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中国乡村医生 burnout 影响因素的横断面研究。

Influential Factors of Burnout among Village Doctors in China: A Cross-Sectional Study.

机构信息

Department of Medical Ethics and Law, School of Health Humanities, Peking University, Beijing 100191, China.

Department of Language and Culture in Medicine, School of Health Humanities, Peking University, Beijing 100191, China.

出版信息

Int J Environ Res Public Health. 2021 Feb 19;18(4):2013. doi: 10.3390/ijerph18042013.

Abstract

(1) Background: The heavy workload and understaffed personnel of village doctors is a challenge to the rural healthcare system in China. Previous studies have documented the predictors of doctors' burnout; however, little attention has been paid to village doctors. This study aims to investigate the prevalence and influential factors of burnout among village doctors. (2) Methods: Data was collected by a self-administered questionnaire from 1248 village doctors who had worked at rural clinics for more than a year. Burnout was measured using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) with three dimensions-emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). A logistic regression model was applied to estimate the influential factors of burnout. (3) Results: The prevalence of overall burnout was 23.6%. Being male (OR = 0.58, 95%CI: 0.41-0.82), poor health status (OR = 0.80, 95%CI: 0.67-0.94), low income (OR = 0.62, 95%CI: 0.40-0.95), and a poor doctor-patient relationship (OR = 0.57, 95%CI: 0.48-0.67) were significantly related to burnout. Conclusion: Burnout is prevalent among Chinese village doctors. Policies such as increasing village doctors' income and investing more resources in rural healthcare system should be carried out to mitigate and prevent burnout.

摘要

(1) 背景:乡村医生的工作量大且人手不足,这对中国农村的医疗体系构成了挑战。先前的研究已经记录了医生倦怠的预测因素;然而,很少有人关注乡村医生。本研究旨在调查乡村医生倦怠的流行情况及其影响因素。

(2) 方法:通过自填式问卷,从在农村诊所工作超过一年的 1248 名乡村医生中收集数据。使用 Maslach 倦怠量表-人类服务调查(MBI-HSS),通过三个维度来衡量倦怠,包括情感耗竭(EE)、人格解体(DP)和个人成就感降低(PA)。应用逻辑回归模型来估计倦怠的影响因素。

(3) 结果:整体倦怠的患病率为 23.6%。男性(OR=0.58,95%CI:0.41-0.82)、健康状况差(OR=0.80,95%CI:0.67-0.94)、收入低(OR=0.62,95%CI:0.40-0.95)和医患关系差(OR=0.57,95%CI:0.48-0.67)与倦怠显著相关。结论:中国乡村医生的倦怠现象普遍存在。应实施增加乡村医生收入和加大农村医疗体系投入等政策,以减轻和预防倦怠。

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