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目的构建医务人员亚健康影响因素之间的关系模型,提出医务人员职业伤害防护策略。方法调查贵州省25家综合医院1 601名医务人员过去1年亚健康现状,采用通径分析探讨各因素与亚健康之间的相互关系。结果医务人员亚健康现状及工作效能感、医院组织环境的满意度均不容乐观,总体得分仅为中等水平。医务人员亚健康发生与工作效能感、医院组织环境满意度有显著相关性,差异均有统计学意义(P<0.001)。工作效能感对医务人员亚健康状态既有直接效应作用,又有中介作用,效应系数为-0.11。组织环境各维度对亚健康影响不一致,防护设施直接效应不明显,通过工作效能感间接影响,效应系数为0.19;环境压力起正向效应(效应系数0.30),既有直接效应作用,还通过工作效能感而间接影响作用(效应系数分别为0.38、-0.08);工作场所在亚健康中起负向效应(效应系数-0.03),具有直接效应和通过工作效能感而间接影响作用(效应系数分别为-0.14、0.11);安全政策在亚健康中的直接效应系数为-0.01;安全文化起正向效应(效应系数为0.23),具有直接效应和通过工作效能感间接影响(效应系数分别为-0.06、0.29)。结论影响医务人员亚健康是多因素共同促成的,需要从提升医务人员的工作效能感,完善安全防护设施、减轻工作环境压力、营造良好的安全文化氛围等方面进行综合干预。
Objective To construct the relationship model between sub-health influencing factors of medical personnel and propose the occupational injury prevention strategy for medical personnel. Methods The sub-health status of 1 601 medical workers in 25 general hospitals of Guizhou Province in the past year was investigated. The path analysis was used to explore the relationship between sub-health and various factors. Results The sub-health status and work efficiency of medical staff, the satisfaction of hospital environment were not optimistic, the overall score was only moderate. There was a significant correlation between the subhealth of medical staff and the sense of work efficiency and the degree of satisfaction of hospital environment. The difference was statistically significant (P <0.001). The sense of work efficiency has the direct effect on the sub-health status of medical staff, and has an intermediary effect with an effect coefficient of -0.11. The sub-health impact of different dimensions of organizational environment is inconsistent, and the direct effect of protective facilities is not obvious. The effect coefficient is 0.19 indirectly through the effect of work efficiency, and the positive effect of environmental pressure (effect coefficient 0.30), both direct effect and work (Effect coefficient was 0.38, -0.08, respectively). The workplace played a negative effect in subhealth (effect coefficient -0.03), with direct effect and indirect influence by work efficacy (effect coefficient respectively (-0.14,0.11). The direct effect coefficient of safety policy in sub-health was -0.01. The safety culture had a positive effect (effect coefficient of 0.23), which had direct effect and indirect impact on work efficiency (the effect coefficients were - 0.06, 0.29). Conclusion The sub-health effects of medical staff are jointly promoted by many factors. It is necessary to make comprehensive interventions in enhancing the sense of work efficiency of medical personnel, improving the safety protection facilities, reducing the pressure on the work environment and creating a good safety and cultural atmosphere.