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Article(id=1241322666506908644, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202304062, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1680537600000, receivedDateStr=2023-04-04, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773883986355, onlineDateStr=2026-03-19, pubDate=1706112000000, pubDateStr=2024-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773883986355, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773883986355, creator=13701087609, updateTime=1773883986355, updator=13701087609, issue=Issue{id=1241322661654098823, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773883985198, creator=13701087609, updateTime=1773890256678, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241348966214849502, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241348966214849503, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=378, endPage=384, ext={EN=ArticleExt(id=1241322666943116282, articleId=1241322666506908644, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=A study on the resilience level and coping style of medical personnel in sudden public health incidents, columnId=1240375111455404044, journalTitle=Modern Preventive Medicine, columnName=Talent Development, runingTitle=null, highlight=null, articleAbstract=
Objective

To provide scientific basis for formulating strategies to improve the health management of medical personnel, we analyze the resilience level, coping styles, and influencing factors of 2 100 medical personnel under sudden public health emergencies.

Methods

Using the convenience sampling method, 22 medical institutions were selected from Pudong New Area, Shanghai, and a self-designed electronic survey questionnaire was distributed based on the professional characteristics of medical personnel, the resilience scale of medical personnel, and the coping style scale.

Results

The total score of medical staffs’ resilience was 71.246±11.442. The total score of medical staffs’ coping style was 58.614±11.493. The results of multiple linear regression analysis showed that the main factors affecting the resilience level of medical staff were hospital type (social health service center t=1.966, P=0.049), employment form (contract system t=4.031, P<0.001), professional title (intermediate professional title t=2.749, P=0.006), marital status (married t=3.471, P=0.001), monthly income (5 000-10 000 t=2153, P=0.031, >10 000 t=2.475, P=0.013), received psychological training (t=6.295, P<0.001). The main factors affecting the coping style level of medical personnel were hospital type (social health service center t=2.612, P=0.009), time of medical activity (11-20 years social health service center t=2.484, P=0.013, >20 years t=2.594, P=0.010), employment form (contract system t=3.716, P<0.001), professional title (intermediate professional title t=2.268, P=0.023), psychological training received (t=6.338, P<0.001) and occupational type (management t=2.218, P=0.027).

Conclusion

The level of resilience and coping style of medical personnel need to be improved. Meanwhile, hospital type, employment form, professional title, marital status and psychological training are the influencing factors of resilience and coping style of medical personnel.

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目的

分析突发公共卫生事件下2 100例医务人员抗逆力水平、应对方式及影响因素，为制定提高医务人员健康管理策略提供科学依据。

方法

采用方便抽样法，从上海市浦东新区选取22家医疗机构，发放结合医务人员职业特点及医务人员抗逆力量表、应对方式量表的自行编制电子调查问卷进行调查。

结果

医务人员抗逆力总得分为71.246 ±11.442；医务人员应对方式总得分为58.614±11.493；多重线性回归分析结果显示：影响医务人员抗逆力水平的因素主要是医院类型（社务卫生服务中心t=1.966，P=0.049）、用工形式（合同制t=4.031，P<0.001）、职称（中级职称t=2.749，P=0.006）、婚姻状况（已婚t=3.471，P=0.001）、月收入（5 000~10 000元 t=2,153，P=0.031、>10 000元t=2.475，P=0.013）、接受过心理学培训（t=6.295，P<0.001）；影响医务人员应对方式水平的因素主要是医院类型（社务卫生服务中心t=2.612，P=0.009）、从事医疗活动时间（11~20年社务卫生服务中心t=2.484，P=0.013、>20年t=2.594，P=0.010）、用工形式（合同制t=3.716，P<0.001）、职称（中级职称t=2.268，P=0.023）、接受过心理学培训(t=6.338，P<0.001)与职业类型(管理t=2.218，P=0.027)。

结论

医务人员的抗逆力水平及应对方式水平有待提升，同时，医院类型、用工形式、职称、婚姻状况、接受过心理学培训是医务人员抗逆力水平和应对方式的影响因素。

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赵江霞，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=SM2KSXY/rsfF1fO/F9TiwQ==, magXml=IsJHFHedKgf0YV/Fto44bA==, pdfUrl=null, pdf=+fZKSaK8ATVu+/v5hB12MA==, pdfFileSize=695297, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=8r/9rpyjWntnCLXnHkMsBg==, mapNumber=null, authorCompany=null, fund=null, authors=

马晓婷（1992—），女，硕士，主管医师，研究方向：医院管理工作

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马晓婷（1992—），女，硕士，主管医师，研究方向：医院管理工作

