医护人员职业倦怠影响因素的结构方程模型分析

张萌; 崔倩; 朱长才

doi:10.16462/j.cnki.zhjbkz.2022.07.011

医护人员职业倦怠影响因素的结构方程模型分析

doi: 10.16462/j.cnki.zhjbkz.2022.07.011

430065 武汉，武汉科技大学公共卫生学院环境卫生与职业医学系

基金项目:

职业危害识别与控制湖北省重点实验室开放基金 OHIC2019G01

详细信息

通讯作者:
朱长才，E-mail: zcc621120@163.com

中图分类号: R395.6
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- 被引次数: 0
出版历程
- 收稿日期: 2021-07-16
- 修回日期: 2021-11-30
- 网络出版日期: 2022-07-19
- 刊出日期: 2022-07-10

The influencing factors of job burnout among medical staff by structural equation model

Department of Environmental Health and Occupational Medicine, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China

Funds:

Open Fund Project of Hubei Provincial Key Laboratory of Occupational Hazard Identification and Control OHIC2019G01

More Information

Corresponding author: ZHU Chang-cai, E-mail: zcc621120@163.com

摘要

摘要: 目的了解医护人员职业倦怠的影响因素及其作用机制，为采取有针对性的干预措施提供科学依据。方法采用多阶段随机抽样方法，选取湖北省某地区1 938名医护人员为研究对象进行职业倦怠现况调查，运用结构方程模型探讨其工作压力、焦虑、社会支持、自我效能等对职业倦怠的作用机制。结果湖北省某地区医护人员的职业倦怠综合得分为[34.00(25.00, 41.00)]分，职业倦怠检出率为64.09%。工作压力、焦虑与职业倦怠均呈正相关(均有P＜0.05)；社会支持、自我效能与职业倦怠均呈负相关(均有P＜0.05)。结构方程模型分析结果显示，工作压力对职业倦怠有直接正向效应(β=0.451, P=0.010)，并通过焦虑产生间接影响(β=0.129, P=0.010)；焦虑对职业倦怠有直接正向效应(β=0.360, P=0.010)；社会支持对职业倦怠有直接负向效应(β=-0.141, P=0.010)，调节变量工作压力与支持利用度对职业倦怠有负向效应(β=-0.051, P=0.018)。结论工作压力和焦虑为湖北省某地区医护人员职业倦怠的危险因素，提高社会支持特别是支持利用程度可以有效地减少其职业倦怠的发生。
- 医护人员 /
- 职业倦怠 /
- 工作压力 /
- 结构方程模型
Abstract: Objective To understand the influencing factors and mechanism of job burnout among medical staff, and to provide the scientific basis for taking targeted intervention measures. Methods A total of 1 938 medical staff in a certain area of Hubei Province were selected as subjects by multi-stage random sampling method. The job burnout status was investigated by questionnaire survey. The mechanism of job burnout caused by work stress, anxiety, social support and self-efficacy was analyzed by structural equation model. Results The overall score of job burnout among medical staff in a certain area of Hubei Province was [34.00(25.00, 41.00)], and the detection rate of job burnout was 64.09%. Job burnout was positively correlated with work stress and anxiety (all P < 0.05), whereas it was negatively associated with social support and self-efficacy (all P < 0.05). The results of the structural equation model showed that work stress had a direct positive effect on job burnout (β=0.451, P=0.010), which was also indirectly affected by anxiety (β=0.129, P=0.010). And anxiety also had a direct positive influence on job burnout (β=0.360, P=0.010), while social support (β=-0.141, P=0.010) and moderating variables such as work stress and support utilization (β=-0.051, P=0.018) had direct negative effects on job burnout. Conclusions Work stress and anxiety are the risk factors of job burnout among medical staff in a certain area of Hubei Province. Work stress and anxiety can be effectively reduced by social support, especially the degree of support utilization.
- Medical staff /
- Job burnout /
- Working pressure /
- Structural equation model

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图 1 湖北省某地区医护人员职业倦怠影响因素的结构方程模型

Figure 1. Structural equation model for influencing factors of job burnout among medical staff in a certain area of Hubei Province

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表 1 湖北省某地区医护人员的职业倦怠情况

Table 1. Job burnout of medical staff in a certain area of Hubei Province

倦怠类型	人数[n(%)]	平均得分[M(P₂₅, P₇₅)]
无倦怠	696(35.91)	23.00(15.00, 28.75)
轻度倦怠	576(29.72)	35.00(31.00, 37.00)
中度倦怠	440(22.71)	41.00(38.00, 44.00)
重度倦怠	226(11.66)	46.00(43.00, 51.00)
合计	1 938(100.00)	34.00(25.00, 41.00)

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表 2 湖北省某地区医护人员职业倦怠相关影响因素间的Spearman相关分析(r)

Table 2. Spearman correlation analysis of influencing factors of job burnout among medical staff in a certain area of Hubei Province (r)

变量	职业倦怠	情绪衰竭	去个性化	低成就感	社会支持	焦虑	自我效能	压力
职业倦怠	1.000	-	-	-	-	-	-	-
情绪衰竭	0.709 ^a	1.000	-	-	-	-	-	-
去个性化	0.769 ^a	0.666 ^a	1.000	-	-	-	-	-
低成就感	0.704 ^a	0.163 ^a	0.280 ^a	1.000	-	-	-	-
社会支持	-0.325 ^a	-0.201 ^a	-0.235 ^a	-0.274 ^a	1.000	-	-	-
焦虑	0.508 ^a	0.440 ^a	0.412 ^a	0.326 ^a	-0.302 ^a	1.000	-	-
自我效能	-0.294 ^a	-0.190 ^a	-0.165 ^a	-0.312 ^a	0.172 ^a	-0.171 ^a	1.000	-
工作压力	0.488 ^a	0.552 ^a	0.547 ^a	0.147 ^a	-0.174 ^a	0.327 ^a	-0.169 ^a	1.000
注：^a为P＜0.05。

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表 3 湖北省某地区医护人员职业倦怠影响因素结构方程模型拟合优度评价结果

Table 3. Evaluation results of model goodness of fit of structural equation model for influencing factors of job burnout among medical staff in a certain area of Hubei Province

评价指标	χ²/df	GFI	AGFI	CFI	IFI	NFI	RMSEA
参考标准	＜5.000	＞0.900	＞0.900	＞0.900	＞0.900	＞0.900	＜0.080
结果	4.843	0.980	0.957	0.978	0.978	0.972	0.045

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表 4 湖北省某地区医护人员职业倦怠影响因素标准化效应分解

Table 4. Standardization effect decomposition of influencing factors of job burnout among medical staff in a certain area of Hubei Province

路径	总效应(95% CI)值	直接效应(95% CI)值	间接效应(95% CI)值
工作压力→焦虑	0.358(0.316~0.404) ^a	0.358(0.316~0.404) ^a	-
工作压力→职业倦怠	0.580(0.545~0.616) ^a	0.451(0.409~0.487) ^a	0.129(0.108~0.150) ^a
焦虑→职业倦怠	0.360(0.305~0.401) ^a	0.360(0.305~0.401) ^a	-
社会支持→职业倦怠	-0.141(-0.180~-0.095) ^a	-0.141(-0.180~-0.095) ^a	-
工作压力×支持利用度→职业倦怠	-0.051(-0.088~-0.025) ^a	-0.051(-0.088~-0.025) ^a	-
注：^a为P＜0.05。

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