您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (7): 102-107.doi: 10.6040/j.issn.1671-7554.0.2020.0022

• • 上一篇    

青岛市两所三甲医院医务人员职业倦怠对生活质量影响的路径分析

冀永娟,项紫霓,匡桂芳   

  1. 青岛市妇女儿童医院心理科, 山东 青岛 266034
  • 发布日期:2020-07-10
  • 通讯作者: 匡桂芳. E-mail:gfkuang@163.com
  • 基金资助:
    青岛市科技局立项[11-2-3-75-(51)-ZHC]

A path analysis on the influence of burnout on quality of life among staff in two tertiary hospitals in Qingdao

JI Yongjuan, XIANG Zini, KUANG Guifang   

  1. Department of Mental Health, Qingdao Women and Childrens Hospital, Qingdao 266034, Shandong, China
  • Published:2020-07-10

摘要: 目的 探讨三甲医院医务人员职业倦怠及生活质量的特点并对二者的关系进行路径分析。 方法 采用随机分层抽样方法选取青岛市两所综合性三甲医院508名医务人员,采用职业倦怠量表(MBI)、生活质量问卷(GQOLI-74)及自编的人口学资料调查表进行调查分析。 结果 职业倦怠方面,职业倦怠检出率为53.6%;女性MBI得分高于男性(36.05±15.89 vs 30.76±15.67,t=3.351, P<0.01);无管理职务者得分高于有管理职务者(36.11±15.02 vs 30.13±16.94, t=5.435, P<0.01);医生得分(37.04±15.52)、护士得分(35.30±16.20)、医技人员得分(35.01±16.78)均高于职能人员(24.88±12.63),差异有统计学意义(F=15.303,P<0.01)。生活质量方面,工龄<10年者得分(55.14±7.02)低于工龄10~20年(56.32±6.73)、工龄>20年者(57.93±5.86),差异有统计学意义(F=4.455, P<0.05);无管理职务者得分低于有管理职务者(55.50±6.31 vs 59.69±5.12,t=9.815,P<0.01);医生得分(55.64±7.13)、护士得分(55.79±6.50)、医技人员得分(55.53±6.23)均低于职能人员得分(57.75±5.53), 差异有统计学意义(F=2.931, P<0.05)。相关、回归与路径分析方面,MBI各因子得分与GQOLI-74心理、躯体及社会功能均呈低度负相关( r= -0.09~-0. 35, P<0.05)。MBI的情绪衰竭和成就感低落得分对GQOLI-74总分有负向预测作用(β=-0.126,-0.123, P<0.01)。去人格化、成就感低落对心理、社会和躯体功能的路径均有统计学意义(路径系数为 -0.12~-0.17, P<0.05)。情绪衰竭对心理和社会功能的路径有统计学意义(路径系数分别为-0.15,-0.16, P<0.05)。 结论 三甲医院医务人员有较高的职业倦怠水平,不同质群体医务人员的职业倦怠和生活质量特点各不相同。去人格化与成就感低落可能是影响其心理、社会、躯体生活质量的因素。

关键词: 职业倦怠, 生活质量, 医务人员, 路径分析

Abstract: Objective To explore the characteristics of burnout and quality of life among staff in two tertiary hospitals, and to analyze the influence of burnout on quality of life. Methods A total of 508 hospital staff in two tertiary hospitals in Qingdao were randomly stratified and surveyed with Maslach Burnout Inventory(MBI), Quality of Life Questionnaire(GQOLI-74)and a self-developed demographic inventory. Results MBI: The rate of burnout was 53.6%; female staff got higher MBI score than male [(36.05±15.89)vs(30.76±15.67), t=3.351, P<0.01; staff without a managerial position displayed more serious burnout compared with those with managerial position [(36.11±15.02)vs(30.13±16.94), t=5.435, P<0.01); burnout in doctors(37.04±15.52), nurses(35.30±16.20)and technicians(35.01±16.78)were all higher than that in functional personnel(24.88±12.63)(F=15.303, P<0.01). GQOLI-74: Staff with less than 10 years of service(55.14±7.02)had reduced GQOLI-74 score than those with more than 10-20 years of service(56.32±6.73)and 20 years of service(57.93±5.86)(F=4.455, P<0.05); staff without a managerial position got lower GQOLI-74 score than those with a managerial position [(55.50±6.31)vs(59.69±5.12), t=9.815, P<0.01)]; GQOLI-74 score of doctors(55.64±7.13), nurses(55.79±6.50)and technicians(55.53±6.23)were lower than that of functional personnel(57.75±5.53), (F=2.931, P<0.05). Correlation, regression and path analysis: All MBI factors demonstrated a negative correlation with mental, physical and social functions in GQOLI-74(r=-0.09 - 0.35, P<0.05); emotional exhaustion and reduced sense of accomplishment in MBI were negative predictors of GQOLI-74(β=-0.126, -0.123, P<0.01); depersonalization and reduced sense of accomplishment in MBI showed statistical significance on the path of psychological, social and physical functions in GQOLI-74(path coefficient: -0.12 - 0.17, P<0.05); emotional exhaustion in MBI displayed statistical significance on the path of psychological and social functions in GQOLI-74(path coefficient was respective -0.15 and -0.16, P<0.05). Conclusion There is a high level of burnout among hospital staff in tertiary hospitals. Characteristics of burnout and quality of life among hospital staff are different in heterogenous subgroups. Depersonalization and reduced sense of accomplishment may be the factors influencing psychological, social and physical functions in quality of life.