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Psychological Monthly, 2022, 17(8): 235-237., articleTitle=Research progress on resilience of community nurses under the normalization of epidemic situation, refAbstract=null)], funds=[Fund(id=1241322675520467303, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, awardId=X2022169, language=CN, fundingSource=上海市医院协会医院管理研究基金(X2022169), fundOrder=null, country=null), Fund(id=1241322675608547693, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, awardId=PWRq2023-27, language=CN, fundingSource=上海市浦东新区卫生系统优秀青年医学人才培养计划(PWRq2023-27), fundOrder=null, country=null), Fund(id=1241322675688239477, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, awardId=2023PDWS01, language=CN, fundingSource=浦东新区卫生健康工作党委党建研究重点立项课题(2023PDWS01), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241322669610692697, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, xref=1., ext=[AuthorCompanyExt(id=1241322669619081306, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, companyId=1241322669610692697, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of nosocomial infection management, Shanghai Pudong New Area People’s Hospital, Shanghai 201299, China), AuthorCompanyExt(id=1241322669627469915, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, companyId=1241322669610692697, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.上海市浦东新区人民医院医院感染管理科，上海 201299)]), AuthorCompany(id=1241322669702967393, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, xref=2., ext=[AuthorCompanyExt(id=1241322669711356002, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, companyId=1241322669702967393, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.上海市浦东新区肺科医院)]), AuthorCompany(id=1241322669812019305, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, xref=3., ext=[AuthorCompanyExt(id=1241322669816213610, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, companyId=1241322669812019305, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.上海交通大学医学院公共卫生学院)]), AuthorCompany(id=1241322669925265517, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, xref=4., ext=[AuthorCompanyExt(id=1241322669937848430, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, companyId=1241322669925265517, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.上海市浦东新区人民医院院部)])], figs=[ArticleFig(id=1241322674585137454, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, language=EN, label=Table 1, caption=

Resistance scores and coping style scores of medical personnel with different baseline characteristics（）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量抗逆力得分t/F值P值应对方式得分t/F值P值
医院类型9.967<0.00110.032<0.001
综合医院（n=909）71.834±11.93059.868±11.896
专科医院（n=427）72.546±11.08458.056±10.887
区卫生服务中心（n=764）69.821±10.89957.433±11.195
性别3.5780.0514.4760.764
男（n=359）72.320±12.21058.780±12.743
女（n=1 741）71.025±11.26858.580±11.221
年龄（岁）11.116<0.0016.699<0.001
≤25（n=114）71.158±11.67061.807±13.078
26~35（n=760）69.730±12.45259.480±12.625
36~45（n=711）71.267±10.87757.947±10.766
≥46（n=515）73.474±10.19457.550±10.058
从事医疗工作时间（年）12.102<0.0017.913<0.001
1~5（n=350）70.523±12.07060.283±12.338
6~10（n=337）68.739±12.36259.466±13.088
11~20（n=708）70.987±11.57358.972±12.036
>20（n=705）73.064±10.19857.018±9.311
用工形式3.8540.02122.234<0.001
正式编制（n=1 461）71.096±10.99857.642±10.766
人事代理（n=209）69.890±11.94758.852±11.412
合同制（n=430）72.416±12.54161.800±13.237
学历0.3370.7142.4060.090
大专及以下（n=444）71.088±11.94258.383±11.736
本科（n=1 414）71.376±11.26458.426±11.300
研究生及以上（n=242）70.777±11.56460.136±12.077
职称7.993<0.00110.493<0.001
初级职称及以下（n=890）70.924±12.31359.910±12.758
中级职称（n=1 006）70.917±10.81357.501±10.471
高级职称（n=204）74.279±10.03058.446±9.828
婚姻状况10.029<0.0012.8390.059
未婚（n=349）68.885±12.14459.550±12.028
已婚（n=1 703）71.783±11.24058.506±11.393
其他（n=48）69.375±11.14455.646±10.564
月收入（元）9.920<0.0010.3570.700
<5 000（n=266）69.049±12.49558.992±13.806
5 000~10 000（n=1 505）71.202±11.39958.637±11.262
>10 000（n=329）73.225±10.39058.204±10.457
通勤时间（min）0.5000.6060.2200.803
<30（n=916）71.294±11.17558.657±11.217
30~60（n=773）70.970±11.24858.423±11.029
>60（n=411）71.659±12.36758.876±12.892
每月夜班次数（次）3.0450.0480.2920.747
<5（n=1 253）71.725±11.04558.712±11.193
5~10（n=745）70.421±11.89058.381±11.706
>10（n=102）71.392±12.61659.108±13.481
疫情期间的岗位为医院0.0790.7780.1470.701
否（n=469）71.377±11.38058.793±12.073
是（n=1 631）71.208±11.46258.562±11.324
疫情期间的岗位为方舱2.9340.0871.5190.218
否（n=1 641）71.020±11.58458.450±11.591
是（n=459）72.054±10.89059.198±11.127
疫情期间的岗位为隔离点<0.0010.9831.9260.165
否（n=1 664）71.243±11.48058.436±11.456
是（n=436）71.257±11.30959.294±11.619
疫情期间的岗位为核酸采样8.8400.0033.6480.056
否（n=778）72.212±11.68359.238±12.031
是（n=1 322）70.678±11.26358.247±11.152
接受过心理学培训43.801<0.00119.621<0.001
否（n=1 697）70.449±11.55358.075±11.211
是（n=403）74.603±10.31860.883±12.368
职业6.3620.0026.1110.002
医生（n=855）71.156±10.83557.830±10.806
护士（n=1 008）70.751±11.67858.783±11.719
管理（n=237）73.679±12.27160.722±12.624
), ArticleFig(id=1241322674861961530, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, language=CN, label=表1, caption=

