医护工作投入和工作特征现况及相关分析

目的:调查、比较医生和护士工作投入与工作特征之间的相关性以及医生和护士工作特征对工作投入的影响作用,为改善医院管理、稳定医护队伍及开发人力资源提供政策依据。方法:采用工作投入量表和工作特征量表,对新疆兵团三甲医院467名医护人员进行问卷调查。结果:医生工作投入得分(3.68±1.055),护士工作投入得分(3.20±1.062),医护两个群体工作投入及工作特征差异有统计学意义,且医生工作投入和工作特征的得分高于护士。结论:医护工作投入处于中等水平,工作特征对其工作投入具有一定影响,医生工作自主性对工作投入影响最大,而护士工作重要性对工作投入的影响最明显。     

医院护理人员工作负荷、工作压力与满意度认知及相关因素研究

目的：护理人员对工作负荷、工作压力和工作满意度的自我认识与评价；工作负荷与工作压力及工作满意度的相关关系；年龄、学历、工作年限等个人特征对工作负荷、工作压力和工作满意度认知的影响。方法：分层整群抽样方法，对两所三级医院按科室分布抽取科室，对所遗科室的所有在壕正式护士进行问卷调查。调查前说明调查目的，取得被调查者知情同意，问卷应答率为93％。结果：83．7％的护理人员认为工作负荷重，80．5％报告护理工作压力大，护理人员工作平均满意度为3．0，收入满意度为2．6。工作负荷与工作压力有正相关关系，与收入和工作满意度呈负相关关系。工作负荷重的原因主要是护理人员缺乏。护理工作压力大的原因主要是工作负荷重和担心人身安全。工作收入低，工作不受重视，个人才能难以发挥，职称晋升难是满意度低的主要因素。结论：护理人员工作负荷重，工作压力大，工作满意度不高。护理工作负荷与工作压力、收入与工作满意度之间有相关关系。调查结果对医院管理人员刳定医院护理人力责源管理对策，合理配备与使用护理人员，减轻护理人员工作负荷与压力，提高其工作满意度有重要参考意义。     

思想政治工作与业务工作要坚持结合与渗透

思想政治工作对各项具体业务工作的服务和保证作用是通过将思想政治工作同医院的各项具体业务工作结合起来进行，使思想政治工作渗透到各项具体业务工作中去，坚持经济手段和行政手段相结合，与解决群众思想实际问题相结合，与群众的各项活动相结合，与医教研工作过程相结合，并做到与工作目标一致，与工作程序一致，把政治工作做到业务工作的重要环节上。     

医生工作负荷、工作满意度及人力配置认知意向调查

目的:医生对工作负荷、人力配置、工作压力和满意度的自我认识与评价;年龄、学历、工作年限等个人特征对工作负荷、工作压力和工作满意度认知的影响。方法:分层整群抽样方法,对两所三级医院按科室分布抽取科室,对所选科室的所有在编医生进行问卷调查。结果:60.3%的医生认为工作负荷重,69.3%报告工作压力大,医生工作平均满意度为3.3%,收入满意度2.6%。有一半以上的医生认为现有人力配置数量、结构不适宜。工作负荷重的原因主要是医生缺乏。工作压力大的原因主要是医疗工作风险大、工作负荷重、急危重病人多。结论:医生工作负荷重、工作压力大、工作满意度不高。调查结果对医院管理人员制定医院医疗人力资源管理对策,合理配备与使用医生,减轻医生工作负荷与压力,提高其工作满意度有着重要的现实意义。     

新疆生产建设兵团基层医院医生工作倦怠和工作特征相关研究

[目的]分析新疆生产建设兵团基层医生工作倦怠与工作特征的相关性,为从工作特征方面有效激励医生,提高工作积极}生,及稳定基层医院医疗队伍提供理论依据。[方法]从新疆生产建设兵团团场医院、连队卫生室及社区卫生服务中心随机抽职372名基层医生,采用马斯勒倦怠问表和工作特征量表进行问卷调查。[结果]工作意义和工作反馈都能较好的减轻医生的情绪衰竭和消极工作症状;工作自主性既能降低的情绪衰竭也可以提高个人成就感;工作负荷和工作对个体情绪表达的要求对情绪衰竭和消极工作具有预测作用,技能多样性、工作意义和工作对个体情绪表达的要求对个人成就感都有积极作用。[结论]降低或保持适度工作负荷,明确工作意义和工作要求,增加培训技能多样性,提高工作自主性意识,给予工作反馈,提高自我保健能力与理性处事能力是预防医生工作倦怠的重要措施。     