Key words: Burnout, Quality of life, Hospital staff, Path analysis

中图分类号: 

  • R574
[1] 邵岑怡,张舜行,台明. 国内外医务人员职业倦怠研究进展[J]. 中华医院管理杂志, 2019, 35(6): 487-489. SHAO Cenyi, ZHANG Shunxing, TAI Ming. Recent studies in job burnout of medical staff at home and overseas [J]. Chinese Journal of Hospital Administration, 2019, 35(6): 487-489.
[2] Rotenstein LS, Torre M, Mata DA. Prevalence of burnout among physicians: a systematic review [J]. JAMA, 2018, 320(11): 1131-1150.
[3] 冀永娟, 衡中玉, 项紫霓, 等. 青岛市551名医务人员心理健康状况及其影响因素分析[J]. 中国健康教育, 2015, 31(6): 577-580. JI Yongjuan, HENG Zhongyu, XINAG Zini, et al. A study of affecting factors on mental health of 551 medical staffs in Qingdao [J]. Chinese Journal of Health Education, 2015, 31(6): 577-580.
[4] Koutsimani P, Montgomery A, Georganta K. The relationship between burnout, depression, and anxiety: a systematic review and meta analysis [J]. Front Psychol, 2019, 10(3): 284.
[5] Dewa CS, Loong D, Bonato S, et al. The relationship between physician burnout and quality of healthcare in terms of safety and acceptability: a systematic review [J]. BMJ Open, 2017, 7(6): e015141. doi: 10.1136/bmjopen-2016-015141.
[6] Panagioti M,Geraghty K,Johnson J,et al. Association between physician burnout and patient safety, professionalism, and patient satisfaction: a systematic review and meta-analysis [J]. JAMA Intern Med, 2018, 178(10): 1317-1330.
[7] 卫生部统计信息中心. 中国医患关系调查研究[M]. 北京: 中国协和医科大学出版社, 2010.
[8] 陈曲, 孟开, 刘旭, 等. 基于文献计量法的我国医护人员职业倦怠研究现状分析[J]. 中国健康教育, 2017, 33(4): 346-348. CHEN Qu, MENG Kai, LIU Xu, et al. Analysis on research status of job burnout among Chinese medical staffs based on bibliometric method [J]. Chinese Journal of Health Education, 2017, 33(4): 346-348.
[9] 项紫霓, 解金娜, 衡中玉, 等. 社会支持、应对方式对医务人员职业倦怠及心理健康影响分析[J]. 中国职业医学, 2017, 44(5): 615-618. XINAG Zini, XIE Jinna, HENG Zhongyu, et al. Analysis on the effect of social support and coping styles on job burnout and mental health in medical staffs [J]. China Occupational Medicine, 2017, 44(5): 615-618.
[10] 孙天聪. 医护人员工作压力、工作倦怠与生活质量相关性研究[J]. 中国卫生产业, 2018, 15(14): 156-157.
[11] 杨培秀. 护理人员职业倦怠感与生活质量相关性调查分析[J]. 齐鲁护理杂志, 2016, 22(3): 65-66.
[12] Maslach C, Schaufeli W. Professional burnout: recent devdopments in theory and research[M]. Washington DC: Taylor Francis,1993.
[13] 李永鑫, 李亿敏. 工作倦怠评价标准的初步探讨[J]. 心理科学, 2006, 29(1): 148-150. LI Yongxin, LI Yimin. Developing the diagnostic criterion of job burnout [J]. Psychological Science, 2006, 29(1): 148-150.
[14] 汪向东, 王希林, 马弘. 心理卫生评定量表手册 [J]. 中国心理卫生杂志, 1999: 81-86.
[15] Maslach C, Schaufeli WB, Leiter MP. Job Burnout [J]. Annu Rev Psychol, 2001, 52(1): 397-422.
[16] Low ZX, Yeo KA, Sharma VK, et al. Prevalence of burnout in medical and surgical residents: a meta-analysis [J]. Int J Environ Res Public Health, 2019, 16(9): 1479.
[17] Rodrigues H, Cobucci R, Oliveira A, et al. Burnout syndrome among medical residents: a systematic review and meta-analysis [J]. PLoS One, 2018, 13(11): e0206840. doi: 10.1371/journal.pone.0206840.
