重庆市基层全科医生工作满意度及其影响因素研究

背景　目前我国基层医疗机构全科医生缺口较大,尤其是西部农村地区,导致了基层全科医生工作任务繁重,执业环境差,长期处于超负荷状态,严重影响了其工作满意度,调查其工作满意度并分析影响因素,可以为稳定基层医疗人才队伍、提升基层医疗服务质量提供依据。目的　调查重庆市基层全科医生工作满意度的现状及其影响因素。方法　于2015年5—11月,采取分层随机抽样的方法,在重庆市抽取了27个区（县）的58家基层医疗卫生机构的354例全科医生进行问卷调查。问卷内容包含基本情况、执业状况、职业认知与素质、工作满意度评价。其中工作满意度评价采用5级评分法,从“很不满意”~“很满意”计为1~5分。最终回收有效问卷338份,有效回收率为95.5%。结果　基层全科医生工作满意度总平均分为（2.75±0.83）分,不同性别、任职科室、每周工作量、工资年收入、工作单位类型、最高学历、职称、家人对从事全科医学工作的支持程度及职业热爱程度的全科医生工作满意度评分比较,差异有统计学意义（P<0.05）。多元线性回归分析显示,影响全科医生工作满意度的因素有性别、任职科室、每周工作量、工作单位类型、最高学历、职称、家人对从事全科医学工作的支持程度及职业热爱程度（P<0.05）。结论　基层全科医生工作满意总体不高。相比较而言女性、任职于妇产科、每周工作量大、工作于乡镇卫生院、具有硕士学历、中级职称、家人支持度低及职业热爱程度低的全科医生工作满意度较低。针对这些因素,通过采取降低工作强度、提高薪资待遇等措施来提高全科医生工作满意度,真正地将人才留在基层。

Job Satisfaction and Associated Factors among General Practitioners from Primary Healthcare Institutions in Chongqing

Background　There has been great shortage of general practitioners（GPs） in primary hospitals in China,especially in western rural areas,where the practice environment is poor and the GPs bear heavy work tasks chronically,resulting in statistically GPs' low job satisfaction.Therefore,investigating GPs' job satisfaction and associated factors contributes to stabilizing the primary care workforce and improving the quality of primary care services.Objective　To investigate the job satisfaction and associated factors among GPs from primary healthcare institutions in Chongqing.Methods　From May to November 2015,a survey was conducted among a stratified random sample of 354 GPs from 58 primary healthcare institutions in 27 districts and counties of Chongqing.A questionnaire was used to investigate：basic personal information,practicing status,career awareness and quality,job satisfaction.Among them,a 5-level scoring method was used to evaluate job satisfaction ,ranging from "very dissatisfied" to "very satisfied" was assigned a score of 1 to 5.A total of 338 cases handed in responsive questionaires,with a response rate of 95.5%.Results　The average total score of job satisfaction in the respondents was（2.75±0.83）.Significant variations in job satisfaction score were found to be related to sex,department,weekly workload,annual salary,type of work unit,highest education level,professional title,family support and professional enthusiasm（P<0.05）.Multiple linear regression analysis showed that gender,department,weekly workload,type of work unit,highest education level,professional title,family support and professional enthusiasm were significantly associated with job satisfaction score（P<0.05）.Conclusion　In general,the job satisfaction level is not satisfactory in GPs in primary healthcare institutions in Chongqing.Female,working at department of obstetrics and gynecology,heavy weekly workload,working in township hospital,master's level education,medium-grade professional title,low family support,and low professional enthusiasm are associated with low job satisfaction.In view of this,reducing the workload and enhancing the salary and other facilitation measures need to be taken to improve job satisfaction level in GPs and to retain general practice talents in primary healthcare institutions.