, Mental health