Occupational Risk Factors for Physical and Mental Health in Primary Healthcare Providers: A National Cross-Sectional Survey from 62 Urban Communities in China.
Occupational Risk Factors for Physical and Mental Health in Primary Healthcare Providers: A National Cross-Sectional Survey from 62 Urban Communities in China.
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DOI：
10.2147/jmdh.s401914
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发表时间：
2023
影响因子：
3.3
通讯作者：
He, Huijing
中科院分区：
文献类型：
--
作者：
Yin, Tao;Lu, Yan;Xiong, Wei;Yu, Chengdong;Yin, Delu;He, Huijing
为了解基层医疗服务人员（包括医生、护士及其他工作人员）的身心健康状况，以及导致抑郁、焦虑和离职意向的工作场所风险因素。
2021年12月，在中国62个城市社区开展了一项全国性横断面调查，邀请所有基层医疗服务人员填写一份标准化问卷。收集了人口统计学、健康相关生活方式、心血管疾病风险因素、身体健康状况、职业压力及离职意向等方面的信息。采用zung氏焦虑/抑郁自评量表（SAS/SDS）评估抑郁和焦虑情况。
共纳入4901名基层医疗服务人员。目前饮酒的男性占67.0%，女性为25.3%；目前吸烟的男性占36.0%，女性为1.4%。值得注意的是，超过半数男性超重或肥胖，而女性这一比例为24.2%。包括高血压、糖尿病、血脂异常、非酒精性脂肪性肝病、痛风及疾病聚集等慢性病的患病率，男性均高于女性。抑郁和焦虑的患病率较高，50%的人存在抑郁，其中15.6%为中重度抑郁。超过15%的参与者存在不同程度的焦虑，约4%为中重度焦虑。年龄在18 - 29岁（优势比[OR]：1.31，95%置信区间[CI]：1.05 - 1.64）、男性（OR：1.34，95%CI：1.14 - 1.57）、职称较低（与高级职称人员相比，中级、初级及无职称人员的OR分别为1.83、2.18和2.49）、从事护理工作（OR：1.41，95%CI：1.20 - 1.65）、感知压力水平较高（OR：1.82，95%CI：1.41 - 2.34）以及严重疲劳（OR：2.55，95%CI：1.99 - 3.27）的基层医疗服务人员更易出现抑郁。同样，年龄较轻、中级职称、感知压力水平较高及疲劳程度较高的基层医疗服务人员更易出现焦虑。
基层医疗服务人员的心理健康状况令人担忧，慢性病负担和职业风险因素较重。年轻的基层医疗服务人员、护士以及工作压力和疲劳程度较高者更容易出现心理问题。较高的离职意向患病率表明，需要制定缓解工作场所压力和提升人力资源能力的策略。
To understand the physical and mental health status of primary healthcare providers (PHPs) including physicians, nurses and other staff and the workplace risk factors for depression, anxiety and intention-to-leave. In December 2021, a national cross-sectional survey was conducted from 62 urban communities in China, and all PHPs were invited to complete a standardized questionnaire. Information on demographic, health-related lifestyle, cardiovascular risk factors and physical health status, occupational stress and intention-to-leave was collected. Depression and anxiety were assessed using the Zung Self-Rating Anxiety/Depression Scale (SAS/SDS). A total of 4901 PHPs were included. 67.0% males currently drank alcohol vs 25.3% in females; 36.0% males currently smoked cigarettes vs 1.4% in females. Notably, more than half males were overweight or obese, but this proportion was 24.2% in females. The prevalence of chronic diseases, including hypertension, diabetes, dyslipidemia, non-alcoholic fatty liver disease, gout, and disease clustering were higher in males than in females. The prevalence of depression and anxiety were high, 50% had depression, of whom 15.6% had moderate/severe depression. Over 15% participants had varied levels of anxiety, and approximately 4% had moderate/severe anxiety. PHPs who aged 18–29 (OR: 1.31, 95% CI: 1.05–1.64), were males (OR: 1.34, 95% CI: 1.14–1.57), with lower professional title (comparing with staff with senior title, the ORs of the intermedium, junior and none were 1.83, 2.18 and 2.49, respectively), took charge in nursing (OR: 1.41, 95% CI: 1.20–1.65), with higher perceived stress level (OR: 1.82, 95% CI: 1.41–2.34), and suffering from severe fatigue (OR: 2.55, 95% CI: 1.99–3.27) were more likely to have depression. Likewise, PHPs who were younger, with intermedium professional title, had higher perceived pressure level, and higher fatigue levels were more likely to have anxiety. The mental health of PHPs is worrisome, with a high burden of chronic diseases and occupational risk factors. Younger PHPs, nurses, and those with higher levels of work pressure and fatigue are more vulnerable to psychological problems. The high prevalence of intention-to-leave calls for strategies that relieve the workplace stress and enhance the human resource capability.