医护人员不同特征抗逆力得分与应对方式得分()

, figureFileSmall=null, figureFileBig=null, tableContent=
变量抗逆力得分t/F值P值应对方式得分t/F值P值
医院类型9.967<0.00110.032<0.001
综合医院（n=909）71.834±11.93059.868±11.896
专科医院（n=427）72.546±11.08458.056±10.887
区卫生服务中心（n=764）69.821±10.89957.433±11.195
性别3.5780.0514.4760.764
男（n=359）72.320±12.21058.780±12.743
女（n=1 741）71.025±11.26858.580±11.221
年龄（岁）11.116<0.0016.699<0.001
≤25（n=114）71.158±11.67061.807±13.078
26~35（n=760）69.730±12.45259.480±12.625
36~45（n=711）71.267±10.87757.947±10.766
≥46（n=515）73.474±10.19457.550±10.058
从事医疗工作时间（年）12.102<0.0017.913<0.001
1~5（n=350）70.523±12.07060.283±12.338
6~10（n=337）68.739±12.36259.466±13.088
11~20（n=708）70.987±11.57358.972±12.036
>20（n=705）73.064±10.19857.018±9.311
用工形式3.8540.02122.234<0.001
正式编制（n=1 461）71.096±10.99857.642±10.766
人事代理（n=209）69.890±11.94758.852±11.412
合同制（n=430）72.416±12.54161.800±13.237
学历0.3370.7142.4060.090
大专及以下（n=444）71.088±11.94258.383±11.736
本科（n=1 414）71.376±11.26458.426±11.300
研究生及以上（n=242）70.777±11.56460.136±12.077
职称7.993<0.00110.493<0.001
初级职称及以下（n=890）70.924±12.31359.910±12.758
中级职称（n=1 006）70.917±10.81357.501±10.471
高级职称（n=204）74.279±10.03058.446±9.828
婚姻状况10.029<0.0012.8390.059
未婚（n=349）68.885±12.14459.550±12.028
已婚（n=1 703）71.783±11.24058.506±11.393
其他（n=48）69.375±11.14455.646±10.564
月收入（元）9.920<0.0010.3570.700
<5 000（n=266）69.049±12.49558.992±13.806
5 000~10 000（n=1 505）71.202±11.39958.637±11.262
>10 000（n=329）73.225±10.39058.204±10.457
通勤时间（min）0.5000.6060.2200.803
<30（n=916）71.294±11.17558.657±11.217
30~60（n=773）70.970±11.24858.423±11.029
>60（n=411）71.659±12.36758.876±12.892
每月夜班次数（次）3.0450.0480.2920.747
<5（n=1 253）71.725±11.04558.712±11.193
5~10（n=745）70.421±11.89058.381±11.706
>10（n=102）71.392±12.61659.108±13.481
疫情期间的岗位为医院0.0790.7780.1470.701
否（n=469）71.377±11.38058.793±12.073
是（n=1 631）71.208±11.46258.562±11.324
疫情期间的岗位为方舱2.9340.0871.5190.218
否（n=1 641）71.020±11.58458.450±11.591
是（n=459）72.054±10.89059.198±11.127
疫情期间的岗位为隔离点<0.0010.9831.9260.165
否（n=1 664）71.243±11.48058.436±11.456
是（n=436）71.257±11.30959.294±11.619
疫情期间的岗位为核酸采样8.8400.0033.6480.056
否（n=778）72.212±11.68359.238±12.031
是（n=1 322）70.678±11.26358.247±11.152
接受过心理学培训43.801<0.00119.621<0.001
否（n=1 697）70.449±11.55358.075±11.211
是（n=403）74.603±10.31860.883±12.368
职业6.3620.0026.1110.002
医生（n=855）71.156±10.83557.830±10.806
护士（n=1 008）70.751±11.67858.783±11.719
管理（n=237）73.679±12.27160.722±12.624
), ArticleFig(id=1241322675029733701, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, language=EN, label=Table 2, caption=

