Article(id=1240633241728775043, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202401184, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1704902400000, receivedDateStr=2024-01-11, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773719614679, onlineDateStr=2026-03-17, pubDate=1716566400000, pubDateStr=2024-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773719614679, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773719614679, creator=13701087609, updateTime=1773719614679, updator=13701087609, issue=Issue{id=1240633237542851387, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773719613680, creator=13701087609, updateTime=1773720039302, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240635022806405370, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240635022806405371, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1805, endPage=1809, ext={EN=ArticleExt(id=1240633242097873800, articleId=1240633241728775043, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Job satisfaction and its influencing factors of health workers in basic public health service projects, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate thejob satisfaction and analyze influencing factors of health workers in basic public health service projects.

Methods

164 primary medical institutions in Jiangxi Province were selected according to the method of phased cluster sampling. A questionnaire survey was conducted on the health personnel providing basic public health services in these institutions. Nonparametric test and ordered multiclass logistic regression were used to analyze the influencing factors of job satisfaction.

Results

Among the 3 018 basic public health service workers, the average score of job satisfaction was 24.52±6.84 points. The proportion of very dissatisfied, relatively dissatisfied, average, fairly satisfied and very satisfied were 3.78%, 9.87%, 39.83%, 23.92% and 22.60%, respectively. Multiple linear regression analysis showed that educational background, job category, working years, income, overtime, training and performance reward mechanism had statistical significance on the overall job satisfaction score (P<0.05).

Conclusion

The job satisfaction of health worker in basic public health service projects in Jiangxi Province was above average. In order to improve the job satisfaction, we can improve the promotion and guarantee mechanism for grassroots talents, strengthen vocational training, and improve the assessment mechanism.

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目的

了解江西省基本公共卫生服务项目卫生人员工作满意度,分析影响因素。

方法

按分阶段整群抽样的方法,在江西省抽取了164家基层医疗卫生机构,对这些机构中提供基本公共卫生服务的卫生人员进行问卷调查,通过非参数检验和多元线性回归分析工作满意度的影响因素。

结果

调查的3 018名基本公共卫生服务项目卫生人员中,工作满意度均值为24.52±6.84分,非常不满意、比较不满意、一般、比较满意、非常满意的占比分别为3.78%、9.87%、39.83%、23.92%、22.60%。多元线性回归分析显示,学历、岗位类别、工作年限、收入、加班情况、培训情况、绩效奖励机制对总体工作满意度得分的影响有统计学意义(P<0.05)。

结论

江西省基本公共卫生服务项目卫生人员工作满意度处于中等偏上水平,提高项目人员的工作满意度,可从完善基层人才晋升和保障机制,加强职业培训,完善考核机制方面着手。

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叶珍珍,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=hWQkMWrOk9QQbRV5lsRGPA==, magXml=PjqqxT2+d0HeqyWxejQPuA==, pdfUrl=null, pdf=brqZs37u5ht7bXAhprJURg==, pdfFileSize=586692, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=rTWthqqGQlxIhQXd2oidnA==, mapNumber=null, authorCompany=null, fund=null, authors=

刘敏仔(1992—),女,硕士,主管医师,研究方向:公共卫生

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Chinese Rural Health Service Administration, 2020, 40(12): 864-868., articleTitle=Current situation and thoughts on the construction of primary health personnel team in China, refAbstract=null)], funds=[Fund(id=1240633247290421404, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, awardId=202311114, language=CN, fundingSource=江西省卫生健康委员会科技计划(202311114), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240633242680882082, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, xref=1., ext=[AuthorCompanyExt(id=1240633242689270691, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, companyId=1240633242680882082, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Jiangxi Provincial Health Development Center, Nanchang, Jiangxi 330006, China), AuthorCompanyExt(id=1240633242693464997, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, companyId=1240633242680882082, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.江西省卫生健康事业发展中心,江西 南昌 330006)]), AuthorCompany(id=1240633242789933992, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, xref=2., ext=[AuthorCompanyExt(id=1240633242798322602, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, companyId=1240633242789933992, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.宜春市疾病预防控制中心)]), AuthorCompany(id=1240633242873820077, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, xref=3., ext=[AuthorCompanyExt(id=1240633242882208685, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, companyId=1240633242873820077, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.江西省胸科医院)]), AuthorCompany(id=1240633242953511860, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, xref=4., ext=[AuthorCompanyExt(id=1240633242978677684, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, companyId=1240633242953511860, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.江西省疾病预防控制中心)])], figs=[ArticleFig(id=1240633246606749788, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, language=EN, label=Table 1, caption=

