| Objective:With the deepening of development in China’s medical and health services and the reform of medical systems, problems in fields of health have become increasingly prominent. Intensified conflicts between doctors and patients become serious. Medical malpractice, "Medical disturbance" and violent attack against medical staff occur frequently. All of the above make the medical staff have to undertake enormous physical and mental stress. Because of high load, high risk and high pressure, medical staff become one of the high risk groups of burnout, which not only affects the medical staff’s health and the doctor-patient relationship, but also seriously affects the quality of medical services, thus affects the reform and development of China’s medical and health services and the social stability. Medical staff burnout becomes the focus and hot issue in researches. Currently researches into medical staff burnout focus on provincial and municipal hospitals and other large or medium-sized medical institutions. While the district, county, township hospitals, village clinics and other primary health care institutions are rarely in consider. Burnout researches among grassroots medical staff in border areas with minorities are rarely reported. Grassroots medical staff in border areas with minorities is facing the specific crowd, working conditions, living environment, education, and welfare benefits, which is significantly different from other general areas. Most of the medical staff themselves are minorities. Therefore, To explore current situation of job burnout, its related factors and the education intervention strategies of grassroots medical staffs in border areas with minorities is of great practical significance and theoretical values in promoting the development of medical and health services in ethnic minority areas and the social stability.Methods:Cluster sampling 982 medical staffs from 24 grass-roots health care institutions in border areas of Yunnan Province, using Maslach Burnout Inventory(MBI), symptom checklist(SCL-90), Social Support Rating Scale(SRRS), General Well Being Schedule(GWB), General Self-Efficacy Scale(GSES) and other assessment tools, to conduct a large sample survey on the medical staff of the border areas with minorities, to analyze the burnout, mental health, social support, general well-being situation and their relationships, and to discuss the education intervention strategies for the medical staff in border areas with minorities.Results:1. Burnout status of medical staff in border areas with minorities(1)Medical staff’s emotional exhaustion, cynicism low achievement scores were significantly lower than the general area(P<0.01).(2)There is a significant group differences and among emotional exhaustion, cynicism scores and MBI scores(P<0.05)in medical staff from different levels of hospital, Scores of District-level are maximum, and scores of Township-level are minimum(3)Female’s emotional exhaustion and cynicism scores are significantly higher than males’(P<0.05).(4)Medical staff’s emotional exhaustion, cynicism, low achievement scores and MBI scores have significant educational degree difference(P<0.05). Who have higher education levels have higher scores.(5)There is a significant ethnic difference between medical staff’s low achievement scores and MBI scores(P<0.05). Dai’s scores are the highest, while Yi’s scores are the lowest.2. Mental health of medical staff in border areas with minorities and its impact on job burnout(1)Except for somatization, psychoticism and phobia axiety,SCL-90 factor scores were significantly lower than the national norm(P<0.05). Detection rate of psychological problems is 44.48%.(2)Except for hostility, female’s SCL-90 factor scores were significantly higher than males’(P<0.05).(3)Medical staff’s SCL-90 factor scores and total average scores have a significant level difference(P<0.05). District hospitals are the highest, and township hospitals are the lowest.(4)Except for psychoticism, medical staff’s scores of SCL-90 factor have significant differences in the categories of persons(P<0.05).(5)Except for phobia axiety, SCL-90 scores have significant degree differences(P <0.01). Factor scores increase with the upgrade of their educational degrees.(6)Except for reduced personal accomplishment, positive symptoms groups of burnout scored significantly higher than negative symptoms groups(P<0.01).3. Social support of medical staff in border areas with minorities and its impact on job burnout(1)93.71% of the medical staff have a satisfactory level of social support.(2)Objective and subjective support of the medical staff and the total scores have significant age differences(P<0.01). 41-50 age group has the highest score, while 20 age group has the lowest score.(3)Male’s subjective support score was significantly higher than that of Female’s(P <0.05).(4)Objective and subjective support of the medical staff and the total scores have significant differences in length of service(P<0.01). 11-20 years group scored the highest, 5 years and below group scored the lowest.(5)Objective and subjective support of the medical staff and the total scores have significant differences in marital status(P<0.01). The married are the highest, and the unmarried are the lowest.(6)Factor’s scores of high social support group were significantly lower than the one of low social support group(P<0.01).4. Overall well-being of grassroots medical staff in border areas with minorities and the impact on job burnout(1)Medical staff’s overall well-being score is higher than the national norm(P <0.01).(2)Medical staff’s overall well-being total score, emotional and behavioral control scores have significant differences in length of service(P<0.01). 21 years and above group scored the highest, 5 years and below group scored the lowest.(3)Medical staff’s overall well-being total score, energy, depression or happy mood scores have significant age differences(P<0.05). 51 years and above are the highest, 20 years and below are the lowest.(4)Except for the life satisfaction and interest and concerns on health, factor scores of medical staff’s overall well-being and the total score have significant hospital-level difference(P<0.05), which in descending order is : Township hospitals, county hospitals and district hospitals.(5)Physicians’ overall well-being total score, energy,control of emotion and behavior scored significantly higher than the one of nurses(P<0.05).(6)Men’s overall well-being total score, energy,concerns on health,melancholy or happy mood,control of emotion and behavior scored significantly higher than Females’(P <0.01).(7)Secondary education level and below scored significantly higher than college and undergraduate levels(P<0.05). Undergraduate level have the lowest score, secondary education level and below have the highest scores.(8)There are significant differences between