疫情防控期间上海市中心城区社区医务人员职业倦怠状况及影响因素分析

李为翊; 张博; 马立人; 高捷; 郑利纬

doi:10.16369/j.oher.issn.1007-1326.2022.05.008

疫情防控期间上海市中心城区社区医务人员职业倦怠状况及影响因素分析

Occupation burnout and influencing factors of community medical staff in Shanghai central urban area during epidemic prevention and control

摘要

摘要:
目的掌握新型冠状病毒肺炎疫情期间社区医务人员职业倦怠情况和影响因素，提升医务人员心理健康水平。
方法随机选取上海市某中心城区社区医务人员843人，开展面对面问卷调查，采用工作内容内卷(JCQ)、付出-回报失衡(ERI)问卷调查医务人员职业紧张情况，采用工作倦怠感量表(MBI)调查职业倦怠情况。采用logistic回归方法分析职业倦怠的影响因素。
结果回收有效问卷835份，有效应答率99.1%。JCQ模式下，835名社区医务人员职业紧张检出率为42.5%，ERI模式下，职业紧张检出率为34.0%。职业倦怠发生率为50.8%，其中轻、中度职业倦怠发生率为42.2%，重度职业倦怠发生率为8.6%。logistic回归分析结果显示：分别相比年龄 < 30岁、工龄 < 10年、临床科室、每周工作时长 < 40 h、不值夜班，年龄40 ~ 49岁(OR = 1.546)、工龄≥ 10年(OR = 1.506 ~ 1.707)、公共卫生科室(OR = 2.085)、每周工作时长≥ 50 h(OR = 2.408)、值夜班(OR =1.811)的社区医务人员发生职业倦怠的风险增加(P < 0.05)；相比月收入 < 3 000元、不运动、每天睡眠时间 < 6 h的人员，月收入≥ 3 000元(OR = 0.098 ~ 0.133)、每周锻炼次数≥1次(OR = 0.308 ~ 0.603)、每天睡眠时间≥ 6 h(OR = 0.300 ~ 0.334)的人员发生职业倦怠的风险降低(P < 0.05)；社会支持(OR = 0.667)、回报(OR = 0.605)的得分越高，社区医务人员发生职业倦怠的风险越小(P < 0.05)；付出(OR = 2.468)、内在投入(OR = 1.549)的得分越高，社区医务人员发生职业倦怠的风险也越大(P < 0.05)。
结论疫情防控期间，社区医务人员存在一定程度的职业倦怠情况。可从个体、组织、社会三方面加强干预，通过提升业务技能水平、合理排班作息、适度运动锻炼、加强心理疏导等途径方式，降低社区医务人员职业倦怠。

Abstract:
Objective To understand the occupation burnout of community medical staff during epidemic and explore the influencing factors, so as to improve the mental health level of medical staff.
Methods Totally 843 community medical staff in the central urban area were studied. They were surveyed by a face-to-face with the questionnaire of JCQ, ERI and MBI.
Results Totally 835 valid questionnaires were recovered with an effective response rate of 99.1%. JCQ mode showed that the detection rate of occupational stress was 42.5%. The ERI mode showed the detection rate of occupational stress was 34.0%. The incidence of job burnout was 50.8%, of which the incidence of mild and moderate job burnout was 42.2% and the incidence of severe job burnout was 8.6%. The logistic regression analysis showed that the risk of job burnout of community medical staff was increased (P < 0.05), OR = 1.546 (aged 40 to < 50 years vs. aged < 30 years), OR = 1.506 to 1.707 (working time more than 10 years vs. less than 10 years), OR = 2.085 (working in public health departments vs. in clinical departments), OR = 2.408 (working more than 50 hours per week vs. less than 40 hours per week), and OR = 1.811 (working with night shift vs. without night shift). Compared with those with monthly income < 3 000 yuan, exercise frequency < 1 time per week and sleep time < 6 h per day, those with monthly income > 3 000 yuan (OR = 0.098 - 0.133), exercise frequency ≥ 1 time per week(OR = 0.308 - 0.603) and sleep time ≥ 6 h per day(OR = 0.300 - 0.334) had a lower risk of job burnout (P < 0.05). The higher the scores of social support (OR = 0.667) and return(OR = 0.605), the lower the risk of burnout of community medical personnel(P < 0.05);the higher the scores of giving (OR = 2.468)and intrinsic input (OR = 1.549), the greater the risk of burnout of community medical personnel(P < 0.05).
Conclusions During the epidemic prevention and control period, there was a certain degree of job burnout among community medical personnel. We can strengthen the intervention from individuals, organizations and society aspects and reduce the job burnout of community medical personnel by improving the level of professional skills, reasonable scheduling, appropriate exercise, and strengthening psychological counseling.

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