Job satisfaction of health workers in basic public health services,Jiangxi Province

, figureFileSmall=null, figureFileBig=null, tableContent=
维度满意度分布情况(%)得分
非常不满意较不满意一般满意比较满意非常满意
薪酬7.5513.2538.3420.3820.483.33±1.16
激励机制6.2311.4339.7321.7020.913.40±1.12
职称晋升6.3010.4740.6221.0121.603.41±1.12
管理制度3.915.8337.0127.7725.483.65±1.04
工作流程3.617.4239.2025.7524.023.59±1.04
工作环境4.419.8336.2226.6422.903.54±1.08
工作氛围3.615.8340.5927.0422.933.60±1.02
总体满意度3.789.8739.8323.9222.6024.52±6.84
), ArticleFig(id=1240633246703218790, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, language=CN, label=表1, caption=

江西省提供基本公共卫生服务卫生人员工作满意度情况

, figureFileSmall=null, figureFileBig=null, tableContent=
维度满意度分布情况(%)得分
非常不满意较不满意一般满意比较满意非常满意
薪酬7.5513.2538.3420.3820.483.33±1.16
激励机制6.2311.4339.7321.7020.913.40±1.12
职称晋升6.3010.4740.6221.0121.603.41±1.12
管理制度3.915.8337.0127.7725.483.65±1.04
工作流程3.617.4239.2025.7524.023.59±1.04
工作环境4.419.8336.2226.6422.903.54±1.08
工作氛围3.615.8340.5927.0422.933.60±1.02
总体满意度3.789.8739.8323.9222.6024.52±6.84
), ArticleFig(id=1240633246782910575, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, language=EN, label=Table 2, caption=

Univariate analysis of job satisfaction of health workers in basic public health services,Jiangxi Province (n=3 018)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量n占比(%)总体满意度得分H/ZP
机构类别1.0100.604
社区卫生服务中心1 16738.6724.43±6.96
一般乡镇卫生院79626.3824.38±6.60
中心卫生院1 05534.9524.72±6.89
地区分布11.6420.003
赣北1 83960.9324.84±6.85
中部91030.1523.88±6.74
赣南2698.9224.48±7.02
性别-0.606a0.545
75925.1524.34±7.03
2 25974.8524.58±6.78
年龄(岁)5.9440.114
18~3086728.7324.98±7.12
>30~401 10036.4524.41±6.96
>40~5072423.9924.17±6.30
>5032710.8324.39±6.82
学历21.303<0.001
高中或中专及以下71123.5625.19±7.08
大专1 10636.6524.67±6.76
本科及以上1 20139.7923.97±6.73
职称11.3140.010
无职称70023.1924.86±6.88
初级1 30843.3424.89±6.99
中级89529.6623.72±6.56
高级1153.8124.41±6.55
聘任方式-3.124a0.002
无编1 34444.5324.97±7.10
有编1 67455.4724.16±6.61
岗位类别10.6140.005
工勤人员1224.0426.05±7.15
专业技术人员2 78192.1524.38±6.81
行政管理人员1153.8126.13±7.02
工作年限(年)14.8510.005
>0~591930.4525.03±7.17
>5~1054518.0624.41±6.73
>10~1581426.9724.47±6.85
>15~2054818.1623.65±6.44
>201926.3624.97±6.44
收入(万元/年)18.105<0.001
>0~358219.2823.51±7.23
>3~61 77958.9524.74±6.72
>6~1060019.8824.63±6.77
>10571.8926.60±6.28
加班情况11.973a<0.001
不加班2 10969.8825.48±6.84
加班90930.1222.28±6.29
培训情况(次/年)79.585<0.001
039313.0221.97±6.69
1~51 96465.0824.73±6.76
6~1038812.8524.42±6.51
>102739.0526.79±7.07
绩效奖励机制-11.033a<0.001
78626.0422.15±6.59
2 23273.9625.35±6.73
), ArticleFig(id=1240633246917128315, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, language=CN, label=表2, caption=

