妇产科规范化培训医师工作压力现状与影响因素研究

目的 调查妇产科规范化培训医师工作压力现状,分析影响其工作压力的因素。方法 选取2019年6月至2020年5月北京市某三甲医院规范化培训基地的住院医师232名为研究对象。采用问卷调查方法,收集一般情况,包括性别、年龄、专业、学历、工作经历、规培时间、收入满意度和对规培必要性的认同度。通过工作压力源量表进行压力现状与影响因素分析。其中工作压力源量表得分越低,反映其压力越大。采用SPSS 22.0软件对数据进行t检验和卡方检验。结果 妇产科规培医师工作压力总分在所有科室中偏低（67.02±12.65）分（P<0.001）,其中“工作量及时间分配”（7.11±2.42）分、“工作环境及资源”（7.21±2.34）分、“管理及人际关系”（15.66±3.69）分为主要压力源,与其他各科室比较差异有统计学意义（P<0.001）。单因素分析结果显示：不同收入满意度之间工作压力得分差异有统计学意义（P=0.003）。结合多重线性回归方程结果,收入满意度不同的妇产科规培医师在“专业及工作”“工作量及时间分配”和“工作环境及资源”3方面压力源总分随满意度下降,得分越低压力越大,差异有统计学意义（P值分别为0.006、0.008、0.012）。而涉及“病人诊疗”和“管理及人际关系”方面,收入满意度不同的规培医师总分差异无统计学意义（P值分别为0.067和0.057）。结论 妇产科规培医师压力普遍偏大,来自临床与医疗相关的事务是其工作压力的主要来源,而收入满意度是其工作压力的主要影响因素。

Study on the status quo and influencing factors of work stress of residents in the standardized training of obstetrics and gynecology

Objective To investigate and analyze the status quo of work stress and its influencing factors among residents in the standardized training of obstetrics and gynecology.Methods A questionnaire survey was carried out among 232 training residents by random sampling from a standardized training base of a tertiary hospital in Beijing from June 2019 to May 2020. The collected general information included gender, age, specialty, education background, work experience, time of training, income satisfaction and recognition of the necessity of training. The current situation and influencing factors of pressure were analyzed through the work pressure source scale. The lower the score means the greater stress. SPSS 22.0 was used to process the data by performing t-test and Chi-square test.Results The total points of work stress (67.02±12.65) of the residents was lower among all the departments (P<0.001). The most important work stressors were workload and time allocation (7.11±2.42), job situation and resources (7.21±2.34), management and personal relationship (15.66±3.69), and those were significantly different in any other departments (P=0.003). One-way analysis of variances showed that job stress scores were significantly different among types of income satisfaction (P=0.003). Combined with the results of logistic regression equation, the total scores of work stressors in such three aspects as "specialty and career", "workload and time allocation", and "job situation and resources" decreased with the satisfaction, and the lower the score, the greater the pressure, with statistical significance (P=0.006, 0.008, 0.012, respectively). However, in terms of "patient diagnosis and treatment", and "management and interpersonal relationship", there was no significant difference between the groups (P=0.067, 0.057, respectively).Conclusions The stress of obstetrics and gynecology residents is generally high. Clinical and medical affairs are the main sources of their work stress, and income satisfaction is the major influencing factor of the work stress.