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中国急诊科医生工作场所暴力与抑郁症状之间的关系:职业倦怠的中介作用

Relationship between workplace violence and depressive symptoms among emergency department physicians in China: the mediating role of occupational burnout.

作者信息

Zhang Ruofan, Qu Ge, Feng Jing, Sun Yuchao, Li Xinyan, Shen Aoqi, Jiang Heng, Luo Yingbin, Xu Zixin, Song Xingyue, Lv Chuanzhu, Zuo Yanli, Li Zhong, Gan Yong, Lu Zuxun

机构信息

Huazhong University of Science and Technology, Tongji Medical College, School of Public Health, Department of Social Medicine and Health Management, Wuhan, China.

La Trobe University, School of Psychology and Public Health, Department of Public Health, Melbourne, Australia.

出版信息

J Glob Health. 2025 Sep 19;15:04259. doi: 10.7189/jogh.15.04259.

Abstract

BACKGROUND

Workplace violence (WPV) was a global public health issue worldwide. Given the specificity of emergency department physicians' professional roles, the incidence of WPV was significantly higher than that of practitioners in other healthcare groups. Investigating the association between exposure to WPV and psychological health can provide a scientific basis for managers to implement precise interventions on violent incidents, thereby effectively reducing the adverse impacts of WPV.

METHODS

A multi-stage random sampling method was employed to conduct a questionnaire survey among 14 848 emergency department physicians across 31 provincial-level administrative regions in China from July to September 2019. This survey utilised the WPV Scale, the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and the Center for Epidemiological Studies Depression Scale (CES-D) to investigate the levels of WPV, burnout, and depressive symptoms among respondents. Data analysis were performed using STATA 17.0 and Amos 26.0 software.

RESULTS

A total of 90.40% of emergency department physicians reported experiencing at least one incident of WPV in the past year. The mean score for depressive symptoms was 16.80 ± 14.78, and the mean score for burnout was 82.94 ± 26.11. The correlation coefficients between WPV and depressive symptoms, WPV and job burnout, and depressive symptoms and job burnout were 0.444, 0.347, and 0.562, respectively (all P < 0.01). Structural equation analysis indicated that the total effect of WPV on depressive symptoms was 0.471, with a mediating effect of burnout at 0.421, accounting for 89.38% of the total effect.

CONCLUSIONS

Emergency department physicians had a severe level of depressive symptoms and burnout, with burnout playing a mediating role between WPV and depressive symptoms. Therefore, future policy efforts are warranted to build a supportive work environment for emergency department physicians and consequently enhance their well-being.

摘要

背景

工作场所暴力(WPV)是一个全球性的公共卫生问题。鉴于急诊科医生职业角色的特殊性,WPV的发生率显著高于其他医疗群体的从业者。调查接触WPV与心理健康之间的关联可为管理者对暴力事件实施精准干预提供科学依据,从而有效降低WPV的不利影响。

方法

采用多阶段随机抽样方法,于2019年7月至9月对中国31个省级行政区的14848名急诊科医生进行问卷调查。本调查使用WPV量表、马氏职业倦怠量表-人类服务调查(MBI-HSS)和流行病学研究中心抑郁量表(CES-D)来调查受访者的WPV、职业倦怠和抑郁症状水平。使用STATA 17.0和Amos 26.0软件进行数据分析。

结果

共有90.40%的急诊科医生报告在过去一年中至少经历过一次WPV事件。抑郁症状的平均得分为16.80±14.78,职业倦怠的平均得分为82.94±26.11。WPV与抑郁症状、WPV与职业倦怠、抑郁症状与职业倦怠之间的相关系数分别为0.444、0.347和0.562(均P<0.01)。结构方程分析表明,WPV对抑郁症状的总效应为0.471,职业倦怠的中介效应为0.421,占总效应的89.38%。

结论

急诊科医生存在严重程度的抑郁症状和职业倦怠,职业倦怠在WPV与抑郁症状之间起中介作用。因此,未来有必要通过政策努力为急诊科医生营造支持性的工作环境,从而提高他们的幸福感。

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