Influence factors of job burnout of medical staff in the anesthesiology department of Nanjing general hospital
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摘要:
目的 了解南京市麻醉科医护人员职业倦怠现状，分析影响职业倦怠的各种因素。 方法 选择5家医院263名麻醉相关人员进行问卷调查。应用马氏工作倦怠量表-服务行业版(Maslach Burnout Inventory-Human Service Survey, MBI-HSS)和一般资料问卷，用非条件logistic回归分析模型分析职业倦怠的影响因素。 结果 所调查的麻醉科医护人员的职业倦怠总检出率为80.53%，重度倦怠的检出率为8.01%。多因素分析显示，没有行政职务(OR=0.164，95% CI: 0.065~0.415)、工作之余经常聊天放松(OR=0.360, 95% CI: 0.167~0.776)、健康状况好(OR=0.441, 95% CI: 0.239~0.815)、工作强度低(OR=0.505, 95% CI: 0.273~0.934)、增加月收入(OR=0.478, 95% CI: 0.328~0.696)会减少医务人员的职业倦怠；而每月手术抢救次数多(OR=1.754, 95% CI: 1.094~2.813)、没有业余兴趣爱好(OR=2.069, 95% CI: 1.145~3.739)、建议不能得到及时反馈(OR=2.244, 95% CI: 1.213~4.154)、缺乏良好职业发展(OR=2.087, 95% CI: 1.196~3.642)会增加医务人员的职业倦怠。 结论 南京市麻醉科医务人员职业倦怠较普遍，且职业倦怠与多种因素有关。 Abstract:Objective To investigate the current status of job burnout levels among medical staff in the anesthesiology department of Nanjing City and to identify its influencing factors. Methods Maslach Burnout Inventory-Human Service Survey (MBI-HSS) and the general information questionnaires were used to evaluate the job burnout status among 263 medical staff members from five hospitals in Nanjing. The unconditional logistic regression model was employed to investigate the influeneing factors of job burnout. Results The detection rate of job burnout and severe job burnout among doctors and nurses in the anesthesiology department were 80.53% and 8.01%, respectively. Multivariate logistic regression analysis showed that being not an administrator (OR=0.164, 95% CI: 0.065-0.415), regular after-work socializing (OR=0.360, 95% CI: 0.167-0.776), having good health condition (OR=0.441, 95% CI: 0.239-0.815) and having low working intensity (OR=0.505, 95% CI: 0.273-0.934), increasing monthly income (OR=0.478, 95% CI: 0.328-0.696) were associated with decreased risk of job burnout. Conversely, having high number of emergency rescue per month (OR=1.754, 95% CI: 1.094-2.813), without hobbies after work (OR=2.069, 95% CI: 1.145-3.739), can not receive feedback for requirement timely (OR=2.244, 95% CI: 1.213-4.154), lack of good career development (OR=2.087, 95% CI: 1.196~3.642) were associated with a increased risk of job burnout. Conclusions Job burnout is common among medical staff in anesthesiology department of Nanjing City, and the burnout was associated with a variety of factors. -
Key words:
- Job burnout /
- Influencing factor /
- Medical staff
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表 1 研究对象的个人基本情况
Table 1. Basic information of study population
变量
Variable组别
Grouping人数(占比/%)
Number of people (proportion/%)变量
Variable组别
Grouping人数(占比/%)
Number of people (proportion/%)性别 Gender 男 Male 86(32.82) 业余兴趣爱好 Hobbies after work 没有 No 112(42.75) 女 Female 176(67.18) 有 Yes 150(57.25) 年龄组/岁 Age group/years < 25 41(15.65) 行政职务 Administrator 没有 No 216(82.44) 25~＜30 121(46.18) 有 Yes 46(17.56) 30~＜35 56(23.37) 职业发展 Career development 没有 No 126(48.09) 35~＜40 21(8.02) 有 Yes 136(51.91) ≥40 23(8.78) 每月手术抢救次数