江西省提供基本公共卫生服务卫生人员工作满意度的单因素分析(n=3 018)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量n占比(%)总体满意度得分H/ZP
机构类别1.0100.604
社区卫生服务中心1 16738.6724.43±6.96
一般乡镇卫生院79626.3824.38±6.60
中心卫生院1 05534.9524.72±6.89
地区分布11.6420.003
赣北1 83960.9324.84±6.85
中部91030.1523.88±6.74
赣南2698.9224.48±7.02
性别-0.606a0.545
75925.1524.34±7.03
2 25974.8524.58±6.78
年龄(岁)5.9440.114
18~3086728.7324.98±7.12
>30~401 10036.4524.41±6.96
>40~5072423.9924.17±6.30
>5032710.8324.39±6.82
学历21.303<0.001
高中或中专及以下71123.5625.19±7.08
大专1 10636.6524.67±6.76
本科及以上1 20139.7923.97±6.73
职称11.3140.010
无职称70023.1924.86±6.88
初级1 30843.3424.89±6.99
中级89529.6623.72±6.56
高级1153.8124.41±6.55
聘任方式-3.124a0.002
无编1 34444.5324.97±7.10
有编1 67455.4724.16±6.61
岗位类别10.6140.005
工勤人员1224.0426.05±7.15
专业技术人员2 78192.1524.38±6.81
行政管理人员1153.8126.13±7.02
工作年限(年)14.8510.005
>0~591930.4525.03±7.17
>5~1054518.0624.41±6.73
>10~1581426.9724.47±6.85
>15~2054818.1623.65±6.44
>201926.3624.97±6.44
收入(万元/年)18.105<0.001
>0~358219.2823.51±7.23
>3~61 77958.9524.74±6.72
>6~1060019.8824.63±6.77
>10571.8926.60±6.28
加班情况11.973a<0.001
不加班2 10969.8825.48±6.84
加班90930.1222.28±6.29
培训情况(次/年)79.585<0.001
039313.0221.97±6.69
1~51 96465.0824.73±6.76
6~1038812.8524.42±6.51
>102739.0526.79±7.07
绩效奖励机制-11.033a<0.001
78626.0422.15±6.59
2 23273.9625.35±6.73
), ArticleFig(id=1240633247080706183, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, language=EN, label=Table 3, caption=

Multivariate linear regression analysis of job satisfaction of health workers in basic public health services,Jiangxi Province

, figureFileSmall=null, figureFileBig=null, tableContent=
变量βS.E.tP共线性统计
容差VIF
常数项125.1790.80531.266<0.001
地区(对照:赣南)
赣北0.2510.4290.5850.5590.3143.182
中部-0.4960.459-1.0810.2800.3103.222
学历(对照:高中及以下)
大专-0.5740.326-1.7610.0780.5561.797
本科及以上-1.0320.365-2.8300.0050.4312.320
职称(对照:无职称)
初级0.1250.3360.3710.7110.4952.021
中级-0.7710.425-1.8130.0700.3642.744
高级-0.2340.755-0.3100.7570.6581.520
聘任方式(对照:无编制)
有编制-0.6820.310-1.6030.0480.5801.724
岗位类别(对照:行政管理)
工勤人员-0.4910.851-0.5760.5640.4892.044
专业技术人员-2.0170.619-3.2570.0010.4952.020
工作年限(年)(对照:>0~5)
>5~10-0.8710.362-2.4040.0160.7071.414
>10~15-0.4410.353-1.2500.2110.5591.788
>15~20-1.1950.425-2.8120.0050.5131.951
>20-0.2670.597-0.4470.6551.545
收入(万元/年)(对照:>0~3)
>3~61.7000.3534.820<0.0010.4572.190
>6~102.3100.4704.918<0.0010.3912.557
>103.5610.9433.777<0.0010.8351.198
加班情况(对照:不加班)
加班-3.1600.262-12.044<0.0010.9491.054
绩效奖励(对照:无)
3.1500.27611.402<0.0010.9351.069
培训情况(次/年)(对照:0)
1~52.2380.3596.225<0.0010.4582.185
6~101.8920.4664.065<0.0010.5531.807
>104.2100.5108.255<0.0010.6281.593
), ArticleFig(id=1240633247177175185, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633241728775043, language=CN, label=表3, caption=