Linear regression analysis of resilience scores of medical personnel

, figureFileSmall=null, figureFileBig=null, tableContent=
变量回归系数(95% CI)标准误tP值
医院类型（ref:综合医院）
综合医院
专科医院0.580(-0.755~1.915)0.6810.8520.394
社区卫生服务中心-1.274(-2.544~-0.003)0.6481.9660.049
年龄（岁）（ref: ≤25）
≤25
26~35-1.223(-3.813~1.367)1.3210.9260.355
36~45-0.917(-4.018~2.184)1.5810.5800.562
≥46-0.134(-3.722~3.453)1.8290.0730.941
从事医疗工作时间（年）（ref: 1~5）
1~5
6~10-1.807(-3.759~0.144)0.9951.8160.069
11~201.390(-0.783~3.562)1.1081.2550.210
>202.213(-0.570~4.996)1.4191.5600.119
用工形式（ref:正式编制）
正式编制
人事代理-0.161(-2.006~1.684)0.9410.1710.864
合同制3.313(1.70~4.924)0.8224.031<0.001
职称（ref:初级职称及以下）
初级职称及以下
中级职称-1.853(-3.176~-0.531)0.6742.7490.006
高级职称-0.651(-2.879~1.578)1.1360.5730.567
婚姻状况（ref:未婚）
未婚
已婚2.990(1.301~4.680)0.8623.4710.001
其他0.307(-3.239~3.853)1.8080.1700.865
月收入（元）（ref: <5 000）
<5 000
5 000~10 0001.694(0.151~3.236)0.7872.1530.031
>10 0002.537(0.527~4.548)1.0252.4750.013
每月夜班次数(次)（ref: <5）
<5
5~10-1.067(-2.158~0.025)0.5571.9170.055
>100.079(-2.182~2.339)1.1530.0680.946
疫情期间的岗位为核酸采样（ref:否）
否
是-0.609(-1.643~0.426)0.5271.1540.249
接受过心理学培训（ref:否）
否
是3.911(2.693~5.129)0.6216.295<0.001
职业（ref:医生）
医生
护士-0.798(-1.994~0.397)0.6101.3100.190
管理1.315(-0.354~2.983)0.8511.5460.122
), ArticleFig(id=1241322675159757133, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, language=CN, label=表2, caption=

医护人员抗逆力得分线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量回归系数(95% CI)标准误tP值
医院类型（ref:综合医院）
综合医院
专科医院0.580(-0.755~1.915)0.6810.8520.394
社区卫生服务中心-1.274(-2.544~-0.003)0.6481.9660.049
年龄（岁）（ref: ≤25）
≤25
26~35-1.223(-3.813~1.367)1.3210.9260.355
36~45-0.917(-4.018~2.184)1.5810.5800.562
≥46-0.134(-3.722~3.453)1.8290.0730.941
从事医疗工作时间（年）（ref: 1~5）
1~5
6~10-1.807(-3.759~0.144)0.9951.8160.069
11~201.390(-0.783~3.562)1.1081.2550.210
>202.213(-0.570~4.996)1.4191.5600.119
用工形式（ref:正式编制）
正式编制
人事代理-0.161(-2.006~1.684)0.9410.1710.864
合同制3.313(1.70~4.924)0.8224.031<0.001
职称（ref:初级职称及以下）
初级职称及以下
中级职称-1.853(-3.176~-0.531)0.6742.7490.006
高级职称-0.651(-2.879~1.578)1.1360.5730.567
婚姻状况（ref:未婚）
未婚
已婚2.990(1.301~4.680)0.8623.4710.001
其他0.307(-3.239~3.853)1.8080.1700.865
月收入（元）（ref: <5 000）
<5 000
5 000~10 0001.694(0.151~3.236)0.7872.1530.031
>10 0002.537(0.527~4.548)1.0252.4750.013
每月夜班次数(次)（ref: <5）
<5
5~10-1.067(-2.158~0.025)0.5571.9170.055
>100.079(-2.182~2.339)1.1530.0680.946
疫情期间的岗位为核酸采样（ref:否）
否
是-0.609(-1.643~0.426)0.5271.1540.249
接受过心理学培训（ref:否）
否
是3.911(2.693~5.129)0.6216.295<0.001
职业（ref:医生）
医生
护士-0.798(-1.994~0.397)0.6101.3100.190
管理1.315(-0.354~2.983)0.8511.5460.122
), ArticleFig(id=1241322675289780567, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, language=EN, label=Table 3, caption=