Surgical rescue monthly0 81(30.92) 专业类别 Profession 麻醉医生 Anesthesiologist 62(23.66) 1~＜3 147(56.11) 麻醉护士 Nurse anesthetist 96(36.64) ≥3 34(12.98) 器械护士 Instrument nurse 40(15.27) 健康状况 Health condition 非常差 Bad 8(3.05) 巡回护士 Circulating nurse 42(16.03) 较差 Relatively bad 33(12.60) 恢复室护士 Recovery room nurse 22(8.40) 一般 General 174(66.41) 月收入/元Monthly income/yuan < 5 000 12(4.58) 较好 Relatively good 45(17.18) 5 000~＜10 000 172(65.65) 非常好 Good 2(0.76) 10 000~＜15 000 58(22.14) 工作强度 Working intensity 非常大 High 46(17.55) 15 000~＜20 000 16(6.11) 比较大 Relatively high 141(53.82) ≥20 000 4(1.53) 一般 General 75(28.63) 比较小 Relatively low 0(0) 非常小 Low 0(0) 
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表 2 麻醉科医护职业倦怠与国内样本相比较
Table 2. Comparison of job burnout between the medical staff sample in the anesthesia department and the domestic sample
职业倦怠维度
Dimensions of job burnout麻醉科医生
Anesthesiologist
(n=62)
(x±s)国内样本
Domestic sample
(n=1 080)
(x±s)t值
valueP值
value手术室护士
Operating room nurse(n=200) (x±s)杭州市护士
Nurse sample in Hangzhou(n=1 320) (x±s)t值
valueP值
valueEE 23.08±9.89 22.19±9.53 0.709 0.481 20.19±7.98 23.02±10.29 -5.004 0.001 DP 7.56±5.39 7.12±5.22 0.650 0.518 6.26±4.89 6.81±5.57 -1.574 0.117 PA 23.11±6.17 36.53±13.25 -17.108 0.001 22.86±6.18 28.55±9.34 -12.995 0.001 注：EE, 情感衰竭; DP, 去人性化; PA, 个人成就感。
Note: EE, emotional exhaustion; DP, depersonalization; PA, personal accomplishment.
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表 3 职业倦怠各维度得分情况
Table 3. Scores of each dimension for job burnout
变量 Variable 例数 Number of people EE
(x±s)t/F值
valueP值
valueDP
(x±s)t/F值
valueP值
valuePA
(x±s)t/F值
valueP值
value性别 Gender 5.046 0.026 2.650 0.105 0.256 0.614 男 Male 86 22.17±9.80 7.58±5.74 22.99±6.89 女 Female 176 20.24±7.81 6.08±4.59 22.89±5.81 职业发展 Career development 0.294 0.588 5.634 0.018 没有 No 126 21.81±8.43 7.26±4.91 0.109 0.072 21.63±5.28 有 Yes 136 20.01±8.59 5.93±5.08 24.11±6.70 工作与家庭冲突
Conflict between work and family4.395 0.001 0.722 0.608 1.559 0.172 非常小 Low 22 16.50±6.08 6.00±4.62 23.18±8.67 较小 Relatively low 24 16.79±4.02 5.58±3.09 21.25±5.01 一般 General 66 21.09±8.57 7.11±5.60 24.48±6.22 较大 Relatively high 38 23.32±9.20 6.58±6.03 22.95±6.33 非常大 High 9 28.11±8.98 8.67±6.00 23.78±3.31 专业类别 Profession 3.118 0.009 3.663 0.003 1.826 0.018 麻醉医生 Anesthesiologist 62 23.08±9.89 7.56±5.39 23.11±6.18 麻醉护士 Nurse anesthetist 96 19.67±7.09 6.28±4.41 22.92±5.67 手术室护士 Operating room nurse 82 20.48±8.23 6.54±6.22 22.21±5.82 恢复室护士 Recovery room nurse 22 23.30±9.96 7.35±4.15 21.10±4.84 行政职务 Administrator 13.498 0.001 3.148 0.077 0.104 0.747 没有 No 216 20.05±7.75 6.31±4.81 22.49±6.14 有 Yes 46 24.78±10.82 7.83±5.90 24.98±5.97 每月手术抢救次数
Surgical rescue monthly13.922 0.001 4.795 0.030 3.229 0.074 0 81 18.4±16.34 5.52±3.91 22.00±5.95 1~＜3 147 21.64±8.96 6.74±5.48 23.31±6.36 ≥3 34 23.47±9.97 8.35±4.94 工作强度 Working intensity 16.307 0.001 3.712 0.026 1.823 0.164 非常大 High 46 26.74±10.65 8.28±5.41 24.43±5.87 比较大 Relatively high 141 20.35±7.51 5.98±4.55 22.44±5.87 一般 General 75 18.27±7.27 6.64±5.49 22.91±6.68 比较小 Relatively low 0 非常小 Low 0 每天睡眠时间/h