儿科护理人员工作压力原因及对策分析

目的：观察儿科护理人员工作压力的原因及对策。方法资料选取于本院儿科工作的护理人员共58例,采用自制的儿科护士工作压力调查问卷对其产生工作压力的原因进行调查,并测定得分。结果40（72.73）例儿科护理工作者认为工作压力主要来源于工作环境或资源;其次39（70.91）例来源于患儿护理及其家属工作;且患儿护理及家属工作（77.25±6.71）分,工作环境或资源（88.75±2.51）分。结论儿科护理人员工作压力的主要来源是工作环境或资源,其次为患儿的护理与家属工作,医院应加强对护理人员工作环境的改善力度,并采取配套措施,有效减轻其工作压力,提升工作质量。     

工作场所暴力对商丘市医务人员工作能力、工作满意度和转岗打算影响的通径分析

目的以职业紧张理论为模式探讨工作场所暴力对医务人员工作能力、工作满意度、转岗打算的影响,为科学评价工作场所暴力的作用过程和不良后果提供理论依据。方法采用分层整群随机抽样的方法抽取河南省商丘市5家市级医院483名医务人员作为研究对象,运用自制调查表对其遭受工作场所暴力、暴力恐惧、暴力应对资源、工作能力、工作满意度、转岗打算等情况进行调查。采用有序结果变量回归和通径分析探讨各变量的关系。结果通径分析显示:(1)工作场所暴力既可直接影响工作能力和工作满意度,又可间接通过暴力恐惧影响工作能力和工作满意度。(2)工作场所暴力通过暴力恐惧、工作满意度间接影响转岗打算。结论遭受工作场所暴力可以通过直接或间接作用影响医务人员的工作能力、工作满意度、转岗打算。应采取措施,控制工作场所暴力的发生以降低其不良影响。     

某市不同专业外科医生职业紧张状况分析

目的探讨不同专业外科医生的职业紧张。方法采用职业紧张测量工具测量职业紧张因素、紧张缓解因素和紧张反应,并调查年龄、性别、文化程度等一般情况。数据分别进行χ2检验、方差分析和逐步回归分析。结果紧张因素中工作冲突、工作危险、工作控制和工作角色,缓解因素中应对策略、自尊感,在不同专业外科医生中得分均不同(P0.05);不同专业外科医生紧张反应中工作满意感、心身症状、日常紧张感得分不同(P0.05)。逐步回归分析显示其主要影响因素为医院等级、工作冲突、与工作无关活动、外科专业、工龄、周工作时间等;工作危险、工作前景、工作角色、工作班、物理环境、应对策略是影响心理卫生的主要因素;社会支持、提升与参与机会、工作前景、物理环境、外科专业、工作角色、工作控制、工作班是影响心身症状的主要因素:工作角色、工作前景、工作危险、性别、行为方式、社会支持、周工作时间、物理环境、应对策略和工作单调性是抑郁症状的主要影响因素;社会支持、工作需求、工作单调性、工作角色、工作危险、物理环境和工作控制则是日常紧张感的主要影响因素。结论不同专业外科医生职业紧张分布不同,要切实降低其职业紧张应采取具有针对性的措施。     

职业人群工作紧张对工作耗竭影响的流行病学研究

目的探讨职业人群工作紧张对工作耗竭的影响。方法采用横断面研究方法,调查上海城区7种职业2 458名20～63岁职业人群。工作紧张评估采用工作要求与控制(JDC)、工作付出—回报(ERI)问卷,同时调查个体特征与行为因素,工作耗竭选用李超平教授在国内修订的MBI-GS,多因素非条件logistic回归方法分析社会心理因素对肌肉骨格症状患病的影响。结果教师、社区医护工作、公交车驾驶员情感耗竭、人格解离的评分明显高于其他职业人群,且工作耗竭的阳性率较高。工作耗竭与高工作紧张、低社会支持、高工作付出—回报不平衡、低工作回报存在联系。结论从事社会服务的职业人群工作耗竭阳性率较高,工作紧张可能是预测城市职业人群工作耗竭的危险因素。     

