Ran Li, Chen Xuyu, Peng Shuzhen, Zheng Feng, Tan Xiaodong, Duan Ruihua
Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Wuhan, China.
Department of Health Management, Huangpi People's Hospital, Wuhan, China.
BMJ Open. 2020 Oct 7;10(10):e036702. doi: 10.1136/bmjopen-2019-036702.
Although China has done a lot in strengthening the primary healthcare system, the high turnover intention is still a social problem to be reckoned with. The objective of this study is to explore the mediating effect of satisfaction between job burnout and turnover intention.
Cross-sectional study.
A cross-sectional study was conducted to make sense of the job burnout, satisfaction and turnover intention among primary healthcare workers in central China. Structural equation modelling (SEM) was performed to study the mediating effect of satisfaction between job burnout and turnover intention with maximum likelihood estimation. The mediation effect test was carried out by using the bootstrap method.
SEM showed that job burnout was positively related to the turnover intention with the standard path coefficient of 0.845 (C.R.=34.055, p<0.001). The partial mediating effect of satisfaction was 0.047, making up 5.32% of the total effect. The goodness-of-fit was acceptable (Goodness of Fit Index=0.947, Comparative Fit Index=0.975, root mean square error of approximation=0.067, Non-Normed Fit Index=0.971, Incremental Fit Index=0.975). Age, education level, monthly income, hire form and night shift were also found significantly correlated with turnover intention, and no difference was found between physicians and nurses.
The turnover intention is significantly affected by job burnout, satisfaction and demographical characteristics including age, education level, monthly income, hire form and night shift. Satisfaction can be regarded as a mediator between job burnout and turnover intention. Relative measures can be taken to promote enthusiasm and satisfaction thus decreasing the turnover rate.
尽管中国在加强基层医疗体系方面做了很多工作，但高离职意愿仍是一个不可忽视的社会问题。本研究的目的是探讨工作倦怠与离职意愿之间满意度的中介作用。
横断面研究。
开展一项横断面研究，以了解中国中部基层医疗工作者的工作倦怠、满意度和离职意愿。采用结构方程模型（SEM），通过最大似然估计研究满意度在工作倦怠与离职意愿之间的中介作用。采用Bootstrap法进行中介效应检验。
SEM显示，工作倦怠与离职意愿呈正相关，标准路径系数为0.845（C.R.=34.055，p<0.001）。满意度的部分中介效应为0.047，占总效应的5.32%。拟合优度可接受（拟合优度指数=0.947，比较拟合指数=0.975，近似均方根误差=0.067，非规范拟合指数=0.971，增值拟合指数=0.975）。年龄、教育程度、月收入、聘用形式和夜班也与离职意愿显著相关，医生和护士之间未发现差异。
离职意愿受工作倦怠、满意度以及年龄、教育程度、月收入、聘用形式和夜班等人口统计学特征的显著影响。满意度可被视为工作倦怠与离职意愿之间的中介变量。可采取相关措施来提高工作积极性和满意度，从而降低离职率。
