南昌市基层医务人员职业认知现状及影响因素分析

摘要

目的：了解南昌市基层医务人员的职业认知现状，并对其影响因素进行分析，为基层卫生综合改革提供政策依据。方法以南昌市新建县、青云谱区2个国家级基层综合改革示范点为样本县区，采用单纯随机方法，抽取6家基层卫生机构的基层医务人员，对其进行职业认知调查，并对影响职业认知的因素进行线性回归分析。结果完成调查的181名基层医务人员总体职业认知为（3．29±0．64）分。不同地区、性别、年龄、职称和每天工作时间的医务人员之间总体职业认知及各维度水平皆没有差异，不同工作类别医务人员的收入与绩效满意度差异有统计学意义（F ＝2．550，P ＜0．05），社区卫生服务中心医务人员的工作环境满意度（F ＝4．960，P ＜0．05）及职业认同水平（F＝3．237，P ＜0．05）皆高于乡镇卫生院，医务人员月平均收入不同，其总体职业认知（F＝3．556，P ＜0．05）及收入与绩效满意度（F＝3．898，P ＜0．05）、职业规划水平（F＝3．632，P ＜0．05）差异有统计学意义。低职称、月平均收入高、护士总体职业认知高（模型 F＝7．256，P ＜0．001）。结论合理提高基层医务人员的收入，建立不同工作类别人群的绩效考核与薪酬管理机制，增加绩效分配的弹性，拓宽绩效来源范畴，建立与其职业期望相适应的相关优惠政策，对稳定基层卫生服务队伍、增强职业认知具有重要意义。%Objective To understand the status of occupational cognition and its influencing factors among grassroots medical workers in Nanchang,and to provide policy basis for the com-prehensive reform of primary health care.Methods Totally 181 grassroots medical workers from 3 urban primary health institutions and 3 rural primary health institutions of 2 national compre-hensive reform pilot sites(Xinjian county and Qingyunpu district)were selected as the samples u-sing the simple random sampling.The occupational cognition was investigated,and its influencing factors were analyzed by linear regression analysis.Results The overall score of occupational cognition was (3.29±0.64)score among the 181 grassroots medical workers.The overall occupa-tional cognition and each dimension level were not associated with the area,gender,age,profes-sional title and daily working time.There were statistical differences in the income and perform-ance satisfaction among different categories of medical workers(F=2.550,P <0.05).The work-ing environment satisfaction and occupational cognition of medical workers from community health service centers were higher than those of medical workers from township hospitals(F =4.960 and 3.237,respectively;P <0.05).In addition,the overall occupational cognition,income and performance satisfaction,and career planning level were significantly different among medical workers with different monthly income(F = 3.556,3.898 and 3.632,respectively;P < 0.05). Grassroots medical workers with low professional title or high monthly income and nurses had high occupational cognition(F=7.256,P <0.001).Conclusion Appropriately improving the in-come of grassroots medical workers,establishing the performance appraisal and compensation management mechanism for different types of staffs,increasing the performance allocation flexi-bility,broadening the scope of performance sources and establishing the career expectation-related preferential policies are important to stabilize grassroots health service team and to increase occu-pational cognition.