The impact of work-family support on job burnout among primary health care workers and the mediating role of career identity and job satisfaction
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摘要:
目的 分析基层卫生人员职业倦怠现状，探讨工作-家庭支持、工作满意度和职业认同对职业倦怠的影响及其关系。 方法 采用多阶段抽样方法，对我国中部地区某省320所基层卫生机构中的基层卫生人员进行整群调查，使用单因素分析、分层线性回归分析、中介效应分析，研究工作-家庭支持、工作满意度、职业认同对基层卫生人员职业倦怠的影响，以及职业认同和工作满意度的中介作用。 结果 在8 135名基层卫生人员中，职业倦怠检出率为62.59%。工作-家庭支持与职业认同、工作满意度呈正相关，与职业倦怠呈负相关(均P＜0.05)。工作-家庭支持(β=-0.192, P＜0.001)、职业认同(β=-0.352, P＜0.001)和工作满意度(β=-0.179, P＜0.001)是职业倦怠的负向关联因子。职业认同、工作满意度在工作-家庭支持对职业倦怠的影响中起部分中介作用，中介效应占比分别为32.80%、22.30%。 结论 工作-家庭支持能够降低基层卫生人员产生职业倦怠的概率，职业认同和工作满意度均是工作-家庭支持对职业倦怠的中介影响因素。 Abstract:Objective To analyze the current status of job burnout among primary health care workers and explore the impact of work-family support, job satisfaction, and career identity on job burnout and their interrelationships. Methods A multi-stage sampling method was used to investigate 8 135 primary health care workers from 320 primary health care institutions in a central Chinese province. Univariate and hierarchical linear regression analyses, along with mediation effect analysis, were used to assess the impact of work-family support, career identity, and job satisfaction on primary health care workers′ job burnout, and to examine the mediating roles of career identity and job satisfaction. Results The prevalence of job burnout among the 8 135 primary health care workers was 62.59%. Work-family support was significantly positively correlated with career identity and job satisfaction and negatively correlated with job burnout (all P<0.05). Work-family support (β=-0.192, P<0.001), career identity (β=-0.352, P<0.001), and job satisfaction (β=-0.179, P<0.001) were negative related with job burnout. Career identity and job satisfaction partially mediated the impact of work-family support on job burnout, with mediation effect proportions of 32.80% and 22.30%, respectively. Conclusions Work-family support can reduce the probability of job burnout among primary health care workers, and both career identity and job satisfaction are mediating factors in the impact of work-family support on job burnout. -
Key words:
- Career identity /
- Job satisfaction /
- Work-family support /
- Job burnout /
- Mediation effect
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图 1 职业认同和工作满意度的中介效应模型
a: P＜0.001；b: 直接效应; c: 总效应; a1×b1: 职业认同的间接效应; a2×b2: 工作满意度的间接效应。
Figure 1. Mediation model of career identity and job satisfaction
a: P<0.001; b: direct effects; c: total effect; a1×b1: indirect effect of career identity; a2×b2: indirect effect of job satisfaction.
表 1 不同特征基层卫生人员工作-家庭支持、职业认同、工作满意度和职业倦怠得分比较
Table 1. Comparison of work-family support, career identity, job satisfaction, and job burnout scores among primary health care workers with different characteristics
变量
Variable人数
Number of people③
(n=8 135)工作-家庭支持
Work-family support④职业认同
Career identity④工作满意度
Job satisfaction④职业倦怠
