精神科医生职业压力、职业倦怠与心理健康的关系

目的 了解精神科医生职业压力、职业倦怠与心理健康的状况并探讨其相互关系.方法 采用一般情况问卷、自编医生工作压力调查表、Maslach职业倦怠-通用版(MBI-GS)、症状自评量表(SCL-90),对216名精神科医生进行问卷调查.结果 (1)精神科医生最感压力的事件是工作负荷；除工作和家庭冲突外,其余各因子压力强度均超过中值3；在职业倦怠的3个维度中,精神科医生的情绪衰竭程度相对较高,女性医生在情绪衰竭方面显著高于男性医生(P＜0.05)；与全国成人常模比较,精神科医生SCL-90各因子得分除恐怖和精神病性外均显著高于国内常模.(2)情绪衰竭与职业压力各维度,情感疏远与工作负荷及医患关系,职业效能感与医患关系,职业倦怠3个维度与SCL-90总均分均呈正相关(P＜0.05).(3)路径分析显示,职业压力和职业倦怠与心理健康间分别存在间接和直接的因果关系.结论 精神科医生职业压力比较大、职业倦怠较为严重,心理健康水平较低；职业倦怠是职业压力和心理健康之间重要的相关因素；社会及各医院管理层应给予充分关注.

Correlation among occupational stress,job burnout and mental health in psychiatrists

Objective To explore occupational stress,job burnout,and mental health status of psy- chiatrists and to investigate the relationship among them. Methods Questionnaires about occupational stress,job burnout and SCL-- 90 Scale were administered to 216 the psychiatrists. Results （1）the most stressful events to Psychiatrists were work load,except work and family conflict, the remaining factors were all measured in higher than the average of 3 points. The degree of emotional exhaustion was rela- tively higher in the three dimensions of burnout. Emotional exhaustion in female psychiatrists was signif- icantly higher than that in male psychiatrists. The results were also compared to the national norm for a- dults. The SCL--90 in psychiatrists was significantly different （P〈0.01） from that in the national nor- mal except horror and psychotic factors. （2）There was a significant correlation among occupational stress,job burnout and mental health. （3）The causal relationship between them was identified with path analysis method. Both occupational stress and job burnout had direct and indirect effect on mental health. Conclusions There is a high level of occupational stress, job burnout and low level of mental health in psychiatrists. Job burnout is an important factor for occupational stress and mental health. Psy- chiatrists require more attention from the society and the administrators of the employers.