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了解 COVID-19 大流行期间不同学科、职责和工作压力下的疾病预防控制人员状况:来自北京疾病预防控制系统的案例。

Understanding the condition of disease prevention and control workforce by disciplines, duties, and work stress during the COVID-19 pandemic: A case from Beijing disease prevention and control system.

机构信息

Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China.

出版信息

Front Public Health. 2022 Aug 18;10:861712. doi: 10.3389/fpubh.2022.861712. eCollection 2022.

Abstract

OBJECTIVE

The duties, discipline cross-complementation, and work stress of professional staff during the COVID-19 pandemic are analyzed and summarized to provide a scientific basis for workforce allocation and reserve in respect of infectious disease prevention and control in the disease prevention and control (DPC) system.

METHOD

The cross-sectional survey was made in April-May 2021 on professional staff in the Beijing DPC system by way of typical + cluster sampling. A total of 1,086 staff were surveyed electronic questionnaire, which was independently designed by the Study Group and involves three dimensions, i.e., General Information, Working Intensity & Satisfaction, and Need for Key Capacity Building. This paper focuses on the former two dimensions: General Information, Working Intensity, and Satisfaction. The information collected is stored in a database built with Microsoft Excel 2010 and analyzed statistically with SPSS 22.0. The results are expressed in absolute quantities and proportions. Assuming that the overload of work stress is brought by incremental duties and cross-discipline tasks, a binary logistic regression model is constructed.

RESULTS

Among the 1086 staff surveyed, 1032 staff were engaged in COVID-19 prevention and control works, and they can be roughly divided into two groups by their disciplines: Public Health and Preventive Medicine (hereinafter referred to P, 637 staff, as 61.72%) and Non-Public Health and Preventive Medicine (hereinafter referred to N-P, 395 staff, as 38.28%). During the COVID-19 pandemic, the 1,032 staff assumed a total of 2239 duties, that is, 2.17 per person (PP), or 2.45 PP for the P group and 1.72 PP for the N-P group. As to four categories of duties, i.e., Spot Epidemiological Investigation and Sampling, Information Management and Analysis, On-site Disposal, Prevention, Control Guidance, and Publicity, the P group accounts for 76.14, 78.50, 74.74, and 57.66%, respectively, while the N-P group accounts for 23.86, 21.50, 25.26, and 42.34%, respectively. Obviously, the former proportions are higher than the latter proportions. The situation is the opposite of the Sample Detection and Other Works, where the P group accounts for 25.00 and 31.33%, respectively, while the N-P group accounts for 75.00 and 68.67%, respectively. The analysis of work stress reveals that the P group and N-P group have similar proportions in view of full load work stress, being 48.67 and 50.13%, respectively, and the P group shows a proportion of 34.38% in view of overload work stress, apparently higher than the N-P group (24.05%). Moreover, both groups indicate their work stresses are higher than the pre-COVID-19 period levels. According to the analysis of work stress factors, the duty quantity and cross-discipline tasks are statistically positively correlated with the probability of overload work stress.

CONCLUSION

The front-line staff in the DPC system involved in the COVID-19 prevention and control primarily fall in the category of Public Health and Preventive Medicine discipline. The P group assumes the most duties, and the N-P group serves as an important cross-complement. The study results indicate that the prevention and control of same-scale epidemic require the duty post setting at least twice than usual. As to workforce recruitment, allocation, and reserve in respect of the DPC system, two solutions are optional: less addition of P staff, or more addition of N-P staff. A balance between P and N-P staff that enables the personnel composition to accommodate both routine DPC and unexpected epidemic needs to be further discussed.

摘要

目的

分析总结新冠肺炎疫情期间专业人员的职责、学科交叉互补以及工作压力,为疾病预防控制体系传染病防控工作提供劳动力配置和储备的科学依据。

方法

2021 年 4 月至 5 月,采用典型+聚类抽样方法对北京市疾病预防控制体系专业人员进行横断面调查。共调查 1086 名工作人员,采用研究小组独立设计的电子问卷,涉及一般信息、工作强度和满意度以及关键能力建设需求三个维度。本文重点关注前两个维度:一般信息、工作强度和满意度。收集的信息存储在 Microsoft Excel 2010 中建立的数据库中,并使用 SPSS 22.0 进行统计分析。结果以绝对数量和比例表示。假设工作压力的过载是由增量职责和跨学科任务带来的,构建了二元逻辑回归模型。

结果

在所调查的 1086 名工作人员中,有 1032 名工作人员从事新冠肺炎防控工作,根据学科可大致分为两组:公共卫生与预防医学(以下简称 P,637 名工作人员,占 61.72%)和非公共卫生与预防医学(以下简称 N-P,395 名工作人员,占 38.28%)。在新冠肺炎疫情期间,1032 名工作人员承担了 2239 项职责,即每人 2.17 项(PP),P 组为 2.45 PP,N-P 组为 1.72 PP。在四个职责类别(现场流行病学调查和采样、信息管理和分析、现场处置、预防、控制指导和宣传)中,P 组分别占 76.14%、78.50%、74.74%和 57.66%,而 N-P 组分别占 23.86%、21.50%、25.26%和 42.34%。显然,前者的比例高于后者。样本检测和其他工作的情况则相反,P 组分别占 25.00%和 31.33%,而 N-P 组分别占 75.00%和 68.67%。工作压力分析表明,P 组和 N-P 组在全负荷工作压力方面的比例相似,分别为 48.67%和 50.13%,而 P 组在超负荷工作压力方面的比例为 34.38%,明显高于 N-P 组(24.05%)。此外,两组均表示工作压力高于新冠肺炎疫情前的水平。根据工作压力因素分析,工作量和跨学科任务与超负荷工作压力的概率呈统计学正相关。

结论

参与新冠肺炎防控的疾病预防控制体系一线工作人员主要属于公共卫生与预防医学学科。P 组承担的职责最多,N-P 组作为重要的交叉补充。研究结果表明,同规模疫情防控至少需要设置两倍的职责岗位。在疾病预防控制体系的劳动力招聘、配置和储备方面,有两种可选方案:减少 P 类人员的增加,或增加 N-P 类人员的增加。需要进一步讨论 P 和 N-P 人员之间的平衡,以使其人员组成能够适应常规疾病预防控制和意外疫情的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f94/9433976/6a5919eef182/fpubh-10-861712-g0001.jpg

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