Job burnout④性别Gender① 男Male 2 618(32.18) 102(88, 111) 51(48, 57) 54(49, 63) 29(18, 36) 女Female 5 517(67.82) 98 (84, 107) 50(47, 56) 54(50, 63) 29(19, 37) Z值value -7.70⑤ -3.02⑤ -2.22⑤ -0.78 年龄/岁Age/years② ≤25 509(6.26) 97(84, 105) 48(46, 53) 54(51, 65) 34(23, 40) ＞25~35 2 319(28.50) 96(82, 105) 49(47, 56) 53(49, 62) 32(22, 40) ＞35~45 2 608(32.06) 99(85, 109) 52(48, 57) 54(50, 63) 28(17, 36) ＞45~55 2 386(29.33) 102(89, 111) 52(48, 57) 54(50, 63) 26(17, 34) ＞55 313(3.85) 102(91, 114) 52(48, 57) 56(51, 64) 26(18, 32) H值value 116.93⑤ 163.55⑤ 19.23⑤ 258.83⑤ 学历Educational background② 高中及以下High school or below 1 636(20.11) 102(90, 112) 51(48, 56) 56(51, 65) 26(17, 34) 大专Junior college 3 504(43.08) 100(85, 109) 51(48, 57) 54(50, 63) 29(18, 37) 大学本科Bachelor′s degree program 2 972(36.53) 97(83, 105) 51(48, 57) 53(49, 61) 30(20, 38) 硕士及以上Master degree or above 23(0.28) 89(81, 104) 51(48, 54) 50(47, 59) 32(23, 40) H值value 105.07⑤ 0.74 64.37⑤ 74.82⑤ 职称Title② 正高级Positive advanced 29(0.36) 103(87, 111) 53(49, 58) 61(51, 66) 25(16, 33) 副高级Deputy senior 346(4.25) 98(86, 107) 53(48, 58) 53(49, 62) 28(19, 35) 中级Intermediate 2 440(29.99) 98(84, 107) 52(48, 57) 53(49, 61) 28(18, 36) 初级Primary 4 467(54.91) 99(85, 108) 50(47, 56) 54(50, 63) 29(19, 38) 无职称No professional title 853(10.49) 102(88, 112) 50(47, 56) 56(51, 66) 29(17, 36) H值value 27.65⑤ 124.17⑤ 60.46⑤ 25.38⑤ 工作年限/年Working years/years② ≤3 873(10.73) 99(85, 106) 48(46, 54) 55(51, 66) 32(21, 39) ＞3~10 1 802(22.15) 97(82, 105) 49(47, 56) 53(49, 62) 32(22, 40) ＞10~20 2 029(24.94) 96(84, 107) 51(48, 57) 53(49, 61) 29(19, 37) ＞20 3 431(42.18) 101(88, 112) 52(48, 57) 55(50, 63) 27(17, 35) H值value 113.22⑤ 152.70⑤ 42.86⑤ 198.54⑤ 个人年收入/元Annual personal income/yuan② ≤30 000 1 257(15.45) 99(84, 107) 49(47, 56) 53(50, 63) 30(19, 38) ＞30 000~50 000 3 059(37.60) 100(85, 110) 50(47, 56) 54(50, 63) 29(18, 37) ＞50 000~100 000 3 410(41.92) 99(85, 107) 51(48, 57) 54(50, 62) 29(19, 36) ＞100 000 409(5.03) 101(88, 109) 53(48, 58) 56(51, 66) 27(17, 35) H值value 8.07⑤ 54.54⑤ 19.61⑤ 9.77⑤ 日均工作时长Average daily working hours/h② <7 269(3.31) 102(89, 113) 51(47, 56) 55(51, 68) 29(19, 37) 7~8 3 613(44.41) 100(86, 108) 50(48, 56) 55(51, 65) 28(18, 36) ＞8~10 3 133(38.51) 98(84, 107) 51(48, 57) 53(49, 62) 29(19, 37) ＞10 1 120(13.77) 99(84, 109) 52(48, 57) 52(47, 59) 29(20, 38) H值value 29.26⑤ 19.29⑤ 150.78⑤ 18.16⑤ 工作场所Workplace① 社区卫生服务中心Community health service center 2 454(30.18) 99(85, 109) 51(48, 57) 55(50, 64) 28(18, 37) 乡镇卫生院Township hospitals 5 678(69.82) 99(85, 108) 51(48, 57) 54(50, 62) 29(19, 36) Z值value -0.66 -0.63 -3.04⑤ -0.49 注：①使用Mann-Whitney U检验；②使用Kruskal-Wallis H检验；③以人数(占比/%)表示；④以M(P25, P75)表示；⑤ P<0.05。
Note: ① Mann-Whitney U test was used; ② Kruskal-Wallis H test was used; ③ Number of people (proportion/%); ④ M(P25, P75); ⑤ P<0.05.
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表 2 基层卫生人员工作-家庭支持、职业认同、工作满意度和职业倦怠的相关性分析
Table 2. Correlation analysis of work-family support, career identity, job satisfaction, and job burnout among primary health care workers
变量
Variable工作-家庭支持
Work-family support工作支持
Work support家庭支持
Family support职业认同
Career identity工作满意度
Job satisfaction职业倦怠
Job burnout情感衰竭
Emotional exhaustion去人格化
Deperson-alization个人成就感
Personal accomplishment工作-家庭支持Work-family support 1.000 工作支持Work support 0.966① 1.000 家庭支持Family support 0.712① 0.545① 1.000 职业认同Career identity 0.406① 0.358① 0.447① 1.000 工作满意度Job satisfaction 0.568① 0.585① 0.307① 0.215① 1.000 职业倦怠Job burnout -0.432① -0.387① -0.421① -0.472① -0.360① 1.000 情感衰竭Emotional exhaustion -0.466① -0.453① -0.338① -0.288① -0.406① 0.633① 1.000 去人格化Depersonalization -0.495① -0.462① -0.424① -0.416① -0.387① 0.761① 0.650① 1.000 个人成就感Personal accomplishment -0.205① -0.160① -0.295① -0.397① -0.146① 0.785① 0.152① 0.359① 1.000 注：①P<0.05。
Note: ① P<0.05.