Linear regression analysis of coping style scores of medical personnel

, figureFileSmall=null, figureFileBig=null, tableContent=
变量回归系数(95% CI)标准误tP值
医院类型（ref:综合医院）
综合医院
专科医院0.446(-0.888~1.780)0.6800.6560.512
社区卫生服务中心-1.590(-2.784~-0.396)0.6092.6120.009
年龄（岁）（ref: ≤25）
≤25
26~350.186(-2.337~2.709)1.2870.1440.885
36~450.812(-2.204~3.829)1.5380.5280.597
≥461.787(-1.709~5.283)1.7831.0020.316
从事医疗工作时间（年）（ref: 1~5）
1~5
6~10-0.781(-2.659~1.097)0.9580.8160.415
11~202.604(0.548~4.660)1.0482.4840.013
>203.578(0.873~6.284)1.3802.5940.010
用工形式（ref:正式编制）
正式编制
人事代理-0.303(-2.146~1.539)0.9400.3230.747
合同制3.041(1.436~4.646)0.8183.716<0.001
职称（ref:初级职称及以下）
初级职称及以下
中级职称-1.521(-2.837~-0.206)0.6712.2680.023
高级职称-0.086(-2.24~2.074)1.1020.0780.938
接受过心理学培训（ref:否）
否
是3.944(2.724~5.165)0.6226.338<0.001
职业（ref:医生）
医生
护士-0.688(-1.868~0.492)0.6021.1430.253
管理1.863(0.216~3.511)0.8402.2180.027
), ArticleFig(id=1241322675390443871, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322666506908644, language=CN, label=表3, caption=

医护人员应对方式得分线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量回归系数(95% CI)标准误tP值
医院类型（ref:综合医院）
综合医院
专科医院0.446(-0.888~1.780)0.6800.6560.512
社区卫生服务中心-1.590(-2.784~-0.396)0.6092.6120.009
年龄（岁）（ref: ≤25）
≤25
26~350.186(-2.337~2.709)1.2870.1440.885
36~450.812(-2.204~3.829)1.5380.5280.597
≥461.787(-1.709~5.283)1.7831.0020.316
从事医疗工作时间（年）（ref: 1~5）
1~5
6~10-0.781(-2.659~1.097)0.9580.8160.415
11~202.604(0.548~4.660)1.0482.4840.013
>203.578(0.873~6.284)1.3802.5940.010
用工形式（ref:正式编制）
正式编制
人事代理-0.303(-2.146~1.539)0.9400.3230.747
合同制3.041(1.436~4.646)0.8183.716<0.001
职称（ref:初级职称及以下）
初级职称及以下
中级职称-1.521(-2.837~-0.206)0.6712.2680.023
高级职称-0.086(-2.24~2.074)1.1020.0780.938
接受过心理学培训（ref:否）
否
是3.944(2.724~5.165)0.6226.338<0.001
职业（ref:医生）
医生
护士-0.688(-1.868~0.492)0.6021.1430.253
管理1.863(0.216~3.511)0.8402.2180.027
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突发公共卫生事件下医务人员抗逆力水平与应对方式研究
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马晓婷 1 , 王萍 2 , 王志强 3 , 祝淋婴 1 , 吴浩 1 , 赵江霞 4
现代预防医学 | 人才培养 2024,51(2): 378-384
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现代预防医学 | 人才培养 2024, 51(2): 378-384
突发公共卫生事件下医务人员抗逆力水平与应对方式研究
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马晓婷1, 王萍2, 王志强3, 祝淋婴1, 吴浩1, 赵江霞4
作者信息
  • 1.上海市浦东新区人民医院医院感染管理科，上海 201299
  • 2.上海市浦东新区肺科医院
  • 3.上海交通大学医学院公共卫生学院
  • 4.上海市浦东新区人民医院院部

    • 马晓婷（1992—），女，硕士，主管医师，研究方向：医院管理工作

通讯作者:

赵江霞，E-mail：
A study on the resilience level and coping style of medical personnel in sudden public health incidents
Xiao-ting MA1, Ping WANG2, Zhi-qiang WANG3, Lin-ying ZHU1, Hao WU1, Jiang-xia ZHAO4
Affiliations
  • Department of nosocomial infection management, Shanghai Pudong New Area People’s Hospital, Shanghai 201299, China
出版时间: 2024-01-25 doi: 10.20043/j.cnki.MPM.202304062
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摘要
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目的

分析突发公共卫生事件下2 100例医务人员抗逆力水平、应对方式及影响因素，为制定提高医务人员健康管理策略提供科学依据。

方法

采用方便抽样法，从上海市浦东新区选取22家医疗机构，发放结合医务人员职业特点及医务人员抗逆力量表、应对方式量表的自行编制电子调查问卷进行调查。

结果

医务人员抗逆力总得分为71.246 ±11.442；医务人员应对方式总得分为58.614±11.493；多重线性回归分析结果显示：影响医务人员抗逆力水平的因素主要是医院类型（社务卫生服务中心t=1.966，P=0.049）、用工形式（合同制t=4.031，P<0.001）、职称（中级职称t=2.749，P=0.006）、婚姻状况（已婚t=3.471，P=0.001）、月收入（5 000~10 000元 t=2,153，P=0.031、>10 000元t=2.475，P=0.013）、接受过心理学培训（t=6.295，P<0.001）；影响医务人员应对方式水平的因素主要是医院类型（社务卫生服务中心t=2.612，P=0.009）、从事医疗活动时间（11~20年社务卫生服务中心t=2.484，P=0.013、>20年t=2.594，P=0.010）、用工形式（合同制t=3.716，P<0.001）、职称（中级职称t=2.268，P=0.023）、接受过心理学培训(t=6.338，P<0.001)与职业类型(管理t=2.218，P=0.027)。

