南京市公立医院医务人员内外部工作动机对工作投入的影响研究

目的 分析公立医院医务人员的内外部工作动机对工作投入的影响机制及内外部动机之间的关系，为提高医务人员的工作投入提供借鉴。方法 利用工作动机量表和工作投入量表，采用分层抽样方法，选取南京市3家三级医院、4家二级医院和16家社区卫生服务中心的医务人员进行问卷调查。结果 结构方程模型显示，内部动机和外部动机对工作投入的各个维度的路径系数分别为0.42、0.35、0.33（P＜0.001）和0.21、0.23、0.29（P＜0.001），内部动机和外部动机的交互项对工作投入的路径系数为- 0.13（P = 0.003）。说明医务人员内部动机、外部动机对工作投入各维度:工作活力、工作奉献和工作专注都有正向影响；外部动机与内部动机协同影响医务人员的工作投入。结论 医院应关注医生内部动机与外部动机间的差异以及工作动机对医生工作投入的影响的不同，有针对性地采用不同的激励手段，全面提升医务人员的职业素养。

Research on the influence of internal and external work motivation on work engagement of medical staff in Nanjing public hospitals

Objective To analyze the influence mechanism of internal and external work motivation of medical staff in public hospitals on work involvement and the relationship between internal and external motivation, so as to provide reference for improving the work involvement of medical staff. Methods Using work motivation scale and work involvement scale, stratified sampling method was used to select medical staff from three tertiary hospitals, four secondary hospitals and 16 primary hospitals of community health service centers in Nanjing. Results Structural equation model showed that the path coefficients of intrinsic motivation and extrinsic motivation on each dimension for work engagement were 0.42, 0.35, 0.33 (P<0.001) and 0.21, 0.23, 0.29 (P<0.001), respectively. The path coefficient of interaction between intrinsic motivation and extrinsic motivation for work engagement was -0.13 (P=0.003). It showed that internal motivation and external motivation of medical staff had a positive impact on each dimension of work engagement: work vitality, work dedication and work focus. External motivation and internal motivation synergistically affected the work engagement of medical staff. Conclusion Hospitals should pay attention to the difference between doctors’ internal motivation and external motivation as well as the difference in the influence of work motivation on doctors’ work involvement, and adopt different incentive means pertinently to comprehensively improve the professional quality of medical staff.