【摘要】 目的了解云南省美沙酮维持治疗(methadone maintenance treatment,MMT)门诊医务人员职业倦怠现况并分析其影响因素。方法采用分层整群抽样的方法,于2016年9~10月抽取云南省6州(市)的33家MMT门诊,采取网络电子化问卷形式对全体医务人员进行问卷调查,内容包括社会人口学特征、工作相关属性、职业倦怠量表。运用x~2检验和非条件Logistic回归模型分别进行职业倦怠的单因素和多因素分析。结果 313名研究对象中,职业倦怠总检出率为70.9%(222/313),三个维度的检出情况分别为:情绪衰竭维度37.4%(117/313),情感疏远维度22.0%(69/313),个人成就感降低维度51.8%(162/313)。多因素分析结果显示,编制外人员(OR=1.775,95%CI:1.012~3.116)、门诊患者人数与医务人员数比例高(OR=1.898,95%CI:1.070~3.368)、工作内容单一(OR=2.265,95%CI:1.156~4.437)会增加MMT门诊医务人员职业倦怠风险;而家人支持(OR=0.448,95%CI:0.243~0.826)、门诊附近居民支持(OR=0.533,95%CI:0.290~0.978)、病人尊重医务人员(OR=0.348,95%CI:0.197~0.617)会降低医务人员的倦怠风险。结论云南省MMT门诊医务人员职业倦怠检出率较高,工作特征相关因素影响较为明显。需要继续加强医务人员业务培训,提升工作能力,争取家人和社会群众支持,建立互相尊重和信任的医患关系。更多还原

【Abstract】 Objective To assess the prevalence and influencing factors of occupational burnout among health workers in clinics of methadone maintenance treatment( MMT) in Yunnan Province. Methods Between September and October of 2016,health workers were selected by random cluster sampling from 33 clinics in 6 prefectures and cities. The information about staff’s demographic characteristics,job-related attributes,and Maslach Burnout Inventory( Version Human Services Survey) were collected through internet-based electronic questionnaire. Descriptive analysis,x~2test,and multivariate Logistic regression analysis were conducted to assess risk factors for burnout. Results Of the 313 staff,the overall occupational burnout was 70. 9%( 222/313). Three dimensions of the burnout,i. e.,emotional exhaustion,depersonalization,and low personal accomplishment were 37. 4%( 117/313),22. 0%( 69/313),and 51. 8%( 162/313),respectively. Multivariate Logistic regression indicated that being a contract staff( OR = 1. 775,95% CI: 1. 012-3. 116),having high patients/staff ratio( OR = 1. 898,95% CI: 1. 070-3. 368),and monotonous working content( OR = 2. 265,95% CI: 1. 156-4. 437) were associated with increased risk of occupational burnout. However,staff’s family support( OR= 0. 448,95% CI: 0. 243-0. 826),nearby community residents’ support( OR = 0. 533,95% CI: 0. 290-0. 978),and patients’ respect( OR = 0. 348,95% CI: 0. 197-0. 617) were associated with decreased risk of occupational burnout. Conclusions Occupational burnout is widespread among health workers of MMT clinics in Yunnan Province. Job-related factors have more significant impacts than the demographic characteristics do. It is necessary to strengthen professional training in medical personnel,to improve the comprehensive ability of working,to strive for the support of the family and the public,to build up mutual respect and trust between patients and health workers.更多还原