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目的分析目前医护人员职业压力及其影响因素,为降低医护人员职业压力,提高身心健康水平,搞好医患关系提供政策建议。方法 2012年8—9月采用分层整群随机抽样,随机抽取深圳市5个城区24个社区健康服务中心和6家医院1 005名医护人员(医生325名,护士525名,技师155名)作为研究对象,拟合个体和城区两个水平的多水平等级Logistic模型,分析医护人员职业压力影响因素。结果医院和社区医护人员所承受的压力有所不同,二者评分比较差异有统计学意义(χ2=1.325,P<0.05)。人口学特征中,性别、年龄、工龄、从事学科、在编状态、职称、职位高低都对职业压力产生影响,差异均有统计学意义(Z=4.15、4.05、4.55、5.15、5.00、3.35、3.39,均P<0.05)。在生物医学因素中,医护人员身体健康状况和性格类型特征对职业压力产生影响,差异有统计学意义(Z=-2.28、-4.40,均P<0.05),尤其是A型性格人员。多水平Logistic模型显示,社会支持度影响强度最大(OR=3.63),个人特征中,影响最大为所从事学科(OR=2.46),最小为性别(OR=2.07)。结论医护人员需要社会与领导的呵护,只有医患互相关心才能促进二者有关系的和谐发展。
Objective To analyze occupational stress and its influencing factors in medical staff at present, and to provide policy recommendations for reducing occupational stress, improving physical and mental health, and improving doctor-patient relationship. Methods From July to September in 2012, stratified cluster random sampling was used to randomly select 24 community health service centers in 5 urban districts of Shenzhen and 1 005 medical staff (325 doctors, 525 nurses and 155 technicians) in 6 hospitals in Shenzhen city. As the research object, we fitted the Logistic model of multi-level and multi-level of individuals and urban areas to analyze the influencing factors of occupational stress in medical staff. Results The pressure on hospitals and community health workers was different. There was significant difference between the two scores (χ2 = 1.325, P <0.05). Demographic characteristics, gender, age, length of service, engaged in disciplines, in the editing state, job title, occupation level have an impact on occupational stress, the differences were statistically significant (Z = 4.15,4.05,4.55,5.15,5.00,3.35, 3.39, all P <0.05). Among the biomedical factors, the health status and personality type of health care workers have an impact on occupational stress, with significant differences (Z = -2.28, -4.40, all P <0.05), especially type A personality. The multi-level Logistic model showed that social support had the strongest influence (OR = 3.63). Among the personal characteristics, the most influential factor was the subject (OR = 2.46) and the least gender (OR = 2.07). Conclusion Medical and nursing staff need the care of the society and leaders. Only the mutual concern of doctors and patients can promote the harmonious development of the relationship between the two.