Sleeping time every day/h8.947 0.001 1.885 0.154 0.637 0.530 < 6 51 25.16±9.91 7.76±4.83 23.35±6.37 6~＜9 208 19.91±7.89 6.30±5.07 22.87±6.15 ≥9 3 15.00±2.65 5.00±4.58 19.33±4.16 健康状况 Health condition 12.972 0.001 5.931 0.001 4.101 0.003 非常差 Bad 8 34.00±13.91 12.25±5.92 20.00±7.21 较差 Relatively bad 33 27.12±9.91 8.96±5.13 21.91±5.50 一般 General 174 19.70±7.65 6.18±5.03 23.13±6.15 较好 Relatively good 45 18.84±6.28 5.49±3.68 22.71±5.74 非常好 Good 2 13.50±3.54 2.50±0.71 38.50±3.54 月收入/元 Monthly income/yuan 4.938 0.001 1.393 0.237 3.973 0.004 < 5 000 12 21.92±11.59 8.42±7.95 21.83±6.05 5 000~＜10 000 172 20.26±8.24 6.17±4.94 22.29±6.20 10 000~＜15 000 58 20.58±6.87 6.81±4.00 23.55±5.01 15 000~＜20 000 16 23.44±10.89 7.75±6.62 27.62±7.87 ≥20 000 4 38.00±6.68 10.00±4.08 27.75±3.09 工作之余聊天放松 Chatting after work 19.009 0.001 18.306 0.001 2.043 0.132 从不 Never 10 35.40±11.98 14.60±7.34 26.00±8.89 偶尔 Occasionally 160 21.05±8.06 6.82±5.17 22.44±5.80 经常 Occasionally 92 19.00±7.41 5.27±3.44 23.42±6.39 建议得到及时反馈
Receive feedback for requirement timely15.368 0.001 0.625 0.430 0.298 0.586 是 Yes 174 19.29±7.37 5.71±4.87 23.55±6.11 否 No 88 24.02±9.79 8.27±4.94 21.68±6.12 注：EE, 情感衰竭; DP, 去人性化; PA, 个人成就感。
Note: EE, emotional exhaustion; DP, depersonalization; PA, personal accomplishment.
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表 4 自变量赋值情况
Table 4. Variable assignment
变量 Variable 赋值情况 Assignment 行政职务 Administrator 有=1；没有=2 Yes=1, No=2 工作强度 Working intensity 非常大=1；比较大=2；一般=3；比较小=4；非常小=5
High=1; Relatively high=2; General=3; Relatively low=4; Low=5健康状况 Health condition 非常差=1；较差=2；一般=3；较好=4；非常好=5
Bad=1; Relatively bad=2; General=3; Relatively good=4; Very good=5工作之余聊天放松 Chatting after work 从不=1；偶尔=2；经常=3
Never=1; Occasionally=2; Often=3每月手术抢救次数 Surgical rescue monthly 0=1；1~＜3=2；≥3=3 业余兴趣爱好 Hobbies after work 有=1；没有=2 Yes=1; No=2 建议得到及时反馈 Receive feedback for requirement timely 是=1；否=2 Yes=1; No=2 职业发展 Career development 有=1；没有=2 Yes=1; No=2 月收入/元 Monthly income/yuan < 5 000=1；5 000~＜10 000=2；10 000~＜15 000=3；15 000~＜20 000=4；≥20 000=5
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表 5 职业倦怠的多因素logistic回归分析模型
Table 5. Multivariate logistic regression analysis of job burnout
职业倦怠维度
Dimensions of job burnout变量
Variableβ sx Wald值
valueOR值
value (95% CI)P值
valueEE 行政职务 Administrator -1.809 0.474 14.541 0.164(0.065~0.415) 0.001 工作之余聊天放松 Chatting after work -1.021 0.391 6.803 0.360(0.167~0.776) 0.009 健康状况 Health condition -0.818 0.313 6.831 0.441(0.239~0.815) 0.009 工作强度 Working intensity -0.683 0.314 4.745 0.505(0.273~0.934) 0.029 DP 工作之余聊天放松 Chatting after work -0.820 0.293 7.848 0.441(0.248~0.782) 0.005 健康状况 Health condition -0.591 0.243 5.930 0.554(0.344~0.891) 0.015 每月手术抢救次数 Surgical rescue monthly 0.562 0.241 5.441 1.754(1.094~2.813) 0.020 业余兴趣爱好 Hobbies after work 0.727 0.302 5.799 2.069(1.145~3.739) 0.016 建议得到及时反馈 Receive feedback for requirement timely 0.808 0.314 6.627 2.244(1.213~4.154) 0.010 PA 月收入 Monthly income -0.738 0.192 14.769 0.478(0.328~0.696) 0.010 职业发展 Career development 0.736 0.284 6.716 2.087(1.196~3.642) 0.010 注：EE, 情感衰竭; DP, 去人性化; PA, 个人成就感。
Note: EE, emotional exhaustion; DP, depersonalization; PA, personal accomplishment.
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