中国医学专业人员工作相关压力源与心理健康之间关联的性别差异：一项全国性横断面研究。
Gender differences of the association between work-related stressors and mental health among Chinese medical professionals: a nationwide cross-sectional study.
作者信息
Chen Lin, Wu Lihong, Xia Jingjing, Cai Xixuan, Chen Liying
机构信息
Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Zhejiang, China.
出版信息
Front Public Health. 2025 Apr 8;13:1561588. doi: 10.3389/fpubh.2025.1561588. eCollection 2025.
BACKGROUND
Chinese medical professionals are under tremendous work pressure, which greatly undermines their mental health, hinders professional performance and impairs the quality of healthcare. However, the specific work-related stressor that affects mental health most and whether gender difference plays a role are not yet known. This study aims to investigate the association between work-related stressors and mental health among medical professionals in China.
METHODS
A cross-sectional online survey was conducted from September 29, 2022 to January 18, 2023 by recruiting 2,976 medical professionals from three representative provinces in China through purposive sampling. Anxiety and depressive symptoms were measured by the 7-item Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire-9 (PHQ-9) scale. Logistic regression models were performed to identify work-related stressor significantly associated with mental health and stratified by gender.
RESULTS
The prevalence of major depressive and anxiety symptoms among Chinese medical professionals was 28.2% (839/2976) and 24.0% (714/2976), respectively. Among the subjects, 43.7% (1,302/2976) of subjects reported having ≥3 work-related stressors, which was positively related to both major depressive and anxiety symptoms. The following work-related stressors were positively associated with major depressive symptoms: violence against medical staff and promotion pressure among males; medical dispute among females. The following work-related stressors were positively associated with major anxiety symptoms: medical dispute and promotion pressure among males. While no work-related stressor showed significant association with major anxiety symptoms among females.
CONCLUSION
These findings identified the specific work-related stressors related with the mental health, and gender differences are indicated in this relationship. Interventions directing at improving doctor-patient relationship may help to improve mental health of Chinese medical professionals. Reforming promotion system may mitigate the anxiety symptoms of male medical professionals.
背景
中国医学专业人员面临巨大的工作压力，这极大地损害了他们的心理健康，阻碍了专业表现，并影响了医疗保健质量。然而，目前尚不清楚最影响心理健康的具体工作相关压力源以及性别差异是否起作用。本研究旨在调查中国医学专业人员工作相关压力源与心理健康之间的关联。
方法
2022年9月29日至2023年1月18日进行了一项横断面在线调查，通过立意抽样从中国三个具有代表性的省份招募了2976名医学专业人员。采用7项广泛性焦虑障碍（GAD-7）量表和患者健康问卷-9（PHQ-9）量表测量焦虑和抑郁症状。进行逻辑回归模型以确定与心理健康显著相关的工作相关压力源，并按性别分层。
结果
中国医学专业人员中重度抑郁和焦虑症状的患病率分别为28.2%（839/2976）和24.0%（714/2976）。在研究对象中，43.7%（1302/2976）的研究对象报告有≥3种工作相关压力源，这与重度抑郁和焦虑症状均呈正相关。以下工作相关压力源与重度抑郁症状呈正相关：男性遭受的针对医务人员的暴力和晋升压力；女性的医疗纠纷。以下工作相关压力源与重度焦虑症状呈正相关：男性的医疗纠纷和晋升压力。而在女性中，没有工作相关压力源与重度焦虑症状显著相关。
结论
这些发现确定了与心理健康相关的具体工作相关压力源，并且在这种关系中存在性别差异。旨在改善医患关系的干预措施可能有助于改善中国医学专业人员的心理健康。改革晋升制度可能减轻男性医学专业人员的焦虑症状。
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