结论

医务人员的抗逆力水平及应对方式水平有待提升，同时，医院类型、用工形式、职称、婚姻状况、接受过心理学培训是医务人员抗逆力水平和应对方式的影响因素。

医务人员  /  抗逆力  /  应对方式  /  影响因素
Objective

To provide scientific basis for formulating strategies to improve the health management of medical personnel, we analyze the resilience level, coping styles, and influencing factors of 2 100 medical personnel under sudden public health emergencies.

Methods

Using the convenience sampling method, 22 medical institutions were selected from Pudong New Area, Shanghai, and a self-designed electronic survey questionnaire was distributed based on the professional characteristics of medical personnel, the resilience scale of medical personnel, and the coping style scale.

Results

The total score of medical staffs’ resilience was 71.246±11.442. The total score of medical staffs’ coping style was 58.614±11.493. The results of multiple linear regression analysis showed that the main factors affecting the resilience level of medical staff were hospital type (social health service center t=1.966, P=0.049), employment form (contract system t=4.031, P<0.001), professional title (intermediate professional title t=2.749, P=0.006), marital status (married t=3.471, P=0.001), monthly income (5 000-10 000 t=2153, P=0.031, >10 000 t=2.475, P=0.013), received psychological training (t=6.295, P<0.001). The main factors affecting the coping style level of medical personnel were hospital type (social health service center t=2.612, P=0.009), time of medical activity (11-20 years social health service center t=2.484, P=0.013, >20 years t=2.594, P=0.010), employment form (contract system t=3.716, P<0.001), professional title (intermediate professional title t=2.268, P=0.023), psychological training received (t=6.338, P<0.001) and occupational type (management t=2.218, P=0.027).

Conclusion

The level of resilience and coping style of medical personnel need to be improved. Meanwhile, hospital type, employment form, professional title, marital status and psychological training are the influencing factors of resilience and coping style of medical personnel.