[18] Chambers CN, Frampton CM, Barclay M, et al. Burnout prevalence in New Zealands public hospital senior medical workforce: a crosssectional mixed methods study [J]. BMJ Open, 2016, 6(11): e013947. doi: 10.1136/bmjopen-2016-013947.
[19] 杨霈, 彭宇竹, 朱敏. 南京市某大型综合公立医院医务人员职业倦怠现状分析[J]. 统计与管理, 2018,(5): 92-95.
[20] Chemali Z, Ezzeddine FL, Gelaye B, et al. Burnout among healthcare providers in the complex environment of the Middle East: a systematic review [J]. BMC Public Health, 2019, 19(1): 1337. doi:10.1186/s12889-019-7713-1.
[21] 周明会. 论做好女性职工工作对医院发展建设的作用[J].中国卫生产业, 2017, 14(21): 195-196.
[22] 潘源. 真正的平等?——两性平权视野下当代中国职场女性的角色冲突略论[J]. 贵州大学学报(社会科学版), 2017, 35(2): 148-153.
[23] 易慧宁, 彭宇竹, 朱敏, 等. 江苏省不同等级公立医院医务人员职业倦怠现状及影响因素分析[J]. 中国医院, 2017, 21(4): 27-30. YI Huining, PENG Yuzhu, ZHU Min, et al. Analysis on the current situation and influencing factors of job burnout of medical staff in different grade public hospitals of Jiangsu province [J]. Chinese Hospitals, 2017, 21(4): 27-30.
[24] Messias E, Gathright MM, Freeman ES, et al. Differences in burnout prevalence between clinical professionals and biomedical scientists in an academic medical centre: a cross-sectional survey [J]. BMJ Open, 2019, 9(2): e023506. doi: 10.1136/bmjopen-2018-023506.
[25] 顾沁怡, 曾靓. 上海某三甲医院医务人员职业倦怠现状调查研究[J].上海医药, 2017, 38(5): 44-48,70. GU Qinyi, ZENG Liang. Investigation of the occupational burnout of medical staff in a tertiary hospital of Shanghai [J]. Shanghai Medical & Pharmaceutical Journal, 2017, 38(5): 44-48,70.
[26] Liang Y, Wang H, Tao X. Quality of life of young clinical doctors in public hospitals in Chinas developed cities as measured by the Nottingham health profile(NHP)[J]. Int J Equity Health, 2015, 14(1): 1-12.
[27] Azevedo WF, Mathias LADST. Work addiction and quality of life: a study with physicians [J]. Einstein(Sao Paulo), 2017, 15(2): 130-135.
[28] 冀永娟, 张福平, 匡桂芳, 等. 青岛市748名医务人员生活质量状况及影响因素分析[J]. 中国健康教育, 2015, 31(11): 1025-1028. JI Yongjuan, ZHANG Fuping, KUANG Guifang, et al. A study of affecting factors on quality of life of 748 medical staff in Qingdao [J]. Chinese Journal of Health Education, 2015, 31(11): 1025-1028.
[29] Asante JO, Li MJ, Liao J, et al. The relationship between psychosocial risk factors, burnout and quality of life among primary healthcare workers in rural Guangdong province: a cross-sectional study [J]. BMC Health Serv Res, 2019, 19(1): 447. doi: 10.1186/s12913-019-4278-8.
[30] Salvagioni DAJ, Melanda FN, Mesas AE, et al. Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies [J]. PLoS One, 2017,12(10): e0185781. doi: 101371/journal.pone.0185781.
[31] 谭健烽, 蔡静怡, 万崇华, 等. 医护人员工作倦怠与生活质量关系[J].中国公共卫生, 2012, 28(6): 812-814. TAN Jianfeng, CAI Jingyi, WAN Chonghua, et al. Relationship between job burnout and quality of life in doctors and nurses [J]. Chin J Public Health, 2012, 28(6): 812-814.
[1] 索东阳,申飞,郭皓,刘力畅,杨惠敏,杨向东. Tim-3在药物性急性肾损伤动物模型中的表达及作用机制[J]. 山东大学学报 (医学版), 2020, 58(7): 1-6.
[2] 张宝文,雷香丽,李瑾娜,罗湘俊,邹容. miR-21-5p靶向调控TIMP3抑制2型糖尿病肾病小鼠肾脏系膜细胞增殖及细胞外基质堆积[J]. 山东大学学报 (医学版), 2020, 58(7): 7-14.
[3] 史爽,李娟,米琦,王允山,杜鲁涛,王传新. 胃癌miRNAs预后风险评分模型的构建与应用[J]. 山东大学学报 (医学版), 2020, 58(7): 47-52.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!