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目的了解全科医生离职倾向水平,并探讨其影响因素。方法拟采用方便抽样法,抽取哈尔滨、大庆、绥化、黑河、大兴安岭和齐齐哈尔6个城市263个社区卫生服机构的全科医生,最终以参加黑龙江省卫生厅在齐齐哈尔举办的社区医务工作者培训现场的215例作为研究对象。于2015-03-21,采用基本信息、职业满意度、工作满意度、工作倦怠、工作嵌入及离职倾向6个问卷在培训现场对其进行调查,问卷填写后一次性收回。共发放问卷362份,回收有效问卷323份,其中全科医生填写问卷215份。全科医生离职倾向的影响因素采用单因素和多因素Logistic回归分析。结果 62.3%(134/215)的全科医生有离职倾向。单因素Logistic回归分析结果显示,工作年限、职业成就、事业进展、职业收入、目标实现度、技能培养、工作满意度、工作倦怠和工作嵌入对全科医生离职倾向的影响有统计学意义(P<0.05);进一步多因素Logistic回归分析结果显示,工作年限、工作嵌入对全科医生离职倾向有负向预测作用(b值分别为-0.05、-0.93,P≤0.05);工作倦怠对全科医生离职倾向有正向预测作用(b=0.74,P<0.05)。结论近2/3的全科医生报告自己具有离职倾向;工作倦怠是影响全科医生产生离职倾向的危险因素,工作年限以及工作嵌入是影响全科医生产生离职倾向的保护因素,缓解全科医生的工作倦怠、提高工作嵌入可有效降低其离职风险。
Objective To understand the level of general practitioner turnover intention and to explore its influential factors. Methods A total of 263 community health service practitioners from 6 cities of Harbin, Daqing, Suihua, Heihe, Daxinganling and Qiqihar were recruited by a convenient sampling method. Finally, they participated in the training of community medical workers in Qiqihar City, Heilongjiang Province 215 cases as the research object. On 2015-03-21, 6 questionnaires, basic information, job satisfaction, job satisfaction, job burnout, job embedding and turnover intention, were investigated at the training site, and the questionnaire was filled in at one time. A total of 362 questionnaires were distributed and 323 valid questionnaires were recovered, of which 215 were filled in by GPs. The influencing factors of general practitioner turnover intention were analyzed by single factor and multivariate logistic regression. Results 62.3% (134/215) of general practitioners had a tendency to leave. The results of univariate logistic regression analysis showed that the influence of working years, occupational achievements, career progress, occupational income, goal achievement, skill development, job satisfaction, job burnout and job embedding on general practitioner turnover intention were statistically significant (P <0.05). Further multivariate Logistic regression analysis showed that working years and job embedding had a negative predictive effect on the turnover intention of general practitioners (b = -0.05, -0.93, P≤0.05, respectively) The doctor’s turnover intention has a positive predictive value (b = 0.74, P <0.05). Conclusions Nearly two-thirds of GPs report that they have a turnover intention. Job burnout is a risk factor that affects general practitioner turnover intention. Working years and job embedding are the protective factors that influence the turnover intention of general practitioners. Job burnout, improve job embedding can effectively reduce the risk of leaving the job.