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山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (7): 108-114.doi: 10.6040/j.issn.1671-7554.0.2020.0739

• 公共卫生与管理学 • 上一篇    

住院医师规范化培训学员压力知觉与留职意愿及影响因素

张娟1,2,3,张璐嘉1,2,肖伟3,李顺平1,2   

  1. 1. 山东大学齐鲁医学院医药卫生管理学院, 山东 济南 250012;2. 国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学), 山东 济南 250012;3. 山东大学附属山东省立医院, 山东 济南 250021
  • 发布日期:2020-07-10
  • 通讯作者: 李顺平. E-mail:lishunping@sdu.edu.cn
  • 基金资助:
    山东省医药卫生科技发展计划项目(2019WS491)

Influencing factors of perceived stress and job retention in national standardized training for resident doctors

ZHANG Juan1,2,3, ZHANG Lujia1,2, XIAO Wei3, LI Shunping1,2   

  1. 1. School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. NHC Key Laboratory of Health Economics and Policy Research, Jinan 250012, Shandong, China;
    3. Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China
  • Published:2020-07-10

摘要: 目的 了解住院医师规范化培训学员(规培学员)的压力知觉与留职意愿。 方法 使用压力知觉量表和留职意愿量表,采用方便抽样,选取山东省9家大型综合医院培训基地的规培学员展开电子问卷调查。对医院的9个科室进行整群抽样,共纳入3 528名规培学员,采用χ2检验和二元Logistic回归对规培学员的压力知觉与留职意愿的影响因素进行统计分析。 结果 规培学员的压力知觉得分为(25.19±7.82)分,52.6%处于健康危险性压力中,留职意愿得分为(3.56±0.74)分,51.0%留职意愿为中低水平;二元Logistic回归分析结果显示,性别、目前身份、是否取得医师资格证、规培专业、月平均收入、平均管理床位数是培训学员压力知觉的影响因素;性别、目前身份、进入基地培训时间、是否获得医师资格证、规培专业、月平均收入、压力知觉水平是留职意愿的影响因素。 结论 山东省住院医师规培学员压力知觉处于较高水平,留职意愿处于中低水平,需重视规培学员的职业压力和经济压力,降低压力知觉水平,提高留职意愿。

关键词: 压力知觉, 留职意愿, 规范化培训, 住院医师

Abstract: Objective To explore the perceived stress and job retention of resident doctors. Methods The resident doctors in 9 standardized training bases in Shandong Province were surveyed with electronic questionnaire of Perceived Stress Scale and the Intention to Retention Scale. Sample was carried out in 9 departments and 3 528 resident doctors were enrolled. The influencing factors of perceived stress and job retention were analyzed with chi-square test and binary Logistic regression. Results The perceived stress score was(25.19±7.82), and 52.6% of the resident doctors were under health risk pressure; the job retention score was(3.56±0.74), and 51.0% of the resident doctors had medium or low intention of job retention. Binary Logistic regression analysis showed that gender, current status, whether to obtain a doctors qualification certificate, training specialty, average monthly income and average number of bed managed were the influencing factors of perceived stress, while gender, current status, time of training, whether to obtain the doctors qualification certificate, training specialty, average monthly income and perceived stress were the influencing factors of job retention. Conclusion The level of perceived stress of resident doctors in Shandong Province is relatively high, while the level of job retention is medium or low. Due attention should be paid to their occupational and economic pressures so as to reduce their perceived stress and increase the level of job retention.

Key words: Perceived stress, Job retention, National standardized training, Resident doctors

中图分类号: 

