上海交通大学学报（医学版）
上海交通大學學報（醫學版）
상해교통대학학보（의학판）
JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY(MEDICAL SCIENCE)
2010年
4期
455-458
,共4页
韩一芃%王申奇%吴佳俊%安宣齐%张劲松
韓一芃%王申奇%吳佳俊%安宣齊%張勁鬆
한일봉%왕신기%오가준%안선제%장경송
焦虑%压力来源%医师%三级公立医院
焦慮%壓力來源%醫師%三級公立醫院
초필%압력래원%의사%삼급공립의원
anxiety%sources of stress%doctors%three classes of public hospitals
目的 了解医师的焦虑、职业压力问题及其与医院、科室间的关系.方法 通过结合焦虑自评量表(sAs)和医师职业压力源量表评估上海市杨浦区公立医院随机抽查的346名医师的焦虑和职业压力强度.各等级医院样本量根据卫生部医院床位数人员配置标准所需医师数量选定.结果 332(有效率96%)名医师的SAS原始分为(36.62±7.01)分,高于我国常模(P<0.01),且在婚姻、性别、受教育程度等混杂因素间差异无统计学意义(P>0.05),在各级医院、不同科室间的差异也无统计学意义(P>0.05);压力强度总平均分为(2.39±1.09)分(轻至中度压力),前三位的职业压力来源为医疗风险、待遇负荷和理解支持.三个等级公立医院医师的压力强度有差异(P=0.000),其中一级医院医师的压力最轻,三级医院医师的压力最重;外科医师的工作压力最大.结论 受调查医师群体的焦虑状况在不同等级或科室中都相似,且高于一般人群.医疗风险在各级医院医师中都是最主要的压力来源;一级医院医师的压力最轻可能与政策扶持有关,而二级医院由于职能定位不明确而使医师压力居中,三级医院医师的压力最重提示了三级医院工作的高强度.医师的高压力和焦虑状况与医患矛盾的产生相关联.
目的 瞭解醫師的焦慮、職業壓力問題及其與醫院、科室間的關繫.方法 通過結閤焦慮自評量錶(sAs)和醫師職業壓力源量錶評估上海市楊浦區公立醫院隨機抽查的346名醫師的焦慮和職業壓力彊度.各等級醫院樣本量根據衛生部醫院床位數人員配置標準所需醫師數量選定.結果 332(有效率96%)名醫師的SAS原始分為(36.62±7.01)分,高于我國常模(P<0.01),且在婚姻、性彆、受教育程度等混雜因素間差異無統計學意義(P>0.05),在各級醫院、不同科室間的差異也無統計學意義(P>0.05);壓力彊度總平均分為(2.39±1.09)分(輕至中度壓力),前三位的職業壓力來源為醫療風險、待遇負荷和理解支持.三箇等級公立醫院醫師的壓力彊度有差異(P=0.000),其中一級醫院醫師的壓力最輕,三級醫院醫師的壓力最重;外科醫師的工作壓力最大.結論 受調查醫師群體的焦慮狀況在不同等級或科室中都相似,且高于一般人群.醫療風險在各級醫院醫師中都是最主要的壓力來源;一級醫院醫師的壓力最輕可能與政策扶持有關,而二級醫院由于職能定位不明確而使醫師壓力居中,三級醫院醫師的壓力最重提示瞭三級醫院工作的高彊度.醫師的高壓力和焦慮狀況與醫患矛盾的產生相關聯.
목적 료해의사적초필、직업압력문제급기여의원、과실간적관계.방법 통과결합초필자평량표(sAs)화의사직업압력원량표평고상해시양포구공립의원수궤추사적346명의사적초필화직업압력강도.각등급의원양본량근거위생부의원상위수인원배치표준소수의사수량선정.결과 332(유효솔96%)명의사적SAS원시분위(36.62±7.01)분,고우아국상모(P<0.01),차재혼인、성별、수교육정도등혼잡인소간차이무통계학의의(P>0.05),재각급의원、불동과실간적차이야무통계학의의(P>0.05);압력강도총평균분위(2.39±1.09)분(경지중도압력),전삼위적직업압력래원위의료풍험、대우부하화리해지지.삼개등급공립의원의사적압력강도유차이(P=0.000),기중일급의원의사적압력최경,삼급의원의사적압력최중;외과의사적공작압력최대.결론 수조사의사군체적초필상황재불동등급혹과실중도상사,차고우일반인군.의료풍험재각급의원의사중도시최주요적압력래원;일급의원의사적압력최경가능여정책부지유관,이이급의원유우직능정위불명학이사의사압력거중,삼급의원의사적압력최중제시료삼급의원공작적고강도.의사적고압력화초필상황여의환모순적산생상관련.
Objective To investigate the anxiety status and professional stress of doctors, and explore their relationship with hospitals and departments. Methods A quantitative self-reporting questionnaire composed with Stressors Scale for Doctors and self-rating anxiety scale (SAS) was performed to evaluate the anxiety status and professional stress of doctors randomly selected from public hospitals in Yangpu District of Shanghai. The sample numbers of each class of hospitals were determined by the staff allocation standard enacted by the Ministry of Health. Results The average score of anxiety state by SAS of 332 participants ( effective rate, 96%) was 36. 62 ± 7. 01, significantly higher than the Chinese norm ( P < 0.01), while there was no significant difference by marriage status, gender, education degree, hospital classes and departments (P>0.05). The general average score of stress was 2. 39 ± 1.09 (mild to moderate level), and the main stressors were medical risks, salary load and understanding and support from patients. There were significant differences in stress levels among doctors in various classes of hospitals (P =0.000), with those in the community hospitals being the lowest and those of the municipal hospitals being the highest. Besides, surgeons experienced greater stress than doctors of the other departments. Conclusion The anxiety status of doctors in Yangpu District of Shanghai is similar in different classes of hospitals and in different departments, and is more severe than that of the general population. Medical risk is the major source of stress in each class of hospitals. Doctors in community hospitals experience the least stress due to beneficial policies, those in districtal hospitals have an ambiguous functional authority, and those in municipal hospitals suffer the greatest professional pressure. The status of anxiety and stress of doctors is related to the contradiction between patients and doctors.
