Department of Psychology, Illinois Institute of Technology.
Department of Preventive Medicine, Northwestern University.
Med Care. 2019 May;57(5):334-340. doi: 10.1097/MLR.0000000000001101.
Poor occupational health among physicians poses a serious risk both to physicians themselves and the patients under their care. Prior research has found that occupational health among nonphysicians is associated with both degree and type of work motivation.
The main purpose of this article was to assess the association between physician work motivation and their occupational health.
This study was a national survey of practicing physicians. A split-sample method was used to validate a measure of work motivation adapted for physicians.
In total, 3589 physicians were selected from the American Medical Association Physician Masterfile among whom 2247 physicians completed a survey (response rate of 62.6%).
Eight-item measure adapted from the Work Extrinsic and Intrinsic Motivation Scale. Grounded in self-determination theory, this measure includes 2 superordinate subscales of autonomous and controlled work motivation (characterized by feeling free and volitional versus pressured or compelled, respectively). Indicators of physicians' occupational health included single-item measures of general health, burnout, job satisfaction, intention to leave their practice, and intention to leave medicine, and a 2-item measure of depression risk.
Confirmatory factor analyses found that an 8-item, 2 superordinate (4 subordinate subscale) measure had good factor structure [χ(14, n=500)=35.62, P<0.001; χ(14, n=1747)=108.85, P<0.001]. Autonomous work motivation was found to be positively related to all 6 indicators of physicians' occupational health. Controlled work motivation was negatively related to 3 of 6 occupational health indicators.
Physicians who are more autonomously motivated at work reported having better occupational health. Fostering a health care work environment that supports autonomous motivation may benefit the well-being of physicians and their patients.
医生的职业健康状况不佳，不仅对医生自身，也对他们所照顾的患者构成严重威胁。先前的研究发现，非医生的职业健康状况与工作动机的程度和类型都有关。
本文的主要目的是评估医生工作动机与职业健康之间的关系。
这是一项对执业医师的全国性调查。采用拆分样本的方法对适应于医生的工作动机测量工具进行验证。
从美国医学协会医师名录中抽取了 3589 名医师，其中 2247 名医师完成了调查（回应率为 62.6%）。
采用工作外在和内在激励量表改编的 8 项测量方法。该测量方法基于自主决定理论，包括自主和控制工作动机两个上位子量表（分别表现为自由和意愿与压力或强制）。医生职业健康的指标包括一般健康、倦怠、工作满意度、离开实践的意向和离开医学的意向的单项测量，以及抑郁风险的 2 项测量。
验证性因子分析发现，8 项、2 个上位（4 个下位子量表）的测量方法具有良好的因子结构[χ(14，n=500)=35.62，P<0.001；χ(14，n=1747)=108.85，P<0.001]。自主工作动机与医生职业健康的 6 个指标均呈正相关。控制工作动机与 6 个职业健康指标中的 3 个呈负相关。
工作中更自主的医生报告职业健康状况更好。营造支持自主动机的医疗保健工作环境可能有益于医生和患者的健康。