江西省提供基本公共卫生服务卫生人员工作满意度的多元线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量βS.E.tP共线性统计
容差VIF
常数项125.1790.80531.266<0.001
地区(对照:赣南)
赣北0.2510.4290.5850.5590.3143.182
中部-0.4960.459-1.0810.2800.3103.222
学历(对照:高中及以下)
大专-0.5740.326-1.7610.0780.5561.797
本科及以上-1.0320.365-2.8300.0050.4312.320
职称(对照:无职称)
初级0.1250.3360.3710.7110.4952.021
中级-0.7710.425-1.8130.0700.3642.744
高级-0.2340.755-0.3100.7570.6581.520
聘任方式(对照:无编制)
有编制-0.6820.310-1.6030.0480.5801.724
岗位类别(对照:行政管理)
工勤人员-0.4910.851-0.5760.5640.4892.044
专业技术人员-2.0170.619-3.2570.0010.4952.020
工作年限(年)(对照:>0~5)
>5~10-0.8710.362-2.4040.0160.7071.414
>10~15-0.4410.353-1.2500.2110.5591.788
>15~20-1.1950.425-2.8120.0050.5131.951
>20-0.2670.597-0.4470.6551.545
收入(万元/年)(对照:>0~3)
>3~61.7000.3534.820<0.0010.4572.190
>6~102.3100.4704.918<0.0010.3912.557
>103.5610.9433.777<0.0010.8351.198
加班情况(对照:不加班)
加班-3.1600.262-12.044<0.0010.9491.054
绩效奖励(对照:无)
3.1500.27611.402<0.0010.9351.069
培训情况(次/年)(对照:0)
1~52.2380.3596.225<0.0010.4582.185
6~101.8920.4664.065<0.0010.5531.807
>104.2100.5108.255<0.0010.6281.593
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江西省基本公共卫生服务项目卫生人员工作满意度调查及影响因素分析
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刘敏仔 1 , 刘莉红 2 , 张慧慧 3 , 叶珍珍 4
现代预防医学 | 基层卫生服务 2024,51(10): 1805-1809
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现代预防医学 | 基层卫生服务 2024, 51(10): 1805-1809
江西省基本公共卫生服务项目卫生人员工作满意度调查及影响因素分析
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刘敏仔1, 刘莉红2, 张慧慧3, 叶珍珍4
作者信息
  • 1.江西省卫生健康事业发展中心,江西 南昌 330006
  • 2.宜春市疾病预防控制中心
  • 3.江西省胸科医院
  • 4.江西省疾病预防控制中心
  • 刘敏仔(1992—),女,硕士,主管医师,研究方向:公共卫生

通讯作者:

叶珍珍,E-mail:
Job satisfaction and its influencing factors of health workers in basic public health service projects
Min-zai LIU1, Li-hong LIU2, Hui-hui ZHANG3, Zhen-zhen YE4
Affiliations
  • Jiangxi Provincial Health Development Center, Nanchang, Jiangxi 330006, China
出版时间: 2024-05-25 doi: 10.20043/j.cnki.MPM.202401184
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目的

了解江西省基本公共卫生服务项目卫生人员工作满意度,分析影响因素。

方法

按分阶段整群抽样的方法,在江西省抽取了164家基层医疗卫生机构,对这些机构中提供基本公共卫生服务的卫生人员进行问卷调查,通过非参数检验和多元线性回归分析工作满意度的影响因素。

