Saijo Yasuaki, Yoshioka Eiji, Hanley Sharon J B, Kitaoka Kazuyo, Yoshida Takahiko
Department of Social Medicine, Asahikawa Medical University.
Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine.
Tohoku J Exp Med. 2018 Jul;245(3):167-177. doi: 10.1620/tjem.245.167.
Shortage of healthcare workers is a global problem. It is important to clarify factors, including job stress, that influence workplace resignation and factors that cause burnout among rural physicians. The study was designed as a cross-sectional questionnaire survey. We sent questionnaires to town or village hospitals and clinics (n = 1,898) in Hokkaido, Tohoku, Shikoku, and Kyushu and Okinawa. The number of participants was 509. Of these 7.7% were female and 21.6% were < 50 years. Internal or general medicine physicians were asked about personal and job factors, job stress based on the demand-control-support model, intention to resign from current position, and burnout evaluated using the Maslach Burnout Inventory-General Survey. Overall, 10.4% of the participants intended to resign, and 21.8% was defined as burnout positive. In the multivariate logistic regression analysis, dissatisfaction with income (OR, 3.63; 95% CI, 1.63-8.10), having one's hometown in another town or village in the same prefecture (OR, 3.53; 95% CI, 1.18-10.62) were significantly related to intention to resign, while high job control (OR, 0.72; 95% CI, 0.58-0.88) had a significantly protective effect. In the multivariate analysis, high job demand (OR, 1.48; 95% CI, 1.28-1.72) was significantly related to burnout, and high job control (OR, 0.66; 95% CI, 0.55-0.78) and high support from co-workers (OR 0.88, 95% CI, 0.78-1.00) had a significantly protective effect. Improving job stress factors, especially job control, and taking into consideration physicians' hometown and income may be important factors to prevent resignation from a current position and burnout among Japanese rural physicians.
医护人员短缺是一个全球性问题。明确包括工作压力在内的影响职场离职的因素以及导致乡村医生职业倦怠的因素很重要。该研究设计为横断面问卷调查。我们向北海道、东北、四国、九州和冲绳的乡镇医院及诊所（n = 1898）发放了问卷。参与者有509人。其中7.7%为女性，21.6%年龄小于50岁。内科或普通科医生被问及个人和工作因素、基于需求 - 控制 - 支持模型的工作压力、从当前职位辞职的意向以及使用马氏职业倦怠量表 - 通用版评估的职业倦怠情况。总体而言，10.4%的参与者打算辞职，21.8%被定义为职业倦怠阳性。在多因素逻辑回归分析中，对收入不满（比值比[OR]，3.63；95%置信区间[CI]，1.63 - 8.10）、家乡在同一县的其他乡镇（OR，3.53；95% CI，1.18 - 10.62）与辞职意向显著相关，而高工作控制（OR，0.72；95% CI，0.58 - 0.88）具有显著的保护作用。在多因素分析中，高工作需求（OR，1.48；95% CI，1.28 - 1.72）与职业倦怠显著相关，高工作控制（OR，0.66；95% CI，0.55 - 0.78）和同事的高支持度（OR 0.88，95% CI，0.78 - 1.00）具有显著的保护作用。改善工作压力因素，尤其是工作控制，并考虑医生的家乡和收入，可能是防止日本乡村医生从当前职位辞职和职业倦怠的重要因素。
