上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (4): 455-.

• 论著（卫生事业管理） • 上一篇    下一篇

上海市杨浦区不同等级公立医院医师焦虑状况和压力来源调查

韩一芃1, 王申奇1, 吴佳俊1, 安宣齐1, 张劲松2   

  1. 上海交通大学 医学院 1. 新华临床医学院, 2. 新华医院临床心理科, 上海 200092
  • 出版日期:2010-04-25 发布日期:2010-04-26
  • 通讯作者: 张劲松, 电子信箱: zhangjsk@online.sh.cn。
  • 作者简介:韩一芃(1987—), 男, 本科生；电子信箱: acecaptain@sjtu.edu.cn。

Anxiety status and stress sources of doctors in different classes of public hospitals in Yangpu District of Shanghai

HAN Yi-peng1, WANG Shen-qi1, WU Jia-jun1, AN Xuan-qi1, ZHANG Jin-song2   

  1. 1. Xinhua School of Clinical Medicine, 2. Department of Clinical Psychology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China
  • Online:2010-04-25 Published:2010-04-26

PDF (PC)

1609

摘要：

目的 了解医师的焦虑、职业压力问题及其与医院、科室间的关系。方法 通过结合焦虑自评量表（SAS）和医师职业压力源量表评估上海市杨浦区公立医院随机抽查的346名医师的焦虑和职业压力强度。各等级医院样本量根据卫生部医院床位数人员配置标准所需医师数量选定。结果 332（有效率96%）名医师的SAS原始分为（36.62±7.01）分，高于我国常模（P<0.01)，且在婚姻、性别、受教育程度等混杂因素间差异无统计学意义（P>0.05），在各级医院、不同科室间的差异也无统计学意义（P>0.05）；压力强度总平均分为（2.39±1.09）分（轻至中度压力），前三位的职业压力来源为医疗风险、待遇负荷和理解支持。三个等级公立医院医师的压力强度有差异（P=0.000），其中一级医院医师的压力最轻，三级医院医师的压力最重；外科医师的工作压力最大。结论 受调查医师群体的焦虑状况在不同等级或科室中都相似，且高于一般人群。医疗风险在各级医院医师中都是最主要的压力来源；一级医院医师的压力最轻可能与政策扶持有关，而二级医院由于职能定位不明确而使医师压力居中，三级医院医师的压力最重提示了三级医院工作的高强度。医师的高压力和焦虑状况与医患矛盾的产生相关联。

关键词: 焦虑, 压力来源, 医师, 三级公立医院

Abstract:

Objective To investigate the anxiety status and professional stress of doctors, and explore their relationship with hospitals and departments. Methods A quantitative self-reporting questionnaire composed with Stressors Scale for Doctors and self-rating anxiety scale (SAS) was performed to evaluate the anxiety status and professional stress of doctors randomly selected from public hospitals in Yangpu District of Shanghai. The sample numbers of each class of hospitals were determined by the staff allocation standard enacted by the Ministry of Health. Results The average score of anxiety state by SAS of 332 participants (effective rate, 96%) was 36.62±7.01, significantly higher than the Chinese norm (P<0.01), while there was no significant difference by marriage status, gender, education degree, hospital classes and departments (P>0.05). The general average score of stress was 2.39±1.09 (mild to moderate level), and the main stressors were medical risks, salary load and understanding and support from patients. There were significant differences in stress levels among doctors in various classes of hospitals (P=0.000), with those in the community hospitals being the lowest and those of the municipal hospitals being the highest. Besides, surgeons experienced greater stress than doctors of the other departments. Conclusion The anxiety status of doctors in Yangpu District of Shanghai is similar in different classes of hospitals and in different departments, and is more severe than that of the general population. Medical risk is the major source of stress in each class of hospitals. Doctors in community hospitals experience the least stress due to beneficial policies, those in districtal hospitals have an ambiguous functional authority, and those in municipal hospitals suffer the greatest professional pressure. The status of anxiety and stress of doctors is related to the contradiction between patients and doctors.

Key words: anxiety, sources of stress, doctors, three classes of public hospitals