住院医师／专科医师对规范化培训带教师资和培训管理的满意度调查分析

目的调查参加规范化培训的住院医师／专科医师对带教师资综合职业能力和培训管理的满意度,进一步了解不同医院开展毕业后医学教育所面临的问题和进行毕业后医学教育规范化培训异同。艿珐采用自制问卷对成都市4所三级甲等医院598名住院／专科医师进行问卷调查．对收集的数据进行因子分析和方差分析。结呆受调查的598名住院医师／专科医师对带教师资的综合职业能力的满意度评分在3．83～4．11之间（满分为5分）．而对培训管理的满意度评分在2．91～3．75之间,且不同医院住院医师/专科医师的满意度有差异性P〈0．05。结论无论教学医院还是非教学医院,都应加强带教师资建设和培训管理．才能提高住院医师／专科医师对规范化培训的满意度,以促进住院医师／专科医师规范化培训的顺利开展。     

公立医院医务人员工作满意度影响因素与治理机制

针对当前医务人员工作满意度偏低、医患矛盾突出的社会现状,现有医务人员工作满意度研究缺失考察患者对医务人员的理性尊重、认可、信任,现行社会医疗体制、公共舆论环境等内容及条目设计,也缺乏将医务人员满意度测评与多元利益相关主体协同治理体系结合起来等理论与现实问题,本文在大量文献研究基础上,界定了治理视角下公立医院医务人员工作满意度概念;提出了"工作本身、组织管理、工作条件、工作回报、人际关系"五要素测评的内在维度;厘清了政府—医患—社会层面参与公立医院治理的主要利益相关主体以及各自职能、权利与社会医疗责任,探寻了影响医务人员工作满意度的外在治理因素;构建了医务人员工作满意度概念及多元协同治理结构逻辑模型,分析了各主体之间及其对医务人员工作满意度的作用机制;针对性提出了治理机制框架及思考,供学界争鸣与讨论。     

Inpatient satisfaction and job satisfaction/stress of medical workers in a hospital with the 7:1 nursing care system (in which 1 nurse cares for 7 patients at a time)

Objectives  

Inpatient satisfaction, job satisfaction/stress of medical workers, and hospital profitability under the 7:1 nursing care system (in which 1 nurse cares for 7 patients at a time) were compared with those under the 10:1 system at a hospital with the diagnosis procedure combination (DPC) payment system.     

重庆市基层医务人员工作压力、工作满意度与离职意愿情况及影响因素分析

目的 了解重庆市基层医务人员工作压力、工作满意度、离职意愿等情况,探究其影响因素,为改善基层人才流失提出建议。方法 分层随机整群抽样的方法抽取重庆市52家基层医疗机构的医务人员进行问卷调查。离职意愿的影响因素分析采用多元线性回归,工作满意度、工作压力则采用单因素分析 结果 重庆市基层医务人员工作压力较大（3.57±0.86）;工作满意度总体情况较好（3.36±0.78）,但工作回报满意度低（3.12±0.91）;26.13%的医务人员有离职意向,离职意愿平均得分为（2.77±1.09）。区县经济水平（β = - 0.066, P＜0.001）、年龄（β = -0.023, P＜0.001）、行政职务（β = 0.108, P = 0.001）、学历（β = 0.043, P = 0.022）、职称（β = 0.046, P = 0.012）、工作回报满意度（β = - 0.343, P＜0.001）、医院组织管理满意度（β = - 0.208, P＜0.001）、医院内工作环境满意度（β = - 0.152, P＜0.001）及工作压力（β = 0.195, P＜0.001）是影响医务人员离职意愿的重要因素。结论 应以提高薪资福利为重点,特设基层职称晋升体系,加强社会支持,拓宽引才渠道,尤其是对全科医生的引进,从而改善基层人才流失问题。     

