基层医疗卫生机构基本公共卫生服务从业人员工作满意度及影响因素研究

背景　国家基本公共卫生服务已经实施十多年并取得了一定的成效，基层基本公共卫生服务从业人员作为服务的直接提供者，研究其工作的满意度及影响因素，有利于提高服务的质量与效率。目的　了解基层基本公共卫生服务从业人员总体工作满意度及其影响因素，并提出相应的建议。方法　于2019年11-12月，从浙江省、山西省、重庆市3个省（市）分别选取2个市辖区作为调查地区，其次依据各地区社区卫生服务中心/乡镇卫生院名单进行方便抽样，共抽取53个基层医疗卫生机构，每个机构至少随机调查10例基本公共卫生服务的从业人员。利用自行设计问卷对553例从事基本公共卫生服务的医务人员进行调查，问卷内容包括一般人口学特征、工作总体满意度及10项满意度因子。结果　回收有效问卷553份，基层基本公共卫生服务从业人员工作总体满意得分为（3.66±0.77）分，60.5%（334/552）从业人员对总体工作感到满意或非常满意。在各项满意度因子中，医患关系得分最高，为（3.84±0.68）分，工作强度满意度最低，为（2.86±0.81）分。多因素逐步Logistic回归分析结果显示，社会尊重、绩效考核、工作能力和工作强度是基本公共卫生从业人员工作总体满意度的影响因素（P<0.05）。结论　从事基本公共卫生服务的医务人员工作总体满意度一般，应增强社会公众对基本公共卫生服务从业医务人员的尊重，优化绩效考核制度，减轻工作负荷，提高从事基本公共卫生服务医务人员的工作满意度。

Job Satisfaction and Influencing Factors among Essential Public Health Practitioners in Primary Care

Background　Some public health achievements have been made in China since the nationwide implementation of essential public health services more than 10 years ago. Public health workers in primary care are the direct providers of essential public health services，so studying their job satisfaction and associated factors is conducive to improve the quality and efficiency of public health services. Objective　To understand the overall job satisfaction and associated factors among essential public health practitioners in primary care，then put forward corresponding suggestions. Methods　From November to December 2019，purposive sampling was used to select six urban districts of three regions（Zhejiang，Shanxi and Chongqing） of China（two districts were extracted from each region）. Secondly，convenient sampling was carried out according to the list of community health service centers/township health centers in each district. A total of 53 grass-roots medical and health institutions were selected，and at least 10 employees of basic public health services were randomly investigated in each institution. A survey was used to collect demographics，scores of overall job satisfaction and satisfaction with 10 job-related factors of these medical workers using a questionnaire developed by our research team. Results　The survey achieved a response rate of 100%. The score of overall job satisfaction rated by participants was （3.66±0.77） on average. The participants who were satisfied or very satisfied with their job accounted for 60.5%（334/553）. Among the satisfaction with job-related factors，the doctor-patient relationship was rated highest（3.84±0.68），and satisfaction with work intensity was rated lowest（2.86±0.81）. Multivariate Logistic regression analysis demonstrated that social recognition，performance appraisal，work ability and work intensity were significantly associated with the overall job satisfaction（P<0.05）. Conclusion　The overall job satisfaction of these public health workers in primary care was fair. Recommendations to improve their job satisfaction are as follows：increasing social recognition of public health workers，optimizing the performance appraisal system，and reducing the workload appropriately.