Turnover intention and related factors among general practitioners in Hubei, China: a cross-sectional study.
Turnover intention and related factors among general practitioners in Hubei, China: a cross-sectional study.
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DOI：
10.1186/s12875-018-0752-3
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发表时间：
2018-05-24
影响因子：
2.9
通讯作者：
Lu Z
中科院分区：
文献类型：
--
作者：
Gan Y;Gong Y;Chen Y;Cao S;Li L;Zhou Y;Herath C;Li W;Song X;Li J;Yang T;Yin X;Lu Z
全科医生的高流动率是中国努力建立可持续、有效的初级保健系统的一个重大挑战，但很少有数据可以帮助理解和解决这一问题。这项研究旨在评估全科医生离职的意向，并调查相关因素。横断面调查于2014年12月12日至2015年3月10日在中国中部湖北省进行。采用结构化自填问卷对1016名全科医生进行问卷调查，应答率为85.67%。本研究采用广义线性回归模型，探讨影响全科医生离职倾向的相关因素。在满分24分的基础上，全科医生离职意向的平均得分为15.40分（SD = 3.43）。78.35%的全科医生有中等及以上的离职意向。631名（62.37%）全科医生曾遭受过各种形式的虐待（肢体攻击18.92%，言语虐待54.38%，威胁33.79%，言语性骚扰22.66%，肢体性骚扰7.59%）。广义线性回归分析表明，男性全科医生；具有职业学校或以上学历；有临时工作合同的；工作满意度较低的人；他们在情绪耗竭方面得分更高；在工作场所遭受暴力的频率较高的人表示更愿意离开目前的职位。本研究表明，湖北省全科医生离职意向较高。此外，在全科医生中，工作场所暴力的发生率很高，特别是在言语虐待和威胁方面。为了维持中国三级医疗体系的基础，需要通过提供永久合同、提高总体工作满意度、改善医患关系等措施来调节全科医生的离职意愿。本文的在线版本（10.1186/s12875-018-0752-3）包含补充资料，仅供授权用户使用。
High turnover among general practitioners (GPs) is a significant challenge in China’s efforts to build a sustainable, effective primary care system, but little data is available to help understand and address this issue. The study was aiming at assessing the intention to leave their posts among a sample of GPs and investigating associated factors. A cross-sectional survey was conducted between December 12, 2014 and March 10, 2015 in Hubei Province, Central China. A total of 1016 GPs (response rate, 85.67%) were investigated by using a structured self-administered questionnaire. A generalized linear regression model was used to identify the associated factors with turnover intention among GPs. Based on a full score of 24, the average score for GPs’ turnover intention was 15.40 (SD = 3.43). 78.35% of the GPs had a moderate or higher level of turnover intention. Six hundred and thirty one (62.37%) GPs had ever been exposed to abuse of any kind (physical assault, 18.92%; verbal abuse, 54.38%; threat, 33.79%; verbal sexual harassment, 22.66%; and physical sexual harassment, 7.59%). Generalized linear regression analysis indicated that GPs who were male; who had a vocational school or higher; who had a temporary work contract; who were with lower level of job satisfaction; who reported higher scores on emotional exhaustion; who had been exposed to higher frequency of workplace violence were expressed higher intention to leave their present positions. This study shows that GP’s intention to leave general practices is high in Hubei, China. In addition, the prevalence of workplace violence is high among GPs, particularly in the verbal abuse and threat. Measures such as offering permanent contract status, increasing overall job satisfaction, and improving doctor-patient relationship, are needed to moderate GP’s turnover intention in order to maintain the foundation of China’s three-tier health system. The online version of this article (10.1186/s12875-018-0752-3) contains supplementary material, which is available to authorized users.
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