西部地区基于行政村分类乡村医生收入水平及满意度影响因素

目的 探讨中国西部地区不同行政村分类下, 乡村医生的收入水平及满意度的差异, 并分析收入满意度的因素。方法 选取青海省和广西壮族自治区4个县的141名乡村医生进行调查, 并采用描述、聚类、多元回归等统计方法进行分析。结果 按照面积、每村平均户数和村民平均年收入3项指标进行聚类分析, 将141个行政村分为发展村(30个)、控制村(70个)和偏远村(41个);三类行政村中的乡村医生月均收入为(1 983.29±1 662.15)元、平均收入满意度(2.35±0.61)分;多元回归分析结果显示, 不同行政村分类下影响乡村医生收入满意度的因素不同;其中, 发展村的影响因素为出(巡)诊最远往返距离、出诊时间、乡镇卫生院是否派人到村卫生室出诊和坐诊时间;控制村的影响因素为是否为新农合定点机构;偏远村的影响因素为坐诊时间和是否从事其他工作。结论 西部地区乡村医生的收入水平及收入满意度现状偏低, 不同类型村庄乡村医生收入满意度的影响因素不同。     

世界卫生组织青年专业职员现状、选送培养经验及启示

目的：定量分析世界卫生组织（World Health Organization,WHO）青年专业职员的规模、国别分布和工作地点,总结优势国家的选送和培养经验,为培养并向世界卫生组织输送青年专业职员提供参考。方法：收集建立世界卫生组织2016—2020年青年专业职员数据库并进行分析;通过文献研究总结优势国家的选送和培养经验。结果：（1）世界卫生组织青年专业职员总体规模在增大,选派国在增多;（2）青年专业职员工作地点主要在总部,除美洲区外,其余五个区域办公室也有分布;（3）选送人数较多国家的做法主要为提供招聘信息、与本国高校合作提供培训、建立交流渠道、提供社交经费等。结论：了解世界卫生组织青年专业职员的现状和人才培养与派遣机制的国际经验,可以为中国参与全球卫生治理、构筑战略性多边关系提供参考。     

县级公立医院薪酬激励与员工满意度研究——基于黑龙江省的调查

目的:了解县级公立医院薪酬激励效果及其对工作满意度的影响。方法:抽取黑龙江省6所县级公立医院,对其医务人员进行问卷调查及访谈。采用因子分析对薪酬激励措施进行归类,用描述性统计及Logistic回归分析薪酬激励效果以及工作满意度的影响因素。结果:通过因子分析将薪酬激励措施分为直接物质报酬、间接物质报酬、职业性奖励和社会性奖励四个维度;对直接物质报酬的评价最高;外科医生的工作满意度高于内科,低于妇产科和儿科;医技人员和护士的满意度低于全科医生;工作5年以下人员满意度最低;有编制的人员满意度高于无编制者;直接物质报酬和职业性奖励与工作满意度正相关。结论:物质报酬整体水平不高,非经济性激励作用发挥不足,编制外人员的薪酬公平性有待提高,应加强对高学历人才的薪酬激励。     

基于供方视角的山东省农村地区家庭医生工作满意度及影响因素分析

目的基于供方的视角,了解山东省农村地区家庭医生工作满意度现状,并分析影响因素,为农村地区家庭医生签约服务稳定发展提供政策建议。方法于2018年采取多阶段分层随机抽样的方法,对山东省农村地区的家庭医生进行问卷调查;采用描述性分析描述调查对象的人口学特征及工作满意度情况,采用二元Logistic回归探讨工作满意度的影响因素。结果山东省农村地区195名家庭医生中,家庭医生工作满意率为57.4%;家庭医生工作压力、工作需要、工作职责、上级支持满意程度、报酬与工作量匹配程度、家庭医生培训是家庭医生工作满意度的影响因素(P<0.05)。结论提升农村地区家庭医生医疗专业能力和建立科学有效的绩效考核机制、激励机制,是提高农村地区家庭医生工作满意度的有效方法,是保证家庭医生签约服务持续稳定发展的重要条件。     

工作动机在基层医务人员工作满意度和工作绩效中的链式中介效应研究

目的:探究中国基层医务人员工作满意度对工作绩效的影响,以及控制性动机和自主性动机的中介作用。方法:利用工作满意度量表、工作动机量表和工作绩效量表对6省12县(市、区)75家基层卫生服务机构1 435名基层医务人员进行问卷调查。结果:我国基层医务人员的工作满意度、控制性动机、自主性动机和工作绩效两两之间显著正相关;工作满意度会影响工作绩效,总效应为1.50,其中直接效应值为0.96,占总效应的64.01%,同时还存在3条间接影响路径,分别是控制性动机的独立中介作用、自主性动机的独立中介作用、控制性动机和自主性动机的链式中介作用,中介效应值分别为0.21、0.11、0.23,占中介效应的比例为38.36%、19.55%、40.97%。结论:本研究证明工作满意度会直接或间接的通过4条路径影响工作绩效,其中工作动机发挥了中介作用,并存在"动机内化"的过程。所以要持续关注其工作满意度水平的变化,特别注意满意度改变带来的工作动机的调整,以物质激励因素为基础,非物质激励为推动力,实现良好主观感受向客观绩效提高的持续转变。     

