CAJ | 학술논문

目的分析医生、护士和疾病预防控制工作人员的职业压力水平及其影响因素.方法采用多阶段分层随机的抽样方法和自填式问卷调查方法,利用工作内容量表调查了1 859名医生(含医技人员)、1 444名护士和684名疾控中心工作人员的职业压力水平,利用logistic多元回归模型分析高紧张型和被动型职业类型的影响因素.结果医务人员职业压力水平较高,超过50％以上为容易导致职业倦怠的紧张型与被动型工作类型,护士群体紧张型与被动型工作类型的比例最高57.9％(833/1 440),疾病预防控制中心工作人员次之53.6％(367/684),而医生(含医技人员)比例最低44.9％(835/1 859).从工作要求分析,医护人员间无显著性差异,而疾控人群工作要求最低.工作自主度护士组人群最低,疾控组人群次之,医生组人群工作自主程度最高.多因素分析可见:导致工作要求上升和工作自由度下降的共同危险因素为收入水平低下、非患病人员、工作超负荷以及城市医务人员.结论综合工作类型以及职业要求与自由度情况分析,护士人群职业压力水平均最高,疾控中心医务人员居中,医生人群最低.通过改善医务人员薪资发放公平和公开性,尽量做到按劳分配可能是缓解医务人员压力的有效途径之一.
목적 분석의생、호사화질병예방공제공작인원적직업압력수평급기영향인소.방법 채용다계단분층수궤적추양방법화자전식문권조사방법,이용공작내용량표조사료1 859명의생(함의기인원)、1 444명호사화684명질공중심공작인원적직업압력수평,이용logistic다원회귀모형분석고긴장형화피동형직업류형적영향인소.결과 의무인원직업압력수평교고,초과50％이상위용역도치직업권태적긴장형여피동형공작류형,호사군체긴장형여피동형공작류형적비례최고57.9％(833/1 440),질병예방공제중심공작인원차지53.6％(367/684),이의생(함의기인원)비례최저44.9％(835/1 859).종공작요구분석,의호인원간무현저성차이,이질공인군공작요구최저.공작자주도호사조인군최저,질공조인군차지,의생조인군공작자주정도최고.다인소분석가견:도치공작요구상승화공작자유도하강적공동위험인소위수입수평저하、비환병인원、공작초부하이급성시의무인원.결론 종합공작류형이급직업요구여자유도정황분석,호사인군직업압력수평균최고,질공중심의무인원거중,의생인군최저.통과개선의무인원신자발방공평화공개성,진량주도안로분배가능시완해의무인원압력적유효도경지일.
Objective To evaluate levels of job stress and its influencing factors among medical staff in hospitals and health personnels in centers for disease control and prevention.Methods Job Content Questionnaire was self-administered to evaluate the job stress level among 1 859 doctors and medical technicians,1 444 nurses,and 684 public health workers selected with multistage cluster random sampling in Liaoning province.Logistic regression was applied to elucidate the influencing factors of the prevalence of high-strain and passive job.Results High prevalence of job stress existed among the medical and health professionals.Over 50％ of the professionals reported high-strain and passivity in their job,which were strongly associated with job burnout,with a higher prevalence rate 57.9％ (833/1 440) in the nurses,a moderate level 53.6％ (367/684) in the staffs of centers for disease control and prevention,and a lower prevalence rate 44.9％ (835/1 859) in the doctors.Doctors and nurses had no significant difference in job demand.The staffs of centers for disease control and prevention had the lowest job demand compared with doctors and nurses.There were significant differences in job freedom among these three groups,with nurses had the lowest,and doctors the highest.Multivariate logistic regression showed that the influencing factors for high-work-demand and low-work-freedom include dissatisfaction to salary,the non-patient,work overload,and working in urban areas.Conclusion Nurses had the greatest job stress.The staffs of centers for disease control and prevention and doctors were the second and third groups.Transparency and fairness of the payment system based on contribution may be effective to relieve job stress among medical and health professionals.