【摘要】：我國龐大的人口和日益增強(qiáng)的醫(yī)療保健意識以及醫(yī)療資源的相對稀缺使得醫(yī)療衛(wèi)生工作人員的工作量也日益增大。與此同時不斷發(fā)生的醫(yī)患沖突事件也使得醫(yī)療衛(wèi)生工作人員對自身工作的不滿和擔(dān)憂逐漸顯露。這一切都增加了醫(yī)務(wù)人員出現(xiàn)職業(yè)倦怠的風(fēng)險,而職業(yè)倦怠是一種對個人身心健康、患者和醫(yī)療機(jī)構(gòu)都非常有害的狀態(tài)。國內(nèi)目前對醫(yī)務(wù)人員職業(yè)倦怠的研究的取樣局限于少數(shù)地區(qū),樣本量也鮮有在1000以上。國內(nèi)現(xiàn)有研究已經(jīng)對工作負(fù)荷、角色應(yīng)激源和工作-家庭沖突分別對倦怠的影響做出了探索,然而卻鮮有研究從工作-家庭沖突的視角來分析工作負(fù)荷、角色應(yīng)激源和倦怠之間的作用機(jī)制,而工作和家庭又非常能夠體現(xiàn)文化的影響,對此進(jìn)行探索的研究就更加少了。 本研究采用工作倦怠問卷、工作要求和決策自主問卷、跨文化角色沖突、角色混淆和角色超載問卷以及工作影響家庭和家庭影響工作問卷對中國東中西部的2530名臨床醫(yī)生進(jìn)行了問卷調(diào)查。通過SPSS19.0和Amos17.0進(jìn)行了描述性分析、相關(guān)分析、驗證性因素分析以及運(yùn)用結(jié)構(gòu)方程模型進(jìn)行多重中介分析,得出如下結(jié)論： (1)在被調(diào)查的臨床醫(yī)生中,有85.4%的醫(yī)生處于倦怠狀態(tài),其中輕度倦怠占到41.6%,中度倦怠占35.2%,高度倦怠占到8.6%,大部分被調(diào)查醫(yī)生處于輕中度倦怠。結(jié)果還顯示,處于情感耗竭狀態(tài)的醫(yī)生占到總?cè)藬?shù)的26.8%,處于人格解體狀態(tài)的醫(yī)生占到44.4%,處于成就感降低狀態(tài)的人數(shù)則占到了93.9%。此外,本研究所調(diào)查醫(yī)生感受到的工作負(fù)荷和角色混淆均為中等偏上,工作影響家庭程度中等偏上,家庭影響工作程度較弱。 (2)本研究調(diào)查醫(yī)生工作負(fù)荷、情感耗竭、工作影響家庭和家庭影響與職業(yè)倦怠之間相關(guān)顯著。具體來說,情感耗竭與角色混淆極其顯著正相關(guān),與工作負(fù)荷極其顯著正相關(guān)。人格解體與角色混淆極其顯著正相關(guān),與工作負(fù)荷無顯著相關(guān)關(guān)系。成就感降低與角色混淆極其顯著正相關(guān),與工作負(fù)荷極其顯著負(fù)相關(guān)。此外,情感耗竭與工作影響家庭和家庭影響工作均極其顯著正相關(guān)。人格解體與工作影響家庭無顯著相關(guān)關(guān)系,與家庭影響工作極其顯著正相關(guān)。成就感降低與工作影響家庭極其顯著負(fù)相關(guān),與家庭影響工作極其顯著正相關(guān)。 (3)工作影響家庭是角色混淆和情感耗竭的部分中介變量以及角色混淆和成就感降低的部分中介變量,是工作負(fù)荷和情感耗竭的部分中介變量,是工作負(fù)荷和成就感降低的完全中介變量。家庭影響工作是角色混淆和情感耗竭的部分中介變量以及角色混淆和人格解體的部分中介變量。
[Abstract]:With the huge population, increasing awareness of medical care and the relative scarcity of medical resources, the workload of medical and health workers is also increasing day by day. At the same time, the continuous doctor-patient conflict has gradually exposed the dissatisfaction and concern of medical and health workers about their own work. All this increases the risk of job burnout for medical staff, which is a very harmful state to personal physical and mental health, patients and medical institutions. At present, the sampling of job burnout of medical staff in China is limited to a few areas, and the sample size is rarely more than 1000. The existing domestic studies have explored the effects of workload, role stress sources and work-family conflict on burnout, respectively. However, few studies have analyzed workload from the perspective of work-family conflict. The mechanism between role stress and burnout, and work and family can reflect the influence of culture very much, and the research on this is even less. In this study, job burnout questionnaire, job requirements and decision-making autonomy questionnaire, cross-cultural role conflict were used. 2530 clinicians in eastern, central and western China were investigated with role confusion and role overload questionnaire, as well as work impact on family and family. Through descriptive analysis, correlation analysis, confirmatory factor analysis and multiple intermediary analysis using structural equation model by SPSS19.0 and Amos17.0, the following conclusions are drawn: (1) among the clinicians surveyed, 85.4% of the doctors were in burnout, of which 41.6% were mild burnout, 35.2% were moderate burnout, 8.6% were highly burnout, and most of the doctors surveyed were mild to moderate burnout. The results also showed that 26.8% of the doctors were in the state of emotional exhaustion, 44.4% in the state of personality disintegration and 93.9% in the state of reduced sense of achievement. In addition, the workload and role confusion felt by doctors in this study were middle and upper, the degree of work affecting the family was higher than that of family, and the influence of family on the degree of work was weak. (2) in this study, doctors' workload, emotional exhaustion, job impact on family and family were significantly correlated with job burnout. Specifically, emotional exhaustion is positively correlated with role confusion and workload. Personality disintegration was positively correlated with role confusion, but not with workload. The decrease of achievement was positively correlated with role confusion and negatively correlated with workload. In addition, emotional exhaustion was positively correlated with the influence of work on family and family. There was no significant correlation between personality disintegration and the influence of work on the family, but there was a significant positive correlation between personality disintegration and the influence of family on work. The decrease of achievement was negatively correlated with the influence of work on the family, and positively correlated with the influence of the family on the work. (3) the influence of work on the family is a part of the intermediary variables of role confusion and emotional exhaustion, as well as some intermediary variables of role confusion and reduced sense of achievement, and is part of the intermediary variables of workload and emotional exhaustion. Is a complete intermediary variable for reduced workload and sense of achievement. Family influence work is a part of intermediary variables of role confusion and emotional exhaustion, as well as some intermediary variables of role confusion and personality disintegration.
【學(xué)位授予單位】：南京師范大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：B844.3

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