【作者】 吴宁；

【导师】 于洗河；

【作者基本信息】 吉林大学 ， 社会医学与卫生事业管理， 2017， 硕士

【摘要】 基层医疗卫生机构在为城乡居民提供安全、方便、质优、价廉的基本医疗服务和公共卫生服务方面具有不可替代的作用,基层医务人员作为卫生服务的直接提供者,是基层医疗卫生服务机构的核心力量,医务人员的工作满意度决定了卫生服务的质量和卫生人力资源的稳定性,更与患者满意度密切相关,提高基层医务人员工作满意度,对于发挥基层医疗卫生服务系统整体功能有至关重要的意义。目的:了解吉林省某地区基层医务人员的工作满意度现状,对基层医务人员的工作满意度进行科学合理的评价,并探讨不同特征(如性别、年龄、职称、工作年限等)和不同维度对工作满意度的影响程度,找出影响基层医务人员工作满意度的主要因素,探讨卫生服务体系管理中存在的问题,为相关政策的制定和完善提供依据。方法:采用多阶段分层整群抽样的方法,对381名吉林省某地区基层医疗卫生机构医务人员进行问卷调查。调查内容包括医务人员的一般情况和医务人员工作满意度两部分。一般情况包括调查对象的社会人口特征(性别、年龄、职称等)和工作特征(机构类别、工作年限、用工形式等);工作满意度调查包括调查对象对薪酬待遇、社会关系、工作环境、晋升培训、工作意义、医院管理、职业风险、工作负荷八个维度的感受。采用Epi Data3.1软件建立数据库,SPSS17.0软件进行数据分析。分类变量资料采用构成比表示,数值变量资料采用均数和标准差来描述。单因素分析采用t检验和单因素方差分析,采用LSD法进行多组均数之间的两两比较,多因素分析采用多元线性回归分析的方法。结果:1.八个维度的满意度得分从低至高依次为薪酬待遇、职业风险、工作负荷、晋升培训、工作环境、医院管理、社会关系和工作意义。2.不同性别、年龄、专业、工作类别、专业技术职称、工作机构、工作年限、用工形式、工资、工作时间会影响基层医务人员的工作总体满意度(P<0.05)。男性医务人员的总体满意度高于女性,其中40-49岁年龄段的基层医务人员的总体满意度最低;财会专业的基层医务人员的总体满意度高于医疗、中医、护理、公共卫生、行政管理和其他专业;全科医生的总体满意度分别低于护士、公共卫生人员、其他技术人员和管理人员;无职称的基层医务人员总体满意度高于士级、师(初)级和中级技术职称;社区卫生服务中心的医务人员总体满意度显著高于乡镇卫生院;工作年限是6-10年的基层医务人员的总体满意度高于5年及以下、11-20年和20年以上的;聘用人员的总体满意度显著高于在编人员;工资收入为3000-3999元的基层医务人员的总体满意度分别高于<2000元和2000-2999元的;工作时间为十小时及以上的基层医务人员总体满意度显著高于工作时间是八小时以下和八小时组的。3.薪酬待遇、工作环境、工作意义、性别是基层医务人员的工作总体满意度的主要影响因素(P<0.05),其中薪酬待遇最为明显。结论:1.吉林省某地区的基层医务人员的工作满意度得分居于一般满意水平,医务人员对工作意义的满意度最高,其中满意度最低的是薪酬待遇,其次是职业风险,对工作负荷的满意度也比较低。2.不同特征的医务人员在各维度上的满意度和总体满意度均存在显著性差异。3.医务人员总体工作满意度的影响因素分别是薪酬待遇、工作环境、工作意义和性别,针对影响工作总体满意度的因素,分析其产生不满的原因,采取针对性的措施。更多还原

【Abstract】 Grass-roots medical and health institutions in urban and rural residents to provide safe,convenient,high quality,cheap basic medical services and public health services has an irreplaceable role,grass-roots medical personnel as a direct provider of health services,primary health care services Of the core strength of the medical staff’s job satisfaction determines the quality of health services and health human resources stability,more closely related to patient satisfaction,improve the grass-roots medical staff job satisfaction,for the primary health care service system to play the overall function Vital significance.Objective:To understand the status quo of job satisfaction of primary medical staff in a certain area of Jilin Province,to evaluate the job satisfaction of primary medical personnel and to explore different characteristics(such as gender,age,title,working life,etc.)and different dimensions The impact of job satisfaction,identify the main factors that affect the job satisfaction of primary health care workers,and discuss the existing problems in the management of health service system,and provide the basis for the formulation and perfection of relevant policies.Methods:A multidimensional stratified cluster sampling method was used to survey 381 medical staff of primary health care institutions in Jilin province.The survey included the general situation of medical staff and the satisfaction of medical staff in two parts.The general situation includes the social demographic characteristics(gender,age,title,etc.)and the working characteristics(organization type,working life,working form,etc.)of the survey object;the job satisfaction survey includes the survey object,the remuneration,the social relations,the working environment,Training,job sense,hospital management,occupational risk,and workload.Using Epi Data3.1 software to build the database,SPSS17.0 software for data analysis.The data of the classification variables are expressed by the composition ratio,and the numerical variables are described by the mean and the standard deviation.Univariate analysis was performed by t test and single factor analysis of variance.LSD method was used to compare the odds ratio between multiple groups.Multivariate analysis was performed by multiple linear regression analysis.Result:1.Eight dimensions of satisfaction score from low to high are in the order of remuneration,occupational risk,workload,promotion training,working environment,hospital management,social relations and work meaning.2.The overall satisfaction(P<0.05)was affected by the gender,age,profession,job category,professional and technical title,working organization,working life,working form,salary and working time.The overall satisfaction of the male medical staff is higher than that of the female,among which the overall satisfaction of the primary medical staff in the 40-49 age group is the lowest;the overall satisfaction of the primary medical staff of the accounting profession is higher than that of the medical,Chinese medicine,nursing,public health and administrative Management and other specialties;general practitioners overall satisfaction were lower than the nurses,public health personnel,other technical staff and management personnel;no title of the primary medical staff overall satisfaction higher than the rank,division(primary)and intermediate The overall satisfaction of the medical staff in the community health service center is significantly higher than that of the township health center.The working period is 6 to 10 years.The overall satisfaction of the primary medical personnel is higher than 5 years and below,11-20 years and 20 years;The overall satisfaction of the employed persons was significantly higher than that of the staff;the overall satisfaction of the primary medical personnel with the salary income of 3000-3999 yuan was higher than that of the <2000 and 2000-2999 yuan;the working hours were ten hours and above The overall satisfaction of the medical staff was significantly higher than the working hours were eight hours and eight hours.3.Salary treatment,working environment,working meaning and gender are the main influencing factors of the overall satisfaction of the primary medical staff(P<0.05).The remuneration is the most obvious.Conclusion:1.The scores of job satisfaction of medical staff in a district of Jilin Province in the level of general satisfaction,staff satisfaction on the meaning of work satisfaction is the lowest among the highest salary,followed by the occupation of risk,work load satisfaction is relatively low.2.There were significant differences in satisfaction and overall satisfaction of medical staff in different dimensions.3.Factors affecting the job satisfaction of medical staff are remuneration,working environment,and the significance of gender factors for overall satisfaction influence work,analyses the cause of discontent,to take targeted measures.更多还原