结果

调查的3 018名基本公共卫生服务项目卫生人员中,工作满意度均值为24.52±6.84分,非常不满意、比较不满意、一般、比较满意、非常满意的占比分别为3.78%、9.87%、39.83%、23.92%、22.60%。多元线性回归分析显示,学历、岗位类别、工作年限、收入、加班情况、培训情况、绩效奖励机制对总体工作满意度得分的影响有统计学意义(P<0.05)。

结论

江西省基本公共卫生服务项目卫生人员工作满意度处于中等偏上水平,提高项目人员的工作满意度,可从完善基层人才晋升和保障机制,加强职业培训,完善考核机制方面着手。

基本公共卫生服  /  工作满意度  /  影响因素
Objective

To investigate thejob satisfaction and analyze influencing factors of health workers in basic public health service projects.

Methods

164 primary medical institutions in Jiangxi Province were selected according to the method of phased cluster sampling. A questionnaire survey was conducted on the health personnel providing basic public health services in these institutions. Nonparametric test and ordered multiclass logistic regression were used to analyze the influencing factors of job satisfaction.

Results

Among the 3 018 basic public health service workers, the average score of job satisfaction was 24.52±6.84 points. The proportion of very dissatisfied, relatively dissatisfied, average, fairly satisfied and very satisfied were 3.78%, 9.87%, 39.83%, 23.92% and 22.60%, respectively. Multiple linear regression analysis showed that educational background, job category, working years, income, overtime, training and performance reward mechanism had statistical significance on the overall job satisfaction score (P<0.05).

Conclusion

The job satisfaction of health worker in basic public health service projects in Jiangxi Province was above average. In order to improve the job satisfaction, we can improve the promotion and guarantee mechanism for grassroots talents, strengthen vocational training, and improve the assessment mechanism.