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表 3 工作-家庭支持对职业倦怠影响的多因素分层线性回归分析
Table 3. Multivariate hierarchical linear regression analysis of the effect of work-family support on job burnout
变量
Variable模型1 β值
Model 1 β value模型2 β值
Model 2 β value模型3 Model 3 方差膨胀因子
variance inflation factorβ值value P值value 性别(对照男) Gender (compared with male) 女Female -0.033 -0.055 -0.034 0.001 1.186 年龄/岁(对照≤25岁) Age/years (compared with≤25 years) ＞25~35 -0.076 -0.057 -0.038 0.086 5.996 ＞35~45 -0.214 -0.159 -0.132 ＜0.001 8.296 ＞45~55 -0.242 -0.180 -0.156 ＜0.001 9.127 ＞55 -0.103 -0.073 -0.063 ＜0.001 2.605 个人年收入/元(对照≤30 000元) Annual personal income/yuan (compared with≤30 000 yuan) ＞30 000~50 000 -0.002 0.008 0.025 0.063 2.292 ＞50 000~100 000 0.028 0.028 0.060 ＜0.001 2.613 ＞100 000 -0.001 0.008 0.031 0.005 1.484 日均工作时长(对照7~8 h) Average daily working hours/h (compared with 7-8 h) ＜7 0.008 0.016 0.014 0.129 1.044 ＞8~10 0.066 0.037 0.043 ＜0.001 1.179 ＞10 0.062 0.038 0.037 ＜0.001 1.180 工作-家庭支持Work-family support -0.446 -0.192 ＜0.001 1.789 职业认同Career identity -0.352 ＜0.001 1.262 工作满意度Job satisfaction -0.179 ＜0.001 1.548 R2 0.040 0.232 0.350 调整后R2 Adjusted R2 0.038 0.231 0.348 F值value 17.033① 2 031.741① 729.569① 注：①P<0.05。
Note: ① P<0.05.
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表 4 总效应、直接效应及中介效应分解
Table 4. Total effects, direct effects, and mediation effects decomposition
效应类型
Effect type效应值
Effect valueBoot标准误
standard errorBoot CI下限
Boot CI lower limitBoot CI上限
Boot CI upper limit效应占比
Effect proportion/%总效应Total effect -0.524② 0.013 -0.559 -0.517 直接效应Direct effect -0.228② 0.016 -0.258 -0.202 44.90 间接效应1 Indirect effect 1① -0.174② 0.007 -0.188 -0.164 32.80 间接效应2 Indirect effect 2① -0.122② 0.008 -0.134 -0.107 22.30 注：①间接效应1为工作-家庭支持→职业认同→职业倦怠；间接效应2为工作-家庭支持→工作满意度→职业倦怠；② P＜0.001。
Note: ① Indirect effect 1 is work family support → career identity → job burnout; The indirect effect 2 was work family support → job satisfaction → job burnout; ② P<0.001.
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[1] Opoku DA, Ayisi-Boateng NK, Osarfo J, et al. Attrition of nursing professionals in Ghana: an effect of burnout on intention to quit[J]. Nurs Res Pract, 2022, 2022: 3100344. DOI: 10.1155/2022/3100344. [2] Saladino V, Auriemma V, Campinoti V. Healthcare professionals, post-traumatic stress disorder, and COVID-19: a review of the literature[J]. Front Psychiatry, 2022, 12: 795221. DOI: 10.3389/fpsyt.2021.795221. [3] Zhang XW, Zhang WJ, Xue L, et al. The influence of professional identity, job satisfaction, burnout on turnover intention among village public health service providers in China in the context of COVID-19: a cross-sectional study[J]. Front Public Health, 2022, 10: 925882. DOI: 10.3389/fpubh.2022.925882. [4] Gilbert C, Johnson M, Karki B, et al. Preventing job burnout: could workplace support protect maternal and child health professionals who are doing public health equity work?[J]. Matern Child Health J, 2024, 28(1): 24-30. DOI: 10.1007/s10995-023-03846-7. [5] Wu TJ, Yuan KS, Yen DC, et al. The effects of JDC model on burnout and work engagement: a multiple interaction analysis[J]. Eur Manag J, 2023, 41(3): 395-403. DOI: 10.1016/j.emj.2022.02.001. [6] Sonnentag S, Meier LL. Gain and loss cycles revisited: what to consider when testing key assumptions of conservation of resources theory[J]. J Manag Sci Rep, 2024, 2(2): 154-167. DOI: 10.1177/27550311241247833. [7] 李永鑫, 赵娜. 工作-家庭支持的结构与测量及其调节作用[J]. 