Medical personnel  /  Stress resistance  /  Coping style  /  Influence factor
马晓婷, 王萍, 王志强, 祝淋婴, 吴浩, 赵江霞. 突发公共卫生事件下医务人员抗逆力水平与应对方式研究. 现代预防医学, 2024 , 51 (2) : 378 -384 . DOI: 10.20043/j.cnki.MPM.202304062
Xiao-ting MA, Ping WANG, Zhi-qiang WANG, Lin-ying ZHU, Hao WU, Jiang-xia ZHAO. A study on the resilience level and coping style of medical personnel in sudden public health incidents[J]. Modern Preventive Medicine, 2024 , 51 (2) : 378 -384 . DOI: 10.20043/j.cnki.MPM.202304062
正文
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突发公共卫生事件，是指突然发生的会对人类健康造成影响的事件[1]。新冠肺炎疫情全球大流行是突发的世界性公共卫生危机。已有不少证据表明疫情之下不少医务人员出现了失眠、焦虑、抑郁、工作倦怠、共情疲劳等问题[2]。抗逆力一词起源于拉丁语“resilo”，也可称之为心理弹性，指个体在经历负面事件后能够积极调整心理状态，积极恢复正常心理的能力[3]。医务人员的抗逆力被发现是一种潜在的保护因素，在大型流行病爆发期间能同时发挥直接和间接的影响。应对方式是个体在压力面前所采取的处理措施[4]。关注医务人员抗逆力水平以及应对突发公共事件的能力，是医院管理的一项重要工作，其对实现“健康中国”战略具有重要意义。目前未见有针对上海地区医务人员抗逆力水平的研究报道，本研究旨在深入探讨上海市医务人员在突发公共卫生事件暴发时的抗逆力水平、应对方式及其影响因素，为提高医务人员抗逆力水平和应对能力，制订医务人员健康管理策略以及提升医务人员应对重大突发公共卫生事件的能力提供提供参考依据。
1　对象与方法
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1.1　研究对象
采用方便抽样法，从上海市浦东新区抽取的包括13家社区卫生服务中心、6家专科医院和3家综合医院在内的共计22家医疗机构，2022年5月16—19日在岗医务人员2 100例为研究对象。本研究通过上海市浦东新区人民医院【（2022）伦审第（K19）号】伦理审批。
1.1.1　调查方法
选取医务人员抗逆力量表、应对方式量表，结合医务人员职业特点自行编制调查问卷。问卷内容包含以下方面：（1）基本情况，包括医院类型、性别、年龄等。（2）抗逆力情况。（3）应对方式情况。共发放电子问卷2 223份，排除未完整作答问卷，回收有效问卷2 100份（94.4%）。
1.1.2　抗逆力水平评定
医务人员抗逆力评价量表由朱厚强等[5]编制, 18个条目，包括决策应对、人际联结、理性思维、柔性自适4个维度，量表每条目采用5级评分法(1~5分别代表“完全不符合”~“完全符合”)，满分90分。分值越高表明抗逆力能力越好，面对逆境时心态更积极，应对能力更强。该量表的Coronach α系数为0.907。
1.1.3　应对方式评定
采用王文娟等人[6]编制的医护人员应对方式量表，共25个条目，由3个维度构成，分别是积极情绪应对、消极情绪应对和问题解决，每条目采用4级评分法（“基本都采用”计4分，“经常采用”计3分，“有时采用”计2分，“没有采用”计1分）。分值越高表明遇到突发事件时采用的应对方式越多。总量表Coronach α系数为0.815。
1.2　统计学方法
采用SPSS 17.0进行统计学分析，正态分布计量资料用表示，计数资料用频数和百分比表示，两组均数组间比较采用t检验，多组均数组间比较采用单因素方差分析；在总人群中对抗逆力水平和应对方式的影响因素进行多重线性回归分析，检验水准α=0.05。
2　结果
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2.1　2 100例医务人员抗逆力量表、应对方式量表总分及各维度得分情况
医务人员抗逆力总得分为71.246±11.442，其中决策应对维度得分24.301±4.112、人际联结维度得分16.656±2.488、理性思维维度得分15.334±3.044、柔性自适维度得分14.955±3.246；医务人员应对方式总得分为58.614±11.493，其中消极情绪应对得分17.556±4.962、积极情绪应对得分19.938±4.850、问题解决得分21.120±4.832、柔性自适维度得分14.960±3.250。
2.2　医护人员不同特征抗逆力得分与应对方式得分分析
结果显示：医院类型、年龄、从事医疗工作时间、用工形式、职称、婚姻状况、月收入、每月夜班次数、疫情期间的岗位为核酸采样、接受过心理学培训与职业是与抗逆力水平相关的影响因素（P<0.05）；医院类型、年龄、从事医疗工作时间、用工形式、职称、接受过心理学培训与职业是与应对方式相关的影响因素（P<0.05），见表1。
2.3　医务人员抗逆力得分多重线性回归分析
为了校正混杂因素，将不同基线特征中与医务人员抗逆力得分相关的影响因素进一步纳入多重线性回归分析，结果显示：医院类型、用工形式、职称、婚姻状况、月收入、接受过心理学培训是与抗逆力水平相关的独立影响因素（P<0.05），见表2。
2.4　医务人员应对方式得分多重线性回归分析
为了校正混杂因素，将不同基线特征中与医务人员应对方式得分相关的影响因素进一步纳入多重线性回归分析，结果显示：医院类型、从事医疗活动时间、用工形式、职称、接受过心理学培训与职业类型是与应对方式水平相关的独立影响因素（P<0.05），见表3。
3　讨论
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在面对突发公共卫生事件时，医务人员拥有较高的抗逆力水平及良好的应对方式尤为重要，国内部分学者也开展了疫情期间医务人员抗逆力水平、应对方式水平及影响因素调查，发现年龄、护龄、月收入等是医务人员抗逆力水平和应对方式水平的影响因素[7-8]。本研究是基于上海市浦东新区多家医疗机构医务人员开展相关调查研究。
3.1　医务人员抗逆力水平现状
