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非工作时间护理工作的工作满意度及压力源——德国农村地区全科医生的一项试点研究

Job satisfaction and stressors for working in out-of-hours care - a pilot study with general practitioners in a rural area of Germany.

作者信息

Leutgeb R, Frankenhauser-Mannuß J, Scheuer M, Szecsenyi J, Goetz Katja

机构信息

Department of General Practice and Health Services Research, University Hospital Heidelberg, Marsilius-Arcades, Western Tower, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.

Headquarter of Control Centre, District Bergstraße, Gräffstrasse 5, 64646, Heppenheim, Germany.

出版信息

BMC Fam Pract. 2018 Jun 22;19(1):95. doi: 10.1186/s12875-018-0777-7.

Abstract

BACKGROUND

Challenging work environment, high workload, and increasing physician shortages characterize current rural general practice in Germany and in most European Countries. These factors extend into Out-Of-Hours Care (OOHC). However, little research about potential stressors for general practitioners (GPs) in OOHC settings is available. This pilot study aimed to evaluate workload, different elements of job satisfaction and stressors for GPs in OOHC and to analyze whether these aspects are associated with overall job satisfaction.

METHODS

Cross-sectional survey with a sample of 320 GPs who are working in OOHC was used to measure workload in OOHC, job satisfaction (using the Warr-Cook-Wall scale) and stressors with the effort-reward imbalance questionnaire. In order to assess associations between workload, job satisfaction and stressors at work we performed descriptive analyses as well as multivariable regression analyses.

RESULTS

The response rate was 40.9%. Over 80% agreed that OOHC was perceived as a stressor and 79% agreed that less OOHC improved job satisfaction. Only 42% of our sample were satisfied with their overall job satisfaction. The regression analysis showed that the modification of current OOHC organization was significantly associated with overall job satisfaction.

CONCLUSIONS

Our results suggest that OOHC in the current form is a relevant stressor in daily work of rural GPs in Germany and one of the reasons for a decreasing overall job satisfaction. Strategic changes such as the implementation of structural reforms e.g. reducing frequency of OOHC duties for each GP and improving continuing professional development options related to OOHC are needed to address current workload challenges experienced by GPs providing OOHC in Germany.

摘要

背景

具有挑战性的工作环境、高工作量以及日益严重的医生短缺是德国和大多数欧洲国家当前农村全科医疗的特点。这些因素延伸到了非工作时间护理(OOHC)。然而,关于非工作时间护理环境下全科医生(GP)潜在压力源的研究很少。这项试点研究旨在评估非工作时间护理中全科医生的工作量、工作满意度的不同要素和压力源,并分析这些方面是否与总体工作满意度相关。

方法

采用横断面调查,对320名从事非工作时间护理的全科医生进行抽样,以测量非工作时间护理的工作量、工作满意度(使用Warr-Cook-Wall量表)以及使用努力-回报失衡问卷测量压力源。为了评估工作量、工作满意度和工作压力源之间的关联,我们进行了描述性分析以及多变量回归分析。

结果

回复率为40.9%。超过80%的人认为非工作时间护理是一种压力源,79%的人认为减少非工作时间护理能提高工作满意度。我们样本中只有42%的人对他们的总体工作满意度感到满意。回归分析表明,当前非工作时间护理组织的改变与总体工作满意度显著相关。

结论

我们的结果表明,当前形式的非工作时间护理是德国农村全科医生日常工作中的一个相关压力源,也是总体工作满意度下降的原因之一。需要进行战略变革,例如实施结构改革,例如减少每个全科医生的非工作时间护理职责频率,并改善与非工作时间护理相关的持续专业发展选择,以应对德国提供非工作时间护理的全科医生目前所面临的工作量挑战。

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