贵州省医务人员亚健康影响因素通径分析

摘要:目的 构建医务人员亚健康影响因素之间的关系模型，提出医务人员职业伤害防护策略。方法 调查贵州省25家综合医院1 601名医务人员过去1年亚健康现状，采用通径分析探讨各因素与亚健康之间的相互关系。结果 医务人员亚健康现状及工作效能感、医院组织环境的满意度均不容乐观，总体得分仅为中等水平。医务人员亚健康发生与工作效能感、医院组织环境满意度有显著相关性，差异均有统计学意义（P ＜ 0.001）。工作效能感对医务人员亚健康状态既有直接效应作用，又有中介作用，效应系数为-0.11。组织环境各维度对亚健康影响不一致，防护设施直接效应不明显，通过工作效能感间接影响，效应系数为0.19； 环境压力起正向效应（效应系数0.30），既有直接效应作用，还通过工作效能感而间接影响作用（效应系数分别为0.38、-0.08）；工作场所在亚健康中起负向效应（效应系数-0.03），具有直接效应和通过工作效能感而间接影响作用（效应系数分别为-0.14、0.11）；安全政策在亚健康中的直接效应系数为-0.01；安全文化起正向效应（效应系数为0.23），具有直接效应和通过工作效能感间接影响（效应系数分别为-0.06、0.29）。结论 影响医务人员亚健康是多因素共同促成的，需要从提升医务人员的工作效能感，完善安全防护设施、减轻工作环境压力、营造良好的安全文化氛围等方面进行综合干预。

Analysis on the influencing factors of sub-health condition among medical staff of general hospital of Guizhou province using the path analysis model

Abstract: Objective The aim of this study was to establish relationship models among influencing factors of sub-health of medical staffs, in order to provide the basis for medical staff occupational injuries protection strategy. Methods A total of 1601 medical staffs from 25 general hospitals were studied using the CALIS process to analysis the implicit variable relationship among the three models in Guizhou Province. Results The sub-health status and self-efficacy of working and hospital organization environment satisfaction of medical staffs were not optimistic. The overall score was medium level. The sub-health of medical staffs were related to self-efficacy of working and hospital organization environment satisfaction (P ＜ 0.001). The self-efficacy of working played a role of direct effect and mediation, and the effect coefficient was -0.11. The direct effect was not obvious of protection facilities to sub-health state, through the self-efficacy indirectly, and the effect coefficient was 0.19. The environmental pressures had a positive effect on sub-health state of medical staff (effect coefficient, 0.30), which can be decomposed into direct effects and indirect effects through job self-efficacy (effect coefficient were respectively 0.38 and -0.08). Workplace negatively influenced on medical personnel of sub-health state (effect coefficient of -0.03), which directly affect the effect coefficient of -0.14. Self-efficacy of working had indirect effect coefficient of 0.11. The security policies played directly effect on sub-health condition of medical staffs (effect coefficient was -0.01). The safety culture played indirect effect on sub-health condition of medical staff (effect coefficient was 0.23), which could be decomposed into direct effects and indirect effects through job self-efficacy (effect coefficient were respectively -0.06 and 0.29). Conclusion The sub-health of medical staffs were affected by multi-factors. We should adopt comprehensive intervention measures to improve the medical staff from job self-efficacy, perfect safety protection facilities, reduce the pressure of the working environment, create a good safety culture atmosphere and so on.