Feng Jing, Sang Wenyuan, Lei Zihui, Qu Ge, Li Xinyan, Ferrier Adamm, Jiang Heng, Pu Bo, Gan Yong
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
School of Business and Tourism, Sichuan Agricultural University, Chengdu, Sichuan, China.
Int J Soc Psychiatry. 2023 May;69(3):705-713. doi: 10.1177/00207640221133939. Epub 2022 Nov 9.
Turnover among general practitioners (GPs) has become a significant public health concern worldwide.
This study aimed to investigate the interrelationships between job satisfaction, professional identity, burnout, and turnover intention among GPs in China and to assess the mediating effect of job satisfaction on the association between burnout and turnover intention and the moderating effect of professional identity on the association between burnout and job satisfaction.
A cross-sectional study was conducted to collect data from 3,236 GPs in eastern, central, and western China between October 2017 and February 2018 using a self-administered questionnaire. Pearson's correlation analysis and hierarchical regression were used to identify the relationships between job satisfaction, professional identity, burnout, and turnover intention among Chinese GPs.
Among these respondents, 65.02% reported a medium or high level of emotional exhaustion (EE), 35.38% reported a moderate or high level of depersonalization (DP), and 62.05% reported reduced personal achievement (PA). Overall, 71.08% of GPs expressed a relatively high intention to seek another position (turnover intention). We found all 3 dimensions of burnout contributed to job dissatisfaction while turnover intention arising from burnout was associated with EE and DP. Job satisfaction had a direct negative impact on turnover intention and partially mediated the impact of EE and DP on turnover intention. Professional identity played a partial moderated role between EE and job satisfaction.
The prevalence of burnout and turnover intention among GPs is high in China. The effect of EE and DP on turnover intention is mediated by job satisfaction, and the effect of EE on job satisfaction is moderated by professional identity.
全科医生（GP）的职业流动已成为全球范围内一个重大的公共卫生问题。
本研究旨在调查中国全科医生工作满意度、职业认同、职业倦怠与离职意愿之间的相互关系，并评估工作满意度在职业倦怠与离职意愿之间的中介作用以及职业认同在职业倦怠与工作满意度之间的调节作用。
采用横断面研究方法，于2017年10月至2018年2月期间，使用自填式问卷对中国东部、中部和西部的3236名全科医生收集数据。采用Pearson相关分析和分层回归分析来确定中国全科医生工作满意度、职业认同、职业倦怠与离职意愿之间的关系。
在这些受访者中，65.02%报告有中度或高度的情感耗竭（EE），35.38%报告有中度或高度的去人格化（DP），62.05%报告个人成就感降低（PA）。总体而言，71.08%的全科医生表示有较高的换岗意愿（离职意愿）。我们发现职业倦怠的所有三个维度都导致工作不满意，而由职业倦怠引起的离职意愿与情感耗竭和去人格化有关。工作满意度对离职意愿有直接负面影响，并部分中介了情感耗竭和去人格化对离职意愿的影响。职业认同在情感耗竭与工作满意度之间起部分调节作用。
中国全科医生职业倦怠和离职意愿的发生率较高。情感耗竭和去人格化对离职意愿的影响通过工作满意度中介，情感耗竭对工作满意度的影响由职业认同调节。