广东省湛江市护士工作投入状况及相关因素

[目的]探讨广东省湛江市护士工作投入的水平,及社会支持和工作家庭冲突对其造成的影响. [方法]便利选取该市的1457名护士,采用一般情况调查表、《社会支持量表》《工作家庭冲突量表》及《工作投入量表》进行问卷调查. [结果]回收有效问卷1250份.护士的社会支持、工作-家庭冲突、家庭-工作冲突、工作投入得分分别为(3.79±0.63)、(4.36±1.41)、(2.81 ±1.10)和(3.45士1.17)分.相关分析显示,社会支持与工作-家庭冲突和家庭-工作冲突呈负相关(r=-0.11、-0.19,P＜0.01),与工作投入呈正相关(r=0.33,P＜0.01);工作-家庭冲突和家庭-工作冲突与工作投入呈负相关(r=-0.28、-0.30,P＜0.01).回归分析显示,社会支持、工作-家庭冲突、家庭-工作冲突都可影响护士的工作投入,累积变异解释率为20％.同时,工作-家庭冲突和家庭-工作冲突在社会支持与工作投入之间发挥部分中介作用. [结论]广东省湛江市护士的社会支持和工作投入不高,仅略高于量表条目得分均值水平,有待进一步提高;工作-家庭冲突较高,家庭-工作冲突得分较低.增加工作中的支持既可直接促进护士的工作投入,也可通过降低护士工作与家庭间的冲突感间接增进工作投入.     

Promotion of work ability, the quality of work and retirement

In this study, the validity of a model designed to promote the work ability of aging workers was examined. The target areas of work ability promotion were searched for the characteristics that explain work ability the best. In addition, the way work ability relates to the quality of work and retirement was examined. The subjects (n = 1101) participated in the follow-up study on aging Finnish workers in 1992 and 1997. The results consistently supported the model for promoting work ability. All four areas of focus-(i) work demands and the environment; (ii) work organization and the work community; (iii) the promotion of workers' health and functional capacity; and (iv) the promotion of professional competence-proved to be strongly associated with work ability. Good work ability was associated with a high quality of work and the enjoyment of staying in one's job. It also predicted active and meaningful retirement.     

Modified Work and Return to Work: A Review of the Literature

Workplace injuries which result in lost time from work can have considerable financial repercussions for employer and employee alike, not to mention their physical and emotional impact on the employee. In order to lessen workers' compensation costs and facilitate the rehabilitation process, some employers offer modified work to their injured employees in order to allow an earlier return to work than would ordinarily be possible. Although modified work is regarded by many as a cornerstone in the job rehabilitation process, little is known about the structure, effectiveness, and efficiency of such programs. This report is a systematic review of the scientific literature on modified work published since 1975. Its objective is to synthesize and critically appraise the research on modified work, and, specifically, to assess the effectiveness of modified work programs. Using a systematic keyword search in three online libraries, 29 empirical studies of modified work programs were selected for review. The studies were evaluated for methodological quality, from which 13 higher quality studies were identified. On the basis of these 13 studies, the effectiveness of modified work programs was evaluated. The main finding of this review is that modified work programs facilitate return to work for temporarily and permanently disabled workers. Injured workers who are offered modified work return to work about twice as often as those who are not. Similarly, modified work programs cut the number of lost work days in half. The available evidence also suggests that modified work programs are cost-effective. Comprehensive cost-benefit analyses are needed to confirm this finding.     

我国医务社会工作发展现状与思考

通过对我国已有的医务社会工作研究成果和前沿信息进行分析,总结国外、港台以及内陆地区医务社会工作的开展现状与工作模式,分析我国现阶段医务社会工作的现状以及存在的问题,归纳并探索适合我国的新型医务社会工作模式与工作内容,为优化我国的医务社会工作提供借鉴。     

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。     

Psychosocial factors at work in relation to low back pain and consequences of low back pain; a systematic, critical review of prospective cohort studies

Relevant studies of low back pain (LBP) published between 1990 and 2002 were systematically retrieved via electronic databases and checking of reference lists. Forty papers fulfilled the inclusion criteria; 10 were of high quality. A wide variety of instruments had been used for collection of data on work related psychosocial factors, many of which had not undergone any form of validation. Moderate evidence was found for no association between LBP and perception of work, organisational aspects of work, and social support at work. There was insufficient evidence for a positive association between stress at work and LBP. No conclusions could be drawn regarding perception of work and consequences of LBP. There was strong evidence for no association between organisational aspects of work and moderate evidence for no association between social support at work and stress at work and consequences of LBP.     