Basic public health service  /  Job satisfaction  /  Influencing factors
刘敏仔, 刘莉红, 张慧慧, 叶珍珍. 江西省基本公共卫生服务项目卫生人员工作满意度调查及影响因素分析. 现代预防医学, 2024 , 51 (10) : 1805 -1809 . DOI: 10.20043/j.cnki.MPM.202401184
Min-zai LIU, Li-hong LIU, Hui-hui ZHANG, Zhen-zhen YE. Job satisfaction and its influencing factors of health workers in basic public health service projects[J]. Modern Preventive Medicine, 2024 , 51 (10) : 1805 -1809 . DOI: 10.20043/j.cnki.MPM.202401184
国家基本公共卫生服务项目是政府向全体居民提供的基础性公共卫生服务,是覆盖范围最大、服务人群最广、投入经费最高的公共卫生干预项目[1-2]。基本公共卫生服务项目自2009年实施以来,项目服务内容由9 类35 项增至16 类57 项,政府补助由每人每年15元逐步增长至89元。随着服务内容增加和资金投入的逐年增长,基本公共卫生服务项目已成为基层医疗卫生机构的重点工作,基层卫生人员也成为基本公共卫生服务的提供主力军[3]。随着“基层首诊、双向转诊、急慢分治、上下联动”分级诊疗政策的提出,家庭医生签约服务的推开,基层卫生人员也成为群众健康的守门人[4],其工作满意度直接影响基本公共卫生服务提供的质量、效率,也一定程度上影响着这支队伍的稳定性[5]。为了解江西省提供基本公共卫生服务基层卫生人员的工作满意度情况,分析影响因素,本文于2023年6月,通过分阶段整群抽样,调查了江西省提供基本公共卫生服务卫生人员的工作满意度情况。
全省基层医疗卫生机构中承担基本公共卫生服务项目的卫生人员。
按分阶段整群抽样的方法,于2023年6月在全省11个地市中,各随机抽取30%的县市区,每个县/区随机抽取4家基层医疗机构(乡镇卫生院/社区卫生服务中心),共计抽取41个县/区、164家基层医疗机构,对164家基层医疗机构中提供基本公共卫生服务的卫生人员进行问卷调查,收回问卷3 066份,其中有效问卷3 018份。
参考国内相关研究[6-8]及实际工作情况,初步制定满意度调查问卷,并通过预调查和实地调研不断完善问卷。调查由江西省卫生健康委基层处组织实施,问卷以“问卷星”的形式下发至各个被调查的基层医疗机构。调查内容包括基本情况、工作情况及工作满意度情况。基本情况包括年龄、性别、学历、职称、专业、编制情况;工作情况包括工作年限、工作内容、加班情况、培训情况及收入情况。满意度调查内容包含薪酬、职称晋升、激励机制、管理制度、工作流程、工作环境、工作氛围七个方面。满意度量表采用Likert 5级计分法,非常不满意、比较不满意、一般、比较满意、非常满意分别计1分、2分、3分、4分、5分。总体满意度为七个维度满意度得分之和,参考相关研究[9-10]将总得分划分为非常不满意、比较不满意、一般、比较满意、非常满意。满意度量表Cronbach’s Alpha系数为0.961,KMO值为0.932,Bartlett 球形检验χ2=2 807.229,P<0.001,说明该量表的信度和效度均较高。
采用Excel 2016和IBM SPSS 22.0进行数据整理和分析;单因素分析采用非参数检验,其中两组之间满意度比较采用Wilcoxcon秩和检验,多组间比较采用Kruskal-Wallis秩和检验;多因素分析采用多元线性回归。检验水准α=0.05。
本次调查的3 018名提供基本公共卫生服务的卫生人员中,38.67%来自社区卫生服务中心,26.38%来自一般乡镇卫生院,34.95%来自中心卫生院。卫生人员以女性多见,占比为74.85%;年龄以30~40岁人群多见,占比36.45%,其中65.18%为18~40岁人群,这有利于基本公共卫生服务项目的提供;学历以大专及以下学历为主,占比为60.21%;职称以初级为主,占比43.34%,其中高级职称仅占3.81%。有编制的占55.47%,无编占44.53%。岗位类别以专业技术人员为主,占92.15%。工作年限以0~5年为主,占30.45%。年收入主要集中在3~6万,占比58.95%。见表2
基本公共卫生服务项目卫生人员总体工作满意度最低值为7分,最高值为35分,平均值为24.52±6.84分,其中管理制度的满意度得分最高,为3.65±1.04分;薪酬满意度最低为3.33±1.16。总体满意度分布中,一般满意的占比最高(39.83%),其次是比较满意(23.92%);七个方面的满意度主要集中在一般满意,其次是比较满意;非常不满意占比最高的是薪酬方面(7.55%),最低的是工作流程(3.61%)和工作氛围方面(3.61%);非常满意占比最高的是管理制度方面(25.48%),最低的是薪酬方面(20.48%)。见表1
总体满意度得分在不同地区分布、学历、职称、聘任方式、岗位类别、工作年限、收入、加班情况、培训情况、绩效奖励机制中存在差异(P<0.05)。见表2