Prevalence of orthorexia nervosa in resident medical doctors in the faculty of medicine (Ankara, Turkey)

This study has been carried out to "identify highly sensitive behavior on healthy nutrition (orthorexia nervosa-ON)" in residence medical doctors (MD) in the Faculty of Medicine. Diagnoses of ON was based on the presence of a disorder with obsessive-compulsive personality. The study is a cross-sectional research, which reached out to the entire 318 MD. The ORTO-15 test was used to propose a diagnostic proceeding and to try verify the prevalence of ON. Those subjects who were classified below 40 from the ORTO-15 test are accepted to have ON. Chi-square test, ANOVA (univariate) analysis and logistic regression were used for analyses of the data. Mean score of the participants from the ORTO-15 test is 39.8+/-0.22, and there is no statistical difference between women and men. A total of 45.5% of the residence MD involved in the research scored below 40 in the ORTO-15 test. Those who do their food shopping themselves, skip a meal with a salad/fruit, care about the quality of the things they eat, think that eating outside is healthy, look at the content of what they eat and the content of food is important in selection of a product score lower in their average marks in ORTO-15 and the difference among the groups is statistically significant. Food selection of 20.1% of the male participants and 38.9% of the female participants among the residence MD is influenced by the programs on nutrition/health in mass-media. The difference between the groups is statistically significant (p<0.05). Female medical doctors are more careful than men of their physical appearance and weight control and consume less caloric food, which is statistically significant. Since those who exhibit "healthy fanatic" eating habits may have a risk of ON in the future, it would be useful to conduct studies that identify the prevalence of ON in the public.     

上海城乡居民医疗保险筹资满意度分析

目的了解居民对城乡居民医疗保险筹资结构满意度及影响因素,为完善上海城乡居民医疗保险筹资制度提供政策建议。方法采用分层随机抽样的方法,自行设计调查问卷,对386名上海城乡居民医疗保险的参保者进行调查,以了解参保居民对城乡居民医疗保险筹资结构的认知度、满意度和期望度。所得数据采用多元logistic回归方法进行统计,检验收入、年龄、身体健康状况、缴费档次、享受水平对筹资结构满意度的影响,分析上海居民医疗保险的筹资满意度并提出建议。结果上海城乡居民对筹资结构的满意度不高,其中城乡居民的收入、年龄是影响筹资结构满意度的主要因素。结论政府应该基于收入设计筹资方案;保证筹资与待遇相匹配;优化政府财政投入结构;逐步取消个人账户,建立统一的国民健康保险。     

中低收入群体医疗服务需求的特点、问题与对策——基于1642户中低收入家庭调查

健康是人类生存和发展的基础,中低收入群体的健康问题和医疗服务需求尤其值得政府和社会的关注。通过对七个省份(直辖市)中低收入群体医疗服务需求的实地调查和1642份问卷的分析,发现了中低收入群体医疗服务需求的特点和存在的问题,如健康状况不容乐观、慢性病发病率高、医疗负担过重等;并提出增加投入、完善基层医疗服务体系、减轻中低收入家庭医疗负担、探索新的医疗服务模式等完善中低收入群体的医疗服务与医疗保障的政策建议。     

Ethical climate, ethics stress, and the job satisfaction of nurses and social workers in the United States

