广东省首批家庭医生式服务试点社区卫生技术人员工作满意度及影响因素分析研究

背景　家庭医生团队在初级保健中以温情守护居民健康，然而受基层医疗建设不足等条件的种种制约，如何保证温情守护？目的　了解广东省首批家庭医生式服务试点社区卫生技术人员的工作满意度现状及其影响因素，为基层卫生人才队伍建设提供参考依据。方法　于2014年6月-2016年6月，在广东省共36个家庭医生式服务试点的社区卫生服务中心采用分层抽样法各层按1∶1∶1的比例从3类卫生技术人员中抽取调查对象。分别是管理人员、技术服务人员及其他社区卫生工作者。采用自行设计的问卷进行调查，问卷内容包括一般人口学特征、总体工作满意度以及21项满意度因子。分析社区卫生技术人员的工作满意度现状及影响因素。结果　共发放问卷275份，回收有效问卷251份，有效回收率为91.3%。社区卫生技术人员自我评价的总体工作满意度得分是（3.8±0.7）分，217名（86.5%）社区卫生技术人员对工作感到满意或非常满意。21项满意度因子的得分均值中，得分最高的是“同事关系”（4.1±0.5）分，得分最低的是“单位福利待遇”（2.8±1.1）分。不同年龄对与领导的关系的满意度、不同文化程度对工作量的满意度、不同职称对得到同事的帮助的满意度比较，差异均有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，工作人数及分配合理程度〔OR=2.118，95%CI（1.072，4.184）〕、个人能力提高情况〔OR=2.220，95%CI（1.181，4.173）〕、单位的监督管理制度〔OR=1.905，95%CI（1.023，3.546）〕、与领导的关系〔OR=4.640，95%CI（1.328，16.214）〕和同事关系〔OR=5.111，95%CI（1.330，19.644）〕是影响总体工作满意度的因素（P<0.05）。结论　家庭医生式服务试点社区卫生技术人员有较高的工作满意度，工作人数及分配合理程度、个人能力提高情况、单位的监督管理制度、与领导的关系和同事是工作满意度的影响因素。

Job Satisfaction and Influencing Factors in the First Batch of Community Health Workers Delivered Pilot Family Doctor Services in Guangdong Province

Background　Family doctor teams in primary care safeguard residents' health in a warm way.However，due to insufficient medical construction and other constraints in primary care，it is necessary to find ways to maintain the safeguard.We explored job satisfaction and influencing factors in the first batch of community health workers delivered pilot family doctor services in Guangdong Province，providing a reference for optimizing the delivery of such services.Objective　To investigate job satisfaction and influencing factors in the first batch of community healthcare workers delivered pilot family doctor services in Guangdong Province，offering a basis for the construction of primary healthcare workforce.Methods　From June 2014 to June 2016，a survey was conducted in 3 types of number-matched health workers，managers，health professionals and other workers selected from 36 community health centers delivered pilot family doctor services by stratified sampling using a self-developed questionnaire for collecting demographic data，overall job satisfaction and satisfaction with 21 job-related factors.The job satisfaction and influencing factors were analyzed.Results　Of the 275 cases participating in the survey，251（91.3%） responded effectively，among whom 217（86.5%） were satisfied or very satisfied with the job.The overall job satisfaction score was（3.8±0.7）.Among 21 job-related factors，"colleague relationship" was scored highest〔with an average satisfaction score of （4.1±0.5）〕，and "unit welfare" was scored lowest〔with an average satisfaction score of （2.8±1.1）〕.Age was associated with the significant difference in the satisfaction with "relationship with leaders"（P<0.05）.Education level was associated with the significant differences in the satisfaction with "workload"（P<0.05）.Professional title was associated with the significant difference in the satisfaction with "help from colleagues"（P<0.05）.Multivariate Logistic regression analysis showed that the number and reasonable allocation of workers〔OR=2.118，95% CI （1.072，4.184）〕，personal ability improvement 〔OR=2.220，95%CI （1.181，4.173）〕，unit supervisory management system 〔OR=1.905，95%CI （1.023，3.546）〕，relationship with leaders 〔OR=4.640，95%CI （1.328，16.214）〕 and colleagues relationship 〔OR=5.111，95%CI （1.330，19.644）〕 were the factors affecting overall job satisfaction （P<0.05）.Conclusion　Family doctor based community health technicians are satisfied with their job.The number of workers and the reasonable allocation，personal ability improvement，unit supervisory management system，relationship with leaders and colleagues relationship are the factors affecting overall job satisfaction.