我国西部地区全科医生工作满意度及其影响因素分析

背景　全科医生作为全科医疗服务的主要提供者，在基层医疗卫生服务中发挥着举足轻重的作用，分析其工作满意度及影响因素，对于改善全科医生素质、稳定全科医生队伍及提高全科医生服务水平具有重要意义。目的　了解西部地区全科医生的工作满意度现状及其影响因素。方法　于2017年10月—2018年2月，采取多阶段分层随机抽样法抽取西部地区社区卫生服务机构（社区卫生服务中心和社区卫生服务站）全科医生1 050例为研究对象进行问卷调查。问卷内容包括全科医生基本情况和工作满意度。采用宋奎勐修订的工作满意度量表进行工作满意度测量，包括物质满意度、关系满意度、成长满意度和整体满意度4个维度。采用二分类Logistic回归分析全科医生工作满意度的影响因素。结果　1 036份（98.67%）西部地区全科医生问卷被视为有效。西部地区全科医生的工作满意度总均分为（37.39±7.35）分，654例（63.13%）全科医生工作满意度总分较高（≥36分）。其中，西部地区全科医生的物质满意度平均分为（11.86±2.71）分，关系满意度平均分为（13.18±2.52）分，成长满意度平均分为（9.17±2.37）分，整体满意度平均分为（3.18±0.79）分。单因素分析结果显示，不同性别、学历、任职方式、加班情况及收入水平全科医生工作满意度比较，差异有统计学意义（P<0.05）。二分类Logistic回归分析结果显示，任职方式、加班情况及收入水平是西部地区全科医生工作满意度的影响因素（P<0.05）。结论　西部地区全科医生的工作满意度较高，任职方式、加班情况及收入水平是其影响因素。因此，建议改善薪酬结构，适当减少工作任务量，有效缓解全科医生工作压力，推行“去编制化”政策，激发全科医生的工作积极性，以提高全科医生工作满意度。

Job Satisfaction and Influencing Factors among General Practitioners in Western China

Background　As a major provider of general medical services，general practitioners（GPs） play a pivotal role in delivering primary health care services.Analyzing their job satisfaction and influencing factors are important for improving GPs' quality and service levels，and stabilizing the GPs workforce.Objective　To examine job satisfaction and influencing factors among GPs in western China.Methods　By use of multistage stratified random sampling，1 050 GPs were selected from community healthcare institutions（including community health centers and community health stations） in western China from October 2017 to February 2018.They received a questionnaire survey covering basic demographic conditions and job satisfaction.The Job Satisfaction Scale revised by SONG Kuimeng was adopted to measure job satisfaction，which includes four dimensions of income，work relationship，growth and overall satisfaction.Binary Logistic regression was used to analyze the influencing factors of job satisfaction.Results　The survey obtained a response rate of 98.67%（1 036/1 050）．The average total score of job satisfaction was（37.39±7.35）．63.13%（654/1 036） of the respondents had higher total scores of job satisfaction（≥36 points）.The average scores for four dimensions of income，work relationship，growth and overall satisfaction were（11.86±2.71），（13.18±2.52），（9.17±2.37），（3.18±0.79），respectively.Univarate analysis showed that gender，education level，mode of employment，overtime and income level were associated with significant differences in job satisfaction level（P<0.05）．Binary Logistic regression analysis revealed that mode of employment，overtime and income level were significantly associated with job satisfaction（P<0.05）．Conclusion　The job satisfaction level of GPs in western China is relatively high，which is mainly associated with mode of employment，overtime and income level.To further motivate GPs' enthusiasm at work and increase their job satisfaction，it is recommended to improve the salary structure，reduce the workload appropriately，alleviate the work pressure effectively，and implement the policy of non-lifetime employment.