Nurses and social workers are fundamental to the delivery of quality health care across the continuum of care. As health care becomes increasingly complex, these providers encounter difficult ethical issues in patient care, perceive limited respect in their work, and are increasingly dissatisfied. However, the link between ethics-related work factors and job satisfaction and intent-to-leave one's job has rarely been considered. In this paper, we describe how nurses and social workers in the US view the ethical climate in which they work, including the degree of ethics stress they feel, and the adequacy of organizational resources to address their ethical concerns. Controlling for socio-demographics, we examined the extent to which these factors affect nurses and social workers' job satisfaction and their interest in leaving their current position. Data were from self-administered mail questionnaires of 1215 randomly selected nurses and social workers in four census regions of the US. Respondents reported feeling powerless (32.5%) and overwhelmed (34.7%) with ethical issues in the workplace and frustration (52.8%) and fatigue (40%) when they cannot resolve ethical issues. In multivariate models, a positive ethical climate and job satisfaction protected against respondents' intentions to leave as did perceptions of adequate or extensive institutional support for dealing with ethical issues. Black nurses were 3.21 times more likely than white nurses to want to leave their position. We suggest several strategies to reduce ethics stress and improve the ethical climate of the workplace for nurses and social workers.     

数字化环境下科技期刊的发展策略与实践——以医学科技期刊为例

【目的】探讨数字化环境下科技期刊应对变革的发展策略和实践建议。【方法】以数字化时代科技期刊的发展环境变化为切入点,采用文献调研法、数据分析法和实证研究法,对科技期刊所在的数字化环境进行了阐述。【结果】分析了由科学研究范式和学术交流模式的演变带来的期刊在出版业务和出版内容上的转变,以医学科技期刊为例,提出了科技期刊应对变化的发展策略和实践建议。【结论】数字化的大环境,科技期刊应该从出版业务流程和出版内容多方面转变思路,构建更加健康的信息服务生态,顺应趋势加强期刊的集团化管理模式,借力于技术平台,更好服务大众。     

Gender and age differences in domain-specific life satisfaction and the impact of depressive and anxiety symptoms: a general population survey from Germany

Purpose  Determine age and gender differences and interaction effects in domain-specific life satisfaction in the German population and examine to which degree depressive and anxiety symptoms are associated with life satisfaction in addition to sociodemographic variables, and which domains are affected. Methods  Representative survey of the German population conducted 2006 with 5,036 participants (53.6% female). Mean age was 48.4 years (SD = 18.0). Measurements included domain-specific life satisfaction (FLZ^M), anxiety (GAD-7), depressive symptoms (PHQ-2), and sociodemographic variables (e.g., marital status, income, employment, education, urbanity, part of Germany, religiousness, age and gender). Results  Women were more satisfied with their family life, men showed greater satisfaction with their leisure activities. Age-group differences appeared in every life satisfaction domain. Age by gender interaction emerged in the field of satisfaction with health, income, and family life. Anxiety and depressive symptoms contributed significantly to the explained variance of domain-specific life satisfaction. Conclusions  Depressive and anxiety symptoms as two psychological variables have an additional impact on domain-specific life satisfaction. Further investigation is needed regarding the impact of psychological variables on domain-specific life satisfaction.     

Unemployment, job insecurity and life satisfaction: results of a study with young adults in the new German states

Zusammenfassung. Fragestellung: Ausgehend von den zahlreichen Forschungen zu psychosozialen Aspekten des Erlebens von Arbeitslosigkeit untersucht die Studie die Folgen von tats?chlicher Arbeitslosigkeit auf die Lebenszufriedenheit und die Auswirkungen von Bedrohung durch Arbeitslosigkeit und wahrgenommener Sicherheit des Arbeitsplatzes auf die Lebenszufriedenheit. Methoden: Im Rahmen der 17. Welle der S?chsischen L?ngsschnittstudie wurden 2003 N = 419 Personen (193 M?nner, 226 Frauen, Mittleres Alter 30.05 Jahre) mit dem Fragebogen zur Lebenszufriedenheit (FLZ M) untersucht. Der Bogen erlaubt die ?konomische Erfassung von acht spezifischen Bereichen der Lebenszufriedenheit (Freunde, Freizeit, Gesundheit, Einkommen, Beruf, Wohnen, Familie, Partnerschaft). Ergebnisse: Zwei Drittel der Studienteilnehmer hatten bereits Erfahrungen mit Arbeitslosigkeit. Personen, die mehrfach arbeitslos waren, waren signifikant unzufriedener mit ihrem Einkommen, ihrer Wohnsituation, ihrem Beruf und ihrer Gesundheit. Jedoch hatten auch die Sicherheit des derzeitigen Arbeits- oder Ausbildungsplatzes und die subjektiv erlebte Bedrohung durch Arbeitslosigkeit bei derzeit Nichtarbeitslosen deutlich negative Auswirkungen auf deren Lebenszufriedenheit. Dies zeigte sich auch in Bereichen, die nicht direkt mit Erwerbsarbeit in Zusammenhang stehen, wie Freunde/Bekannte oder Familienleben. Schlussfolgerung: Die Studie unterstreicht bekannte Befunde zum Zusammenhang von Arbeitslosigkeit und (negativer) Lebenszufriedenheit. Nachgewiesen wird, dass auch bereits der antizipierte Verlust des Arbeitsplatzes zu einer eindeutig schlechteren subjektiven Lebenszufriedenheit in vielen Bereichen führt.

