Hu Lujia, Chen Chen, Zhu Junli, Zhang Yao, Chen Yun, Jia Yufei
School of Public Health, Capital Medical University & Research Center for Capital Health Management and Policy, Beijing, People's Republic of China.
Department of Basic Health Care, Tianjin Hedong District Health Commission, Tianjin, People's Republic of China.
J Multidiscip Healthc. 2023 Apr 7;16:997-1010. doi: 10.2147/JMDH.S397501. eCollection 2023.
In China, physicians have long faced long working hours, high stress levels, and tensions between physicians and patients, which can lead to negative behaviors. Understanding physicians' expectations and requirements of the hospital and increasing satisfaction with their psychological contract can help improve physician motivation and stabilize the hospital team.
The study aims to analyze the relationship between physicians' psychological contract violations and different behavioral choices, encourage hospitals to conclude a balanced psychological contract with physicians, and provide governance and intervention strategies for hospital human resource management.
Stratified cluster sampling was used to select 321 physicians from four public hospitals in Beijing for questionnaire surveys. Descriptive statistical analysis, -test, ANOVA, correlation analysis, and regression models were performed using Stata 15.0 and SPSS 26.0 to analyze the relationship between psychological contract violations, physicians' EVLN behaviors and organizational justice.
Psychological contract violation had a positive effect on exit behavior and neglect behavior, and a negative effect on voice behavior and loyalty behavior. Organizational justice plays a mediating role between psychological contract violation and physicians' exit, voice and loyalty behaviors.
Psychological contract violation can drive negative behavior among physicians, and organizational justice can play a mediating role in this. Public hospitals should establish a healthy psychological contract with physicians and place a premium on organizational justice to promote constructive behaviors and prevent destructive behaviors. This study constructs a more complete theoretical framework to explain physicians' behavior, and further dynamic tracking investigations are necessary because the evolution of physicians' behavior is a dynamic and long-term process.
在中国，医生长期面临工作时间长、压力大以及医患关系紧张等问题，这些可能导致消极行为。了解医生对医院的期望和要求，并提高他们对心理契约的满意度，有助于提升医生的工作积极性，稳定医院团队。
本研究旨在分析医生心理契约违背与不同行为选择之间的关系，鼓励医院与医生达成平衡的心理契约，并为医院人力资源管理提供治理和干预策略。
采用分层整群抽样法，从北京四家公立医院选取321名医生进行问卷调查。使用Stata 15.0和SPSS 26.0进行描述性统计分析、t检验、方差分析、相关性分析和回归模型分析，以探讨心理契约违背、医生的EVLN行为与组织公平之间的关系。
心理契约违背对离职行为和忽视行为有正向影响，对建言行为和忠诚行为有负向影响。组织公平在心理契约违背与医生的离职、建言和忠诚行为之间起中介作用。
心理契约违背会引发医生的消极行为，组织公平在其中起中介作用。公立医院应与医生建立健康的心理契约，重视组织公平，以促进建设性行为，防止破坏性行为。本研究构建了一个更完整的理论框架来解释医生的行为，由于医生行为的演变是一个动态且长期的过程，因此有必要进一步进行动态跟踪调查。