  • R197.1
[1] 毕业后医学教育网. 住院医师规范化培训招收实施办法(试行)[EB/OL]. [2015-09-14]. https://www.ccgme-cmda.cn/news/19/1/article.
[2] 崔永, 王天佑. 从美国住院医生培训看中国住院医师规范化培训的挑战和方向[J]. 中国肺癌杂志, 2016,19(6): 321-327. CUI Yong, WANG Tianyou. From the residency training in the United States to see the challenges and directions of China Residency Standardized Training [J]. Chinese Journal of Lung Cancer, 2016, 19(6): 321-327.
[3] 谭晓雪, 满强. 医学研究生就业压力知觉调查研究[J]. 重庆医学, 2020, 49(6): 994-997. TAN Xiaoxue, MAN Qiang. Investigation on perceived stress of medical graduates [J]. Chongqing Medicine, 2020, 49(6): 994-997.
[4] 李娟, 王玉玲. 手术室护士工作压力源、职业疲溃感与留职意愿的相关性研究[J]. 天津护理, 2018, 26(1): 25-27. LI Juan, WANG Yuling. Study on the relationships among job stress source, job burnout and intent to stay of operating room nurses [J]. Tianjin Journal of Nursing, 2018, 26(1): 25-27.
[5] Anastasiadis C, Tsounis A, Sarafis P. The relationship between stress, social capital and quality of education among medical residents[J]. BMC Res Notes, 2018, 11(1): 274. doi: 10.1186/s13104-018-3387-5.
[6] Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress [J]. J Health Soc Behav, 1983, 24(4): 385-396.
[7] Ho RTH. Effects of dance movement therapy on Chinese cancer patients: a pilot study in Hong Kong [J]. Arts Psychother, 2005, 32(5): 337-345.
[8] 杨廷忠, 黄汉腾. 社会转型中城市居民心理压力的流行病学研究[J]. 中华流行病学杂志, 2003, 24(9): 11-15. YANG Tingzhong, HUANG Hanteng. An epidemiological study on stress among urban residents in social transition period [J]. Chinese Journal of Epidemiology, 2003, 24(9): 11-15.
[9] Turnley WH, Feldman DC. Psychological contract violation during corporate restructuring [J]. Human Resource Management, 1998, 37(1): 71-83.
[10] Turnley WH, Feldman DC. Re-examining the effects of psychological contract violations: unmet expectations and job dissatisfaction as mediators [J]. J Organiz Behav, 2000, 21(1): 25-42.
[11] 王琳, 陶红, 刘晓虹. 国外护士留职研究进展及其对我国的启示[J]. 解放军护理杂志, 2008, 25(8): 31-33. WANG Lin, TAO Hong, LIU Xiaohong. The progress of the study of the job intention of foreign nurses and its enlightenment to China [J]. Nursing Journal of Chinese Peoples Liberation Army, 2008, 25(8): 31-33.
[12] 常璇. 全科医生工作满意度、职业倦怠与留职意愿的关系研究[D]. 济南: 山东大学, 2015.
[13] 许鑫. 北京市F医院医生工作满意度、职业倦怠与留职意愿影响因素研究[D]. 北京: 中国地质大学, 2018.
[14] 陶红, 王琳. 中文版护士留职意愿问卷的修订[J]. 第二军医大学学报, 2010, 31(8): 925-927. TAO Hong, WANG Lin. Establishment of questionnaire for nurse intention to remain employed: the Chinese version [J]. Academic Journal of Second Military Medical University, 2010, 31(8): 925-927.
[15] 周红翠, 王芳, 徐平. 规范化培训护士离职意愿现状调查及分析[J]. 世界最新医学信息文摘, 2019, 19(35): 274-275. ZHOU Hongcui, WANG Fang, XU Ping. Investigation and Analysis on the Current Situation of Nurses willingness to Leave their Jobs in Standardized Training [J]. World Latest Medicine Information, 2019, 19(35): 274-275.
[16] 王波, 孟开, 张玲, 等. 我国住院医师规范化培训制度现状研究[J]. 中国卫生事业管理, 2016, 33(10): 780-781. WANG Bo, MENG Kai, ZHANG Lin, et al. Studying on the status of standardized residency training program in China [J]. Chinese Health Service Management, 2016, 33(10): 780-781.
[17] 臧慧. 广西住院医师规范化培训学员职业倦怠现状及影响因素研究[D]. 南宁: 广西医科大学, 2019.
[18] 唐广良, 何兰, 夏结, 等. 长沙市二级及以上医院护士职业承诺和工作满意度对留职意愿的影响研究[J]. 护理管理杂志, 2013,13(10): 700-702. TANG Guangliang, HE Lan, XIA Jie, et al. Influence of nurses occupational commitment and job satisfaction on job retention in 2-class and above general hospitals of Changsha [J]. Journal of Nursing Administration, 2013,13(10): 700-702.
[19] 孙骞, 常璇, 尹爱田. 山东省全科医疗从业人员现状与留职意愿研究[J]. 中国卫生事业管理, 2016, 33(10): 777-779. SUN Jian, CHANG Xuan, YIN Aitian. Study on the current situation and stay intention of general practitioners in Shandong province [J]. Chinese Health Service Management, 2016, 33(10): 777-779.
[20] Ali Jadoo SA, Aljunid SM, Dastan I, et al. Job satisfaction and turnover intention among Iraqi doctors-a descriptive cross-sectional multicentre study [J]. Hum Resour Health, 2015, 13: 21. doi: 10.1186/s12960-015-0014-6.
[21] 黄思敏, 黄葭燕. 医患矛盾对上海市某三甲医院青年医务人员留职意愿的影响[J]. 医学与社会, 2018, 31(2): 67-70. HUANG Simin, HUANG Jiayan. Influence of Doctor-Patient Conflicts on Young Medical Staffs Retention Willingness in A Third Grade Class A Hospital in Shanghai City [J]. Medicine and Society, 2018, 31(2): 67-70.
[22] 王影珍. 儿科护士心理资本和付出回报失衡与留职意愿相关性分析[D]. 开封: 河南大学, 2017.
[23] 侯玲, 杜悦, 尚云晓. 关于医学生儿科临床实习问题的分析与思考[J]. 卫生职业教育, 2020, 38(2): 31-32. HOU Ling, DU Yue, SHANG Yunxiao. Analysis and reflection on clinical practice in medical students pediatrics [J]. Health Vocational Education, 2020, 38(2): 31-32.
[24] Yvonne A, Baukje M, Julie E, et al. Factors influencing family medicine resident retention and newly graduated physicians first practice location[J]. Journal of New Brunswick Studies / Revue détudes sur le Nouveau-Brunswick, JNBS, 2017, 8: 159-173.
[25] McInnes S, Peters K, Bonney A, et al. An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice [J]. J Adv Nurs, 2015, 71(9): 1973-1985.
[26] Martin S, Igor Z, M C K, et al. The influence of temperament and character profiles on specialty choice and well-being in medical residents [J]. Peer J, 2016, 4: e2319. doi: 10.7717/peerj.2319. eCollection 2016.
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