以总体满意度得分为因变量,地区分布、学历、职称、聘任方式、岗位类别、工作年限、收入、加班情况、培训情况、绩效奖励机制为自变量进行多元线性回归,分类变量均设置成哑变量进行分析。结果显示,学历、岗位类别、工作年限、收入、加班情况、培训情况、绩效奖励机制对总体工作满意度得分的影响有统计学意义(P<0.05);自变量的方差膨胀系数(VIF)均小于5,说明回归模型中自变量之间无共线性问题;模型R2为0.374,F值为22.12,P<0.001,提示模型拟合效果较好。本科及以上学历满意度低于高中及以下学历人群(β本科及以上=-1.032);专业技术人员满意度低于行政管理人员(β专业技术=-2.017);工作年限在5~10年、15~20年之间的满意度低于0~5年之间的人群(β5~10=-0.871,β15~20=-1.195);年收入3~6、6~10、>10万元的满意度高于收入0~3万元的人群(β3~6=1.700,β6~10=2.310,β>10=3.561);加班的工作满意度低于不加班人群(β加班=-3.160);单位有绩效奖励机制的满意度高于没有绩效奖励机制(β=3.150);培训次数1~5、6~10、>10次/年的满意度高于0次/年(β1~5=2.238,β5~10=1.892,β>10=4.210)。见表3
调查显示,江西省基本公共卫生服务项目人才队伍特点如下:一是性别结构失衡,女性占比高达75%,基层医疗卫生机构中女性偏多,这一特点与其他地区报道一致[11-12];二是学历偏低,大专及以下学历人群占比达60%,本科及以上学历比例低于全国水平[13];三是职称结构不平衡,无职称者占比仍接近25%,初级职称占比接近45%,这种职称结构的不平衡可能与基层医疗机构职称晋升困难、晋升途径窄有关;四是收入偏低,年收入低于6万人群占比高达75%。
基本公共卫生服务项目卫生人员总体工作满意度24.52±6.84分,“比较满意”和“非常满意”占比之和为46.56%,总体上处于中等偏上水平。但仍然有13.65%的人员工作满意度处于“比较不满意”和非常不满意,存在工作积极性不高、工作认同感不强的情况,有人员流失可能性。影响工作满意度的因素有学历、岗位类别、工作年限、收入、加班情况、培训情况及绩效奖励机制等。分析结果显示,本科及以上学历的满意度得分比高中及以下学历人群低1.03分,即,低学历人群的工作满意度较高,这与陈东明[14]的研究结果一致。学历越高就业期望值越高,而低学历人群就业期望值相对较低,加上政府相关政策的导向,使得基层医疗机构低学历人群工作满意度相对较高[15]。专业技术人员满意度得分低于行政管理人员,这可能与专业技术人员收入与职称挂钩,而职称晋升受职数、评聘机制等限值,上升难度大有关。加班和收入是工作满意度的影响因素,这一结果与余芳[16]的报道一致。低收入缺乏工作积极性,频繁加班易产生工作倦怠情绪,故低收入人群、需要加班的人群工作满意度较低。而绩效奖励机制可以激励职工的工作积极性,所以单位有绩效激励机制的人群工作满意度更高。随着国家基本公共卫生服务均等化政策的推行,基本公共卫生的工作在基层医疗机构中的占比越来越大,许多缺乏公共卫生工作经验的人员也从事这项工作,对基本公共卫生服务项目培训的需求也越来越大[17]。因此,在本文分析结果中,有机会参加培训的卫生人员工作满意度高于从未参加过培训的人员。
基层医疗卫生机构是维护群众健康的重要屏障,其人才储备水平直接决定了这道屏障是否坚实可靠。而基层卫生机构工资待遇低,晋升难度大、医疗资源配置匮乏等情况制约了基层卫生人才成长的可能性与积极性[18-19]。此外本调查显示基层工作还面临诸多困难和挑战,一是服务人口流动性较大;二是服务对象对项目的认可度和配合度不高;三是基层专业人员不足且人员流失较多;四是基层卫生人才尚不能满足当下医疗卫生服务及公共卫生服务需求。这些因素影响着基本公共卫生服务项目任务的完成进度,也影响着工作人员的工作积极性。调动基层卫生人员的积极性,提高基层卫生人员工作的满意度,可从以下几个方面着手。一是完善基层人才晋升和保障机制,不断完善基层人才薪酬分配、福利待遇保障机制及绩效工资总量调整管理机制,减少人才的流失[20]。二是加强职业培训,以实际需求为导向,补短板为目标,提高基层医疗卫生和家庭医生团队的服务能力,以满足群众对医疗卫生服务的需求[21]。三是加强项目的宣传力度,提高群众对基本公共卫生服务项目的认同感。四是完善考核机制,基本公共卫生服务项目考核频繁且存在“重量轻质”的现象,导致基层卫生机构疲于完成任务,工作压力较大。因此迫切需要从省、市、县层面制定精细化的绩效管理和激励措施,以减轻基层医疗卫生机构的考核压力。
  • 江西省卫生健康委员会科技计划(202311114)
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2024年第51卷第10期
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doi: 10.20043/j.cnki.MPM.202401184
  • 接收时间:2024-01-11
  • 首发时间:2026-03-17
  • 出版时间:2024-05-25
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  • 收稿日期:2024-01-11
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江西省卫生健康委员会科技计划(202311114)
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    1.江西省卫生健康事业发展中心,江西 南昌 330006
    2.宜春市疾病预防控制中心
    3.江西省胸科医院
    4.江西省疾病预防控制中心

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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