Turnover intention among primary health workers in China: a systematic review and meta-analysis.
Turnover intention among primary health workers in China: a systematic review and meta-analysis.
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DOI：
10.1136/bmjopen-2020-037117
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发表时间：
2020-10-16
期刊：
影响因子：
2.9
通讯作者：
Mao Y
中科院分区：
文献类型：
--
作者：
He R;Liu J;Zhang WH;Zhu B;Zhang N;Mao Y
目的分析基层卫生工作者离职倾向的现状及其影响因素，为改进基层卫生工作者的留用措施提供依据。系统综述和荟萃分析。检索了截至2019年10月的4个英文数据库（PubMed、EMBASE、科克伦图书馆、PsycINFO）和3个中文数据库（CNKI、CSPD、CBM）。合格的研究是在中国大陆进行的观察性或描述性研究。在每个纳入的研究中，必须明确报告卫生工作者中TI的患病率和相关因素。数据由一位作者提取，并由另外两位作者独立审查。对于每一个因素进行荟萃分析，该因素被要求是相同的，在不同的研究，并至少有三个研究必须包括it. The研究的质量进行了评估，使用Newcastle-Ottawa量表和异质性进行了评估，使用I2统计。我们确定了16项横断面研究，共调查了37672名PHW。TI的患病率为30.4%。亚组分析显示，社区基层医疗机构和东部省份的患病率最高。Meta分析结果显示，人口统计学因素（性别、年龄、文化程度、婚姻状况）、工作特征因素（职称、工龄、报酬、社会地位、组织归属、工作压力）和工作满意度因素（学习培训机会、人际关系、工作条件和环境等）等21个因素与工作满意度显著相关。这项研究突出了中国公共卫生工作者的TI问题。应努力改善工作领域和工作以外领域的条件。政策制定者应继续完善奖励制度、基础设施建设和晋升制度，并更多地关注公共卫生工作者的工作之外的生活，满足他们的生活需求。
To analyse the prevalence and determinants of turnover intention (TI) among primary health workers (PHWs) in China to provide evidence for improving retention measures. Systemic review and meta-analysis. Four English-language databases (PubMed, EMBASE, Cochrane Library, PsycINFO) and three Chinese databases (CNKI, CSPD, CBM) were searched up to October 2019. Eligible studies were observational or descriptive studies conducted in mainland China. The prevalence of TI among health workers and related factors had to be explicitly reported in each included study. Data were extracted by one author and reviewed independently by two other authors. For each factor analysed by a meta-analysis, the factor was required to be the same across different studies, and at least three studies had to include it. The quality of studies was assessed using the Newcastle–Ottawa Scale and heterogeneity was evaluated using the I2 statistic. We identified 16 cross-sectional studies investigating a total of 37 672 PHWs. The prevalence of TI was 30.4%. Subgroup analysis revealed that the highest prevalence was observed in the community primary healthcare institutions and the eastern provinces of China. Meta-analyses indicated that 21 factors were significantly associated with TI, including demographic factors (gender, age, education, marital status), job characteristic factors (title, work seniority, remuneration, social status, organisational affiliation, work stress) and job satisfaction factors (learning and training opportunity, interpersonal relationship, work condition and environment, and so on). This study highlights the problem of TI among PHWs in China. Efforts should be made to improve conditions in both work-related areas and areas outside of work. Policymakers should continue to improve reward systems, the construction of infrastructure and promotion systems, and pay more attention to PHWs’ lives outside of work and meet their living needs.
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