Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
School of Health and Nursing, Wuchang University of Technology, Wuhan, China.
Front Public Health. 2022 Jun 16;10:901251. doi: 10.3389/fpubh.2022.901251. eCollection 2022.
There is evidence that occupational stress is a risk factor for turnover intentions. However, the structural relationship between occupational stress and turnover intention among emergency physicians has rarely been studied. This study aimed to examine the pathways of occupational stress on turnover intention through job satisfaction and depressive symptoms among emergency physicians in China.
A cross-sectional study was conducted in China from July 2018 to August 2018. Data were collected using a structured questionnaire that included demographic characteristics, occupational stress, job satisfaction, depressive symptoms, and turnover intention. Hierarchical linear regression was performed to explore the related factors of turnover intention. Structural equation modeling was used to examine the pathways from occupational stress to turnover intention.
A total of 10,457 emergency physicians completed the questionnaire. The score of turnover intention was 11.34 (SD = 3.25), and the average item score of turnover intention was 2.84 (SD = 0.81). In structural equation modeling, the occupational stress not only had a direct effect on turnover intention (standardized direct effect = 0.311, bias-corrected 95% confidence interval [0.261, 0.361], < 0.001), but also had an indirect effect through job satisfaction and depressive symptoms (standardized indirect effect = 0.448, bias-corrected 95% confidence interval [0.412, 0.484], < 0.001). However, the effect of depressive symptoms on turnover intention was weak (standardized coefficient [β] = 0.08, < 0.001).
Job satisfaction partially mediated the relationship between occupational stress and turnover intention. However, due to the weak effect of depressive symptoms on turnover intention, the mediating role of depressive symptoms between occupational and turnover intention had little practical value. It is recommended that hospital administrators prioritize increasing job satisfaction of emergency physicians to reduce the impact of occupational stress on their turnover intention.
有证据表明职业压力是离职意向的一个风险因素。然而，职业压力与中国急诊医师离职意向之间的结构关系很少被研究。本研究旨在通过工作满意度和抑郁症状检验职业压力对中国急诊医师离职意向的作用途径。
2018 年 7 月至 8 月在中国进行了一项横断面研究。使用包括人口统计学特征、职业压力、工作满意度、抑郁症状和离职意向的结构化问卷收集数据。采用分层线性回归分析来探讨离职意向的相关因素。采用结构方程模型检验职业压力与离职意向的作用途径。
共有 10457 名急诊医师完成了问卷。离职意向的得分是 11.34（SD=3.25），离职意向的平均项目得分是 2.84（SD=0.81）。在结构方程模型中，职业压力不仅对离职意向有直接影响（标准化直接效应=0.311，偏校正 95%置信区间[0.261,0.361]，<0.001），而且通过工作满意度和抑郁症状有间接影响（标准化间接效应=0.448，偏校正 95%置信区间[0.412,0.484]，<0.001）。然而，抑郁症状对离职意向的影响较弱（标准化系数[β]=0.08，<0.001）。
工作满意度部分中介了职业压力与离职意向之间的关系。然而，由于抑郁症状对离职意向的影响较弱，抑郁症状在职业压力与离职意向之间的中介作用实际意义不大。建议医院管理者优先提高急诊医师的工作满意度，以降低职业压力对其离职意向的影响。