本研究发现医务人员抗逆力总得分为（71.246±11.442），横向对比四川省医务人员的抗逆力总分（58.34±13.42）[9]与哈尔滨市某三家医院医护人员抗逆力总分（68.53±0.74）[10]，本次研究所得分数高于同类研究。同时与其他人群对比，本研究中医务人员抗逆力得分低于某二级医院护士抗逆力得分与社区工作者的抗逆力总分[11]，处于中等水平。同时，医务人员应对方式总得分为（58.614±11.493），与国内学者调查[12]结果进行比较，本次参与调查的医务人员应对方式得分低于助产士（62.31±9.02）。研究结果说明应对方式在积极情绪应对和问题解决能力的双重作用下，能够提高医务人员抗逆力的得分。从而在重大突发事件压力下，能够良好的恢复和具有较强的适应能力，帮助医务人员有效应对职业压力，纠正负性情绪。
3.2　医务人员抗逆力水平影响因素分析
(1)医院类型中：综合医院抗逆力得分与应对方式得分均高于社区卫生服务中心，可能的原因有综合医院医疗设施、环境服务、医院管理与技术较好，工作压力大、任务繁重，疫情期间无论生理、心理都承担着较大的压力，医务人员在2年多的疫情防控工作中，处置能力及心理适应能力增强。因此具有抗逆力水平与应对能力更好。(2)从事医疗工作时间：研究发现，从事医疗工作长的医务人员应对方式得分更高，与秦娜娜等人[13]的结果一致，一方面由于工作年限的增长，医务人员积累的工作经验亦随之增加，对于工作性质、环境以及服务对象有着更为合理的预期，处理突发事件的能力更强。另一方面,从事医疗工作时间长的，其年龄也会相应偏高，心理社会适应能力也会更强。（3）职称：不同于其他学者职称越高抗逆力与应对方式得分越高的研究[14]，本研究发现初级职称的医务人员抗逆力水平更好，可能的原因是，初级职称的医务人员因为工作时间虽然不长，需要面临技能提升、工作任务重，家庭压力大，在经历了诸多压力性事件的同时，也积累了更多家庭、社会资源，更易采用积极地方式看待问题，保持乐观的心态，因此得分较高。（4）用工形式：合同制医务人员得分高于正式编制医务人员，合同编制的医务人员面临着职业发展、技术提升等问题，在疫情期间会更加注重对自己能力的锻炼，为获取编制积累抗疫工作经验，因此得分更高。(5)在婚姻状况比较中，已婚人群抗逆力得分高于未婚人群，与韩鹏等人的研究结果一致[15]，可能的原因婚姻关系可以帮助缓解压力，伴侣间的相互支持会潜移默化的影响抗逆力水平，在遇到困难时，多了一份支持与压力应对资源，能够更好地帮助我们采用积极地心态面对并克服困难，拥有更丰富的心理资源。(6)在月收入比较中，收入越高，抗逆力水平越好，分析原因可能与高收入会换来高的工作投入度有关。收入高的医务人员往往身兼重任，是医院应急管理的中坚力量，在日常工作中承担着重要责任。因此，面对问题时的心态更稳定，专业能力、应急处置能力更强。而收入较低的医务人员除了要面对疫情影响下收入减少带来的生活压力还要面对疫情来临被抽调到一线岗位工作的心理压力，更容易产生消极、恐慌心理，导致抗逆力得分较低[16]。(7)接受过心理学培训的人群抗逆力与应对方式得分均高于未接受过心理学培训的人群，培训可以让医务人员掌握一些专业的心理调适方式，面对应激事件时会尽可能采用成熟型应对方式，如有效利用社会支持、自我减压等，增强他们面对疫情危机的信心以及对突发事件的应对能力[17]，从而有条不紊地做好临床医疗工作。(8)管理岗位人员的应对方式的得分较高，行政管理人员是医疗机构应急管理的中坚力量，具有承上启下的关键作用。疫情期间，医疗机构管理人员要根据最新文件和精神，及时调整防控工作制度和工作流程。同时，还需要处理很多突发事件，因此，其应对能力更强。
3.3　医务人员抗逆力水平改善建议
综上所述，医疗机构管理人员应关注医务人员抗逆力、应对方式影响因素，给予医务人员更多的人文关怀。包括但不限于以下方式：（1）情感支持，关注医务人员身心健康，可在医疗机构内开设心理调解室，通过心理问询及时了解医务人员工作压力情况及相关诉求，帮助她们合理减压，以饱满的精神状态投入工作；(2)外部支持，提供安全的医疗环境和休息场所，加强应急物资的管理，保障充足的物资及营养供给。(3)对于疫情期间表现突出者，给予一定的物质表彰及精神奖励，充分肯定她们在疫情期间的付出。同时加强培训，在今后管理中提高对突发事件的应急应对能力培训和心理危机干预，帮助医务人员提升抗疫信心[18]。（4）在医疗机构内，广泛宣传健康文化，通过多种途径提升医务人员抗逆力水平和应对能力，提高医疗机构管理效率，降低突发公共卫生事件再次造成冲击和损伤的可能性。
基金
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  • 上海市医院协会医院管理研究基金(X2022169)
  • 上海市浦东新区卫生系统优秀青年医学人才培养计划(PWRq2023-27)
  • 浦东新区卫生健康工作党委党建研究重点立项课题(2023PDWS01)
文献
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2024年第51卷第2期
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doi: 10.20043/j.cnki.MPM.202304062
  • 接收时间：2023-04-04
  • 首发时间：2026-03-19
  • 出版时间：2024-01-25
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  • 收稿日期：2023-04-04
基金
上海市医院协会医院管理研究基金(X2022169)
上海市浦东新区卫生系统优秀青年医学人才培养计划(PWRq2023-27)
浦东新区卫生健康工作党委党建研究重点立项课题(2023PDWS01)
作者信息
    1.上海市浦东新区人民医院医院感染管理科，上海 201299
    2.上海市浦东新区肺科医院
    3.上海交通大学医学院公共卫生学院
    4.上海市浦东新区人民医院院部

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2种不同金属材料的力学参数
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Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
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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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