School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, China.
Department of Academic Affairs, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China.
Front Public Health. 2022 Sep 20;10:925882. doi: 10.3389/fpubh.2022.925882. eCollection 2022.
In China, COVID-19 has undoubtedly posed a huge challenge to the capacity of rural public health services. Village public health service providers are responsible for reporting and dealing with infectious diseases and public health emergencies. However, the turnover of village public health service providers is gravely threatening the stability of rural primary health system step by step. This study systematically evaluated the effects of professional identity, job satisfaction, burnout on turnover intention of village public health service providers, and further measured the mediating effect of job satisfaction and burnout between professional identity and turnover intention.
From May to June 2019, 1,244 village public health service providers in Shandong Province were selected as the research objects. Sociodemographic characteristics, professional identity, job satisfaction, burnout and turnover intention were quantitated by self-completed questionnaire and measured by Likert 5-7 scale. Person correlation analysis, One-way ANOVA, and Structural Equation Modeling (SEM) were used for statistical analysis and mediating effect evaluation.
Five hundred and sixty-four (45.3%) village public health providers had high turnover intension. Professional identity had a direct positive effect on job satisfaction (β = 0.146, < 0.001), job satisfaction had a direct negative effect on burnout (β = 0.263, < 0.001), and turnover intension (β = -0.453, < 0.001), while burnout had a direct positive effect on turnover intension (β = 0.242, < 0.001). Between professional identity and turnover intention, job satisfaction 95%CI: (-0.289)-(-0.11) had significant mediating effects. Job satisfaction 95%CI: (-0.216)-(-0.077) also had significant mediating effects between professional identity and burnout, and burnout had significant mediating effects between job satisfaction and turnover intension, 95%CI: (-0.116)-(-0.052). These results strongly confirm that professional identity, job satisfaction, and burnout are early and powerful predicators of turnover intention.
According to the results, medical administration and management departments should pay attention to improve the professional attraction of public health services by improving the public's understanding of the profession, reducing work intensity, timely granting of subsidy funds, improving old-age security, ensuring the income level, increasing the new force and so on, so as to reduce turnover intension and ensure the health equity of village residents.
在中国，COVID-19 无疑对农村公共卫生服务能力提出了巨大挑战。乡村公共卫生服务提供者负责报告和处理传染病和突发公共卫生事件。然而，乡村公共卫生服务提供者的人员流动正逐渐威胁着农村初级卫生系统的稳定。本研究系统评估了专业认同、工作满意度、倦怠对乡村公共卫生服务提供者离职意愿的影响，并进一步衡量了工作满意度和倦怠在专业认同与离职意愿之间的中介作用。
2019 年 5 月至 6 月，从山东省选取 1244 名乡村公共卫生服务提供者作为研究对象。采用自填式问卷对人口统计学特征、专业认同、工作满意度、倦怠和离职意愿进行定量测量，采用 Likert 5-7 量表进行测量。采用Person 相关分析、One-way ANOVA 和结构方程模型（SEM）进行统计分析和中介效应评价。
564 名（45.3%）乡村公共卫生提供者离职意愿较高。专业认同对工作满意度有直接的正向影响（β=0.146，<0.001），工作满意度对倦怠有直接的负向影响（β=0.263，<0.001），对离职意愿（β=-0.453，<0.001），而倦怠对离职意愿有直接的正向影响（β=0.242，<0.001）。在专业认同与离职意愿之间，工作满意度 95%CI：（-0.289）-（-0.11）有显著的中介效应。工作满意度 95%CI：（-0.216）-（-0.077）在专业认同和倦怠之间也有显著的中介效应，而倦怠在工作满意度和离职意愿之间有显著的中介效应，95%CI：（-0.116）-（-0.052）。这些结果有力地证实了专业认同、工作满意度和倦怠是离职意愿的早期和强大预测因子。
根据研究结果，医疗管理部门应通过提高公众对职业的认识、降低工作强度、及时发放补贴资金、改善老年保障、确保收入水平、增加新力量等措施，提高公共卫生服务的职业吸引力，以降低离职意愿，确保农村居民的健康公平。
