Abstract: Background　The workload of family doctors in Minhang District，Shanghai，is increasing with the continuous promotion of the local community healthcare reform and the gradual improvement of family doctor system.High workload may induce burnout，which should not be neglected.So it is imperative to adequately understand the occupational stress and burnout in family doctors and deliver targeted and precise interventions in time.Objective　To investigate the occupational stress and burnout among family doctors in Minhang District，Shanghai，providing evidence for delivering mental health interventions for this population.Methods　From October to November，2018，by use of cluster sampling，308 eligible family doctors from Minhang District were enrolled after signing the written informed consent form.They received a self-administered survey with a self-developed General Personal Information Questionnaire，the Psychosomatic Tension Relaxation Inventory and the Maslach Burnout Inventory（MBI）for understanding general personal information，occupational stress and burnout，and the results were analyzed.Results　Among the 308 respondents，190（61.7%）had excessive stress，72（23.4%）had moderate stress and 46（14.9%）had low stress.Occupational stress did not vary significantly by gender，age，marital and childbearing status，hukou，education level，professional title，working length，and ways for achieving general practitioner qualification（P>0.05）.The prevalence rates of no burnout，moderate and severe burnout were 39.0%（120/308），49.0%（151/308）and 12.0%（37/308），respectively.The degree of burnout differed significantly by hukou and working length（P<0.05），but not by gender，age，marital and childbearing status，education level，professional title and ways for achieving general practitioner qualification（P>0.05）.Higher mean scale score and subscales（emotional exhaustion，depersonalization and low personal accomplishment）scores of MBI were found in those with excessive occupational stress than those with moderate or low occupational stress，and were found in those with moderate occupational stress instead of those with low occupational stress（P<0.05）.Conclusion　Most family doctors in Minhang District have excessive occupational stress，and moderate to severe burnout，so interventions should be delivered to them in time.In addition，special guidance should be given to those with Shanghai hukou or working length of 6-10 years，to cope with stress and relieve burnout appropriately.

Key words: Family doctor；Occupational stress；Burnout, professional；Cross-sectional studies；Shanghai

摘要： 背景　随着上海市社区卫生综合改革持续推进、家庭医生制度的逐步完善，闵行区家庭医生的工作负荷不断增加，由此导致的职业倦怠问题不容忽视。正视家庭医生的工作压力及职业倦怠问题，及时了解现状，精确干预势在必行。目的　调查上海市闵行区家庭医生的工作压力、职业倦怠现状，为家庭医生心理健康干预工作提供依据。方法　于2018年10—11月，采用整群抽样的方法选取闵行区符合条件、知情同意的308例家庭医生为调查对象，采用一般资料调查问卷、心理身体紧张松弛测试问卷、职业倦怠问卷调查家庭医生的基本情况、工作压力与职业倦怠状况，分析调查结果。结果　308例家庭医生中，压力过大者190例（61.7%）、压力适中者72例（23.4%）、压力过小者46例（14.9%）。性别、年龄、婚育情况、户籍、学历、职称、工作年限、全科医师资格取得途径不同的家庭医生工作压力程度比较，差异无统计学意义（P>0.05）。308例家庭医生中，工作状态良好者120例（39.0%）、一般倦怠者151例（49.0%）、严重倦怠者37例（12.0%）。性别、年龄、婚育情况、学历、职称、全科医师资格取得途径不同家庭医生职业倦怠程度比较，差异无统计学意义（P>0.05）；户籍、工作年限不同家庭医生职业倦怠程度比较，差异有统计学意义（P<0.05）。压力过大家庭医生职业倦怠总得分及情绪衰竭、玩世不恭、成绩感低3个维度得分高于压力适中和压力过小家庭医生，压力适中家庭医生职业倦怠总得分及情绪衰竭维度得分高于压力过小家庭医生，差异有统计学意义（P<0.05）。结论　闵行区家庭医生的工作压力、职业倦怠现状不佳，应采取措施及时干预。尤应对沪籍、家庭医生工作年限6~10年者开展心理干预，引导其正确应对压力、缓解倦怠。

关键词: 家庭医生；工作压力；倦怠, 职业性；横断面研究；上海