新医改前后基层医生职业心理变化研究——基于3次问卷调查的比较

发布时间：2018-11-28 12:27

【摘要】：目的分析新医改前后基层医生职业心理的变化。方法采用本课题组2007、2011、2013年对来自山东省济南、潍坊、德州三市基层医疗机构(乡镇卫生院、社区卫生服务机构)的基层医生进行的问卷调查和访谈资料,分析基层医生对总体工作满意度、疲劳度、工作稳定性、职业承诺变化情况。结果 3次调查中基层医生对总体工作满意度比较,差异有统计学意义(χ2=27.700,P0.05)。3次调查中基层医生的心理疲劳、身体疲劳、情感疲劳度比较,差异均有统计学意义(χ2=140.800、45.795、177.540,P0.05);其中2011年和2013年的心理疲劳同意率高于2007年,2011年和2013年的情感疲劳同意率低于2007年,差异有统计学意义(P0.05)。3次调查中基层医生工作稳定性比较,差异有统计学意义(P0.05);其中2011年和2013年"我经常想离开所在的医院""我经常想换一下工作,不做医生了""明年我很有可能会找一份新工作"的同意率均低于2007年,差异有统计学意义(P0.05)。2011年和2013年调查中基层医生职业承诺调查项目中仅"做医生是很好的职业选择"同意率间差异有统计学意义(P0.05)。结论新医改前后,基层医生职业承诺变化不明显;心理疲劳度增加,但情感疲劳度得到改善;同时工作稳定性改善,离职意向减弱。显示新医改稳定了基层队伍,但仍存在激励效果有限的问题;政府需强化对基层卫生人力资源的投资,完善激励机制。
[Abstract]:Objective to analyze the changes of occupational psychology of primary doctors before and after the new medical reform. Methods A questionnaire survey and interview data of primary medical institutions (township health centers, community health service institutions) from Jinan, Weifang and Texas, Shandong Province, in 2013 were conducted by our research group in 2007 / 2011. Analyze the changes of job satisfaction, fatigue, job stability and career commitment. Results there were significant differences in the total job satisfaction of the basic level doctors in the three surveys (蠂 2 + 27.700 P 0.05), and the comparison of psychological fatigue, physical fatigue and emotional fatigue among the basic level doctors in the three surveys. The difference was statistically significant (蠂 2: 140.800, 45.795177.540, P 0.05); The rate of psychological fatigue consent in 2011 and 2013 was higher than that in 2007, and the rate of emotional fatigue consent in 2011 and 2013 was lower than that in 2007. The difference was statistically significant (P0.05). The difference was statistically significant (P0.05). In 2011 and 2013, "I often wanted to leave the hospital," I often wanted to change jobs, not to be a doctor, "I'm likely to find a new job next year," the approval rate was lower than in 2007. The difference was statistically significant (P0.05). In 2011 and 2013, there was significant difference in the rate of consent between the survey items of "doing doctor is a good choice of occupation" in the survey of professional commitment of primary level doctors (P0.05). Conclusion before and after the new medical reform, the changes of occupational commitment of primary level doctors are not obvious; psychological fatigue is increased, but emotional fatigue is improved; meanwhile, job stability is improved and turnover intention is weakened. It shows that the new medical reform has stabilized the grassroots team, but there still exists the problem of limited incentive effect, and the government should strengthen the investment in the basic health human resources and perfect the incentive mechanism.
【作者单位】：潍坊医学院管理学院健康风险预警治理协同创新中心 "健康山东"重大社会风险预测与治理协同创新中心;
【基金】：国家自然科学基金资助项目(71103129);国家自然科学基金资助项目(71173158);国家自然科学基金资助项目(70573078) 教育部人文社会科学研究规划项目(09YJA630114)
【分类号】：R192

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