探索医生的不满情绪和工作相关压力:PhyDis量表的编制
Exploring Physicians' Dissatisfaction and Work-Related Stress: Development of the PhyDis Scale.
作者信息
Pedrazza Monica, Berlanda Sabrina, Trifiletti Elena, Bressan Franco
机构信息
Department of Human Sciences, University of Verona Verona, Italy.
Department of Economics, University of Verona Verona, Italy.
出版信息
Front Psychol. 2016 Aug 18;7:1238. doi: 10.3389/fpsyg.2016.01238. eCollection 2016.
Research, all over the world, is starting to recognize the potential impact of physicians' dissatisfaction and burnout on their productivity, that is, on their intent to leave the job, on their work ability, on the amount of sick leave days, on their intent to continue practicing, and last but not least, on the quality of the services provided, which is an essential part of the general medical care system. It was interest of the provincial medical board's ethical committee to acquire information about physician's work-related stress and dissatisfaction. The research group was committed to define the indicators of dissatisfaction and work-related stressors. Focus groups were carried out, 21 stressful experience's indicators were identified; we developed an online questionnaire to assess the amount of perceived stress relating to each indicator at work (3070 physicians were contacted by e-mail); quantitative and qualitative data analysis were carried out. The grounded theory perspective was applied in order to assure the most reliable procedure to investigate the concepts' structure of "work-related stress." We tested the five dimensions' model of the stressful experience with a confirmatory factor analysis: Personal Costs; Decline in Public Image and Role Uncertainty; Physician's Responsibility toward hopelessly ill Patients; Relationship with Staff and Colleagues; Bureaucracy. We split the sample according to attachment style (secure and insecure -anxious and avoidant-). Results show the complex representation of physicians' dissatisfaction at work also with references to the variable of individual difference of attachment security/insecurity. The discriminant validity of the scale was tested. The original contribution of this paper lies on the one hand in the qualitative in depth inductive analysis of physicians' dissatisfaction starting from physicians' perception, on the other hand, it represents the first attempt to analyze the physicians' dissatisfaction with reference to attachment styles, which is recognized as being a central variable of individual difference supporting caregiving practices. This study represents an original and innovative attempt to address physicians' dissatisfaction and job satisfaction. The PhyDis scale has been developed and, in line with international findings, our results indicate that role uncertainty and loss of social esteem are the most dissatisfying factors.
世界各地的研究开始认识到医生的不满和职业倦怠对其工作效率的潜在影响,也就是说,对他们离职的意愿、工作能力、病假天数、继续行医的意愿,以及最后但同样重要的,对所提供服务质量的影响,而服务质量是一般医疗体系的重要组成部分。省级医学委员会伦理委员会有兴趣获取有关医生工作相关压力和不满的信息。研究小组致力于确定不满和工作相关压力源的指标。开展了焦点小组讨论,确定了21个压力体验指标;我们开发了一份在线问卷,以评估工作中与每个指标相关的感知压力程度(通过电子邮件联系了3070名医生);进行了定量和定性数据分析。采用扎根理论视角以确保调查“工作相关压力”概念结构的最可靠程序。我们用验证性因素分析测试了压力体验的五维度模型:个人成本;公众形象下降和角色不确定性;医生对绝症患者的责任;与工作人员和同事的关系;官僚作风。我们根据依恋风格(安全型和不安全型——焦虑型和回避型)对样本进行了划分。结果显示,医生工作不满的复杂表现也涉及依恋安全/不安全个体差异变量。测试了该量表的区分效度。本文的原创贡献一方面在于从医生的感知出发对医生不满进行定性深入归纳分析,另一方面,它代表了首次尝试参照依恋风格分析医生的不满,而依恋风格被认为是支持护理实践的个体差异的核心变量。本研究是解决医生不满和工作满意度的一次原创性和创新性尝试。已经开发了医生不满量表(PhyDis),并且与国际研究结果一致,我们的结果表明角色不确定性和社会尊重的丧失是最令人不满的因素。
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