McComb Ewan D
Department of Pathology, Dunedin School of Medicine, P O Box 913, Dunedin, New Zealand.
N Z Med J. 2008 May 9;121(1273):25-36.
To assess the predictive ability of various demographic and psychological variables in respect of New Zealand general practitioners' (GPs') intention to leave general practice.
1000 GPs were surveyed. Demographic variables measured were gender, age, life status, income, hours worked, and work arrangements. Psychological variables measured were satisfaction with general practice (measured by a single item), and commitment to general practice (measured by the Meyer and Allen1,2 three-component model questionnaire). Intention to leave general practice was measured at two time intervals: within 6 months and within 5 years.
The response rate was 58%. Twelve percent of GPs indicated an intention to leave general practice within 6 months, and nearly 30% indicated an intention to leave within 5 years. Despite these intentions, the reported level of satisfaction was reasonably high (mean score 3.67/5) as was the level of commitment (overall 72% reported being committed to general practice). While some demographic variables exhibited statistically significant relationships with intended withdrawal from the occupation, their predictive ability was very poor. Satisfaction with and commitment to general practice were both significantly negatively related to intention to leave and had much higher predictive value than demographic variables. The relationship between satisfaction and intention to leave was mediated by commitment.
For those interested in the maintenance of an adequate GP workforce, these results suggest some attention should be paid to commitment. Further work is necessary to establish how commitment develops and is maintained.
评估各类人口统计学和心理变量对新西兰全科医生离开全科医疗行业意向的预测能力。
对1000名全科医生进行了调查。所测量的人口统计学变量包括性别、年龄、生活状况、收入、工作时长和工作安排。所测量的心理变量包括对全科医疗的满意度(通过一个单项进行测量)以及对全科医疗的忠诚度(通过迈耶和艾伦1,2的三成分模型问卷进行测量)。离开全科医疗行业的意向在两个时间间隔进行测量:6个月内和5年内。
回复率为58%。12%的全科医生表示有在6个月内离开全科医疗行业的意向,近30%表示有在5年内离开的意向。尽管有这些意向,但报告的满意度水平相当高(平均得分3.67/5),忠诚度水平也是如此(总体72%报告对全科医疗行业忠诚)。虽然一些人口统计学变量与打算退出该职业存在统计学上的显著关系,但其预测能力非常差。对全科医疗的满意度和忠诚度均与离开意向显著负相关,且预测价值远高于人口统计学变量。满意度与离开意向之间的关系由忠诚度介导。
对于那些关注维持充足全科医生劳动力的人来说,这些结果表明应关注忠诚度。有必要开展进一步工作以确定忠诚度是如何形成和维持的。