心理学报, 2009, 41(9): 863-874. DOI: 10.3724/SP.J.1041.2009.00863.Li YX, Zhao N. Structure and measurement of work-family support and its moderation effect[J]. Acta Psychol Sin, 2009, 41(9): 863-874. DOI: 10.3724/SP.J.1041.2009.00863. [8] 吴昊. 公立医院医护工作者职业认同问题研究[D]. 成都: 西南财经大学, 2012.Wu H. Research on professional identity of medical workers in public hospitals[D]. Chengdu: Southwestern University of Finance and Economics, 2012. [9] 赵红, 路迢迢, 张彩云, 等. 护士职业认同量表中文版的信度与效度研究[J]. 中国护理管理, 2010, 10(11): 49-51. DOI: 10.3969/j.issn.1672-1756.2010.11.018.Zhao H, Lu TT, Zhang CY, et al. Testing for reliability and validity of chinese version of the nurse's career identity scale[J]. Chin Nurs Manag, 2010, 10(11): 49-51. DOI: 10.3969/j.issn.1672-1756.2010.11.018. [10] Weiss DJ, Dawis RV, England GW, et al. Manual for the minnesota satisfaction questionnaire[M]. Minneapolis: University of Minnesota, Industrial Relations Center, 1967: 120. [11] 李超平, 时勘. 分配公平与程序公平对工作倦怠的影响[J]. 心理学报, 2003, 35(5): 677-684.Li CP, Shi K. The influence of distributive justice and procedural justi ce on job burnout[J]. Acta Psychol Sin, 2003, 35(5): 677-684. [12] Xu WC, Pan ZJ, Li Z, et al. Job burnout among primary healthcare workers in rural China: a multilevel analysis[J]. Int J Environ Res Public Health, 2020, 17(3): 727. DOI: 10.3390/ijerph17030727. [13] 张萌, 崔倩, 朱长才. 医护人员职业倦怠影响因素的结构方程模型分析[J]. 中华疾病控制杂志, 2022, 26(7): 808-814. DOI: 10.16462/j.cnki.zhjbkz.2022.07.011.Zhang M, Cui Q, Zhu CC. The influencing factors of job burnout among medical staff by structural equation model[J]. Chin J Dis Control Prev, 2022, 26(7): 808-814. DOI: 10.16462/j.cnki.zhjbkz.2022.07.011. [14] Eden AR, Jabbarpour Y, Morgan ZJ, et al. Gender differences in personal and organizational mechanisms to address burnout among family physicians[J]. J Am Board Fam Med, 2020, 33(3): 446-451. DOI: 10.3122/jabfm.2020.03.190344. [15] 朱靖, 陈祉妍. 医疗卫生工作者心理健康水平现状[J]. 科技导报, 2019, 37(11): 53-63.Zhu J, Chen ZY. Status quo of mental health status of medical staff[J]. Sci Technol Rev, 2019, 37(11): 53-63. [16] 周燕, 林志文, 周葭蔚, 等. 基于ABC-X模型的珠海市医务人员职业倦怠水平及影响因素研究[J]. 江苏卫生事业管理, 2024, 35(7): 930-935.Zhou Y, Lin ZW, Zhou JW, et al. Study on the level of burnout and influencing factors of medical personnel in Zhuhai based on the ABC-X model[J]. Jiangsu Health System Management, 2024, 35(7): 930-935. [17] Feng J, Sang WY, Lei ZH, et al. The impact of burnout on turnover intention among Chinese general practitioners: the mediating effect of job satisfaction and the moderating effect of professional identity[J]. Int J Soc Psychiatry, 2023, 69(3): 705-713. DOI: 10.1177/00207640221133939. [18] 唐郑皓, 石武祥, 郑楚, 等. 全科医生基层工作意愿的状况及其影响因素研究[J]. 中国农村卫生事业管理, 2024, 44(8): 544-549. DOI: 10.19955/j.cnki.1005-5916.2024.08.003.Tang ZH, Shi WX, Zheng C, et al. General practitioners'willingness to work in township heath centers and the influencing factors[J]. Chinese Rural Health Service Administoation, 2024, 44(8): 544-549. DOI: 10.19955/j.cnki.1005-5916.2024.08.003. [19] 张冬欣. 工作-家庭支持对女性职业成功的促进研究: 以心理资本为中介变量[D]. 长春: 东北师范大学, 2023.Zhang DX. Research on the promotion of work-family support to women's career success: taking psychological capital as mediating variable[D]. Changchun: Northeast Normal University, 2023. [20] Chan XW, Kalliath P, Chan C, et al. How does family support facilitate job satisfaction? Investigating the chain mediating effects of work-family enrichment and job-related well-being[J]. Stress Health, 2020, 36(1): 97-104. DOI: 10.1002/smi.2918. -
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