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Summary. Unemployment, job insecurity and life satisfaction: results of a study with young adults in the new German states Objectives: Based on research about the psychosocial aspects of experiencing unemployment, the present study analyses the effects of actual unemployment and the impact of being at risk of becoming unemployed and the influence of perceived job insecurity on life satisfaction. Methods: In the 17^th wave of the Saxon Longitudinal Study (S?chsische L?ngsschnittstudie) in 2003, 419 people (193 male, 226 female, mean age 30.05 years) were examined with a life satisfaction questionnaire. This questionnaire addresses eight areas of life satisfaction: friends, leisure time, health, income, job, housing, family, partnership. Results: Two-thirds of the participants have had experiences with unemployment so far. People who had been unemployed several times were significantly more dissatisfied with their income, housing, profession and health. Still, considering people employed at the time of survey, the subjective job insecurity and the perceived risk of becoming unemployed had noticeably negative effects on life satisfaction. This could be also shown for areas which are not directly connected to occupation, such as friends and family life. Conclusions: The study emphasizes the known results regarding the connection between unemployment and (poor) life satisfaction. Evidence was provided that even the anticipated loss of the workplace causes a decrease in life satisfaction, affecting many areas of subjective evaluation.

Wir danken der Otto-Brenner-Stiftung (http://www.otto-brenner-stiftung.de) für die freundliche Unterstützung der S?chsischen L?ngsschnittstudie.     

Compassion satisfaction and compassion fatigue among medical social workers in Korea: the role of empathy

ABSTRACT

Medical social workers are affected by their clients’ suffering, which has an impact on social workers’ professional quality of life. This study examined the role of empathy in relation to professional quality of life among medical social workers in South Korea. Using the Professional Quality of Life Scale and Interpersonal Reactivity Index, we found that empathic concern and personal distress were significant components of empathy and were correlated with professional quality of life. Empathic concern was positively associated with compassion satisfaction and negatively associated with burnout. Personal distress was correlated with all components of quality of life: compassion satisfaction, secondary traumatic stress, and burnout. Women had significantly higher levels of burnout than men; religious affiliation was associated with higher levels of compassion satisfaction; and longer years of employment was associated with higher levels of secondary traumatic stress. Medical social workers should be educated on and trained in how empathy can help them address compassion fatigue and promote compassion satisfaction.     

The relationship between dual practice,intention to work abroad and job satisfaction: A population-based study in the Serbian public healthcare sector

Increasing dual practice and emigration of health workers threatens the effectiveness of the healthcare system. Insufficient information exists about these phenomena in the transitional countries of South-East Europe. Serbia, a European Union candidate, permits dual practice and there is a high intention to work abroad among its prospective healthcare professionals. A population-based, cross-sectional study was conducted to determine the prevalence and predictors of job satisfaction, dual practice, and intention to work abroad of all workers in the Serbian public healthcare sector (73,940 employees, a response rate of 83.8%). This study observed that 22.6% of the respondents were dissatisfied with their jobs, 11.7% reported dual practice, and 14.3% had an intention to work abroad. Physicians and nurses younger than 55 years of age employed in a tertiary healthcare institution, and males were more likely to be dissatisfied than other workers. Poor management and working conditions increased job dissatisfaction, with a subsequent increased odds for dual practice and intention to work abroad by 1.5 and 3.6 times, respectively. The national and institutional framework for health workforce policy and management must be powerful and efficient when taking advantage of the positive effects and managing the negative aspects of dual practice and the intention to work abroad.