The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, Nanjing, China.
State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China.
BMJ Open. 2019 Jul 30;9(7):e028844. doi: 10.1136/bmjopen-2018-028844.
The impact of presenteeism on doctors' health, quality of patient care and overall performance of health institutions has been reported. The study aimed to investigate the prevalence of presenteeism among doctors, the association between presenteeism and anxiety/depression, and aspects that can help alleviate presenteeism.
A cross-sectional anonymous survey study was conducted between 2017 and 2018.
30 hospitals in Hangzhou city, Zhejiang Province, China including 10 category 1 hospitals (20-99 beds), 10 category 2 hospitals (100-499 beds) and 10 category 3 hospitals (> 500 beds) which had the highest population coverage.
At least 3 doctors from each department in the studied hospitals participated. Each participant received a gift worth around US$5 at completion of the survey.
The prevalence of presenteeism and its relationship with anxiety or depression were evaluated as the primary outcomes. Secondary outcomes included the prevalence of abnormal cases of anxiety and depression.
The survey was completed by 1153/1309 hospital doctors (response rate 88.1%). Presenteeism was reported by 66.4% of participants. Using the Hospital Anxiety and Depression Scale, 68.8% and 72.3% of participants had abnormal cases of anxiety and depression, respectively. Logistic regression analysis showed that participants with abnormal cases of anxiety, borderline cases of depression or abnormal cases of depression were more likely to practice presenteeism (all p<0.05). Other significant work-related contributing factors included: time working at the current hospital, management duty, monthly salary and ease of replacement (all p<0.05).
Presenteeism was prevalent among doctors in China and the association of presenteeism with abnormal cases of anxiety or depression was significant. Considering the modifiable work-related contributing factors, appropriate measures at the healthcare institutions to support doctors' mental health, help them develop and reinforce management skills, and ensure appropriate manpower are important to alleviate presenteeism behaviour.
已有研究报告称，出勤主义对医生的健康、患者护理质量和医疗机构整体绩效都有影响。本研究旨在调查医生出勤主义的流行程度、出勤主义与焦虑/抑郁的关系，以及可以帮助减轻出勤主义的方面。
2017 年至 2018 年期间进行了一项横断面匿名调查研究。
中国浙江省杭州市的 30 家医院，包括 10 家 1 类医院（20-99 张床位）、10 家 2 类医院（100-499 张床位）和 10 家 3 类医院（>500 张床位），这些医院的人口覆盖率最高。
每家研究医院至少有来自每个科室的 3 名医生参与。每位参与者在完成调查后获得一份价值约 5 美元的礼物。
评估出勤主义的流行程度及其与焦虑或抑郁的关系是主要结果。次要结果包括焦虑和抑郁异常病例的流行率。
共有 1153/1309 名医院医生完成了调查（应答率 88.1%）。66.4%的参与者报告存在出勤主义。使用医院焦虑和抑郁量表，分别有 68.8%和 72.3%的参与者出现焦虑异常和抑郁边缘病例。Logistic 回归分析显示，焦虑异常、抑郁边缘或抑郁异常的参与者更有可能存在出勤主义（均 p<0.05）。其他显著的与工作相关的促成因素包括：在当前医院工作的时间、管理职责、月薪和易于替代（均 p<0.05）。
中国医生中存在出勤主义，且出勤主义与焦虑或抑郁异常显著相关。考虑到可改变的与工作相关的促成因素，医疗机构采取适当措施支持医生的心理健康，帮助他们发展和加强管理技能，并确保适当的人力，对于减轻出勤主义行为很重要。