Case-control study of risk factors for disease in the neck and shoulder area.

A case-control study was performed to elucidate the strength of the relation between musculoskeletal disorders in the neck and shoulders and physical, organisational, and psychosocial aspects of the work environment. Cases were identified as those persons who consulted a physician in a community in southern Sweden for new musculoskeletal disorders in the neck and shoulders during a study period from August 1988 to the end of October 1989. One hundred and nine cases were collected and clinically examined. The cases also answered the Nordic questionnaire on symptoms as well as a questionnaire on work conditions and background factors. Controls were drawn as a random sample of the working population in the community where the cases appeared. A total of 637 controls answered the same questionnaires as the cases. Odds ratios (ORs) were calculated by logistic regression. The odds ratios were 11.4 for women, 4.9 for immigrant background, and 3.7 for current smoking. To exercise rarely, compared with often, appeared as a preventive factor with an OR of 0.3. The ORs for various determinants of physical work load were 7.5 for repetitive movements demanding precision, 13.6 for light lifting, 3.6 for uncomfortable sitting positions, 4.8 for work with lifted arms, and 3.5 for a rushed work pace. Regarding work organisational determinants, the ORs were 16.5 for ambiguity of work role (uncertainty whether the person could manage the work) 2.6 for low quality work, and 3.8 for high demands on attention. Several of the determinants showed a significant dose-response relation with disease. It seems that work organisation and psychosocial work conditions are as important determinants for disease in the neck and shoulders as are the physical work conditions.     

Barriers for Early Return-to-Work of Workers with Musculoskeletal Disorders According to Occupational Health Physicians and Human Resource Managers

Recent studies have indicated positive effects of modified work for workers with musculosceletal complaints. The question remains how effectively modified work can be implemented in companies. This study describes barriers for introducing modified work for workers on sickness absence due to musculoskeletal complaints. Modified work was defined as gradually increasing the physical demands at work until the worker is ready for full duty in his regular job. In order to describe barriers in implementation of modified work, a model based on health education was used, consisting of six successive stages. A questionnaire derived from this model was sent to human resource managers of different companies and their occupational health physicians. The internal consistency was estimated with the Cronbach's alpha. The results showed a large number of barriers for modified work. According to 52% of the company management and 54% of the occupational health physicians evident barriers were found due to lack of knowledge on modified work and negative attitudes of the employees. Both companies and physicians reported a barrier in the possibilities to change the work tasks (45-54%) or the organization of the work (45-38%). About 62% of the companies reported barriers due to a mismatch between the education of the sick worker and the specific requirements of modified work. Despite the assumed positive effects of modified work, the implementation process is hampered by a large number of barriers. A maximum effort from all parties involved is required for a successful rehabilitation process.     

The work of hospitalized patients

Patient's participation in their own care, conceived as work, is the central theme of this paper. A second theme is the patients' work in relation to technology. A third is: the prevalence of chronic illness and how this relates to patients' work in the service of their own care. Data are from a multi-hospital field-research and interviewing study of technology and patient care, carried out in San Francisco and the Bay Area, California. Questions addressed in this paper include the following: What are the sources of patients' work? What types of work do patients do? How does that work relate to courses of illness and the phases? What is the relation of that work to staff work? Under what conditions is the work visible or invisible to staff? Under what conditions is the work appreciated or not by staff? What are some consequences of patient work for staff work, for the management of the courses of illness, and for the patients' own medical and biographical fates? How does patient work at the hospital relate to patient work done at home?     

ICU护士工作压力现状及其影响因素

目的了解ICU护士工作压力现状及其影响因素,为减轻ICU护士工作压力提供科学依据。方法 2013年10月,对唐山市工人医院13个重症监护室的204名护士进行问卷调查。结果护士工作轻度压力41人,占20.1%;中度压力144人,占70.6%;重度压力19人,占9.3%。多元回归分析发现,ICU护士工作压力受医院待遇满意度、对工作环境满意度、社会支持和患者病情的影响（P〈0.05）。结论 ICU护士工作压力呈中度水平,应引起高度重视。