School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Hebei Medical University, Hebei, 050017, China.
BMC Prim Care. 2024 Sep 17;25(1):341. doi: 10.1186/s12875-024-02593-0.
Primary health-care workers (PHWs) managed increased workloads and pressure during the COVID-19 pandemic. This study conducted a national survey examining burnout among PHWs at the end of the COVID-19 pandemic, and identifies related factors. By doing so, it addresses the gap in understanding the burnout situation among PHWs at a national level, taking into account urban-rural disparities.
We conducted a nationwide cross-sectional survey of PHWs in China from May to October 2022, covering 31 provinces. The MBI-HSS was used to measure overall burnout and emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). We used multivariable logistic regression to identify risk factors, and subgroup analyses to identify differences between rural and urban areas.
3769 PHWs from 44 primary health-care institutions completed the survey. Overall, 16.6% reported overall burnout, and the prevalence of EE, DP, and reduced PA was 29.7%, 28.0%, and 62.9%, respectively. The prevalence of overall burnout (17.6% vs. 13.7%, P = 0.004) and EE (31.5% vs. 24.8%, P < 0.001) was higher in urban than rural areas (AOR = 1.285; 95%CI, 1.021-1.617). Job satisfaction was a protective factor against burnout in both settings. The protective factors of overall burnout, EE and DP vary between urban and rural areas.
The Mental Health Status Questionnaire-Short Form (MSQ-SF) score functioned as a protective factor against burnout across both rural and urban locales, highlighting the intrinsic link between job satisfaction and burnout. Other influencing factors differed between urban and rural areas, so interventions should be tailored to local conditions. Rural married PHWs experienced the lower prevalence of burnout indicates the support structure may play a significant role. In urban settings, it is recommended to strategically pre-emptively stock essential supplies like PPE.
初级保健工作者（PHWs）在 COVID-19 大流行期间管理着增加的工作量和压力。本研究通过全国性调查，在 COVID-19 大流行结束时对 PHWs 的倦怠情况进行了研究，并确定了相关因素。这样做可以解决全国范围内 PHWs 倦怠情况理解不足的问题，同时考虑到城乡差异。
我们于 2022 年 5 月至 10 月期间在中国进行了一项全国性的 PHWs 横断面调查，涵盖了 31 个省份。使用 MBI-HSS 来衡量整体倦怠、情绪疲惫（EE）、去人格化（DP）和成就感降低（PA）。我们使用多变量逻辑回归来确定风险因素，并进行亚组分析以确定城乡之间的差异。
来自 44 个初级保健机构的 3769 名 PHWs 完成了调查。总体而言，16.6%的人报告存在整体倦怠，EE、DP 和 PA 降低的患病率分别为 29.7%、28.0%和 62.9%。城市地区的整体倦怠（17.6%比 13.7%，P=0.004）和 EE（31.5%比 24.8%，P<0.001）的患病率高于农村地区（AOR=1.285；95%CI，1.021-1.617）。工作满意度是两种环境下倦怠的保护因素。整体倦怠、EE 和 DP 的保护因素在城乡之间有所不同。
心理健康状况问卷-短式（MSQ-SF）评分在城乡地区都是倦怠的保护因素，突出了工作满意度和倦怠之间的内在联系。城乡地区的其他影响因素不同，因此干预措施应因地制宜。农村已婚 PHWs 的倦怠患病率较低，表明支持结构可能发挥重要作用。在城市地区，建议战略性地预先储备基本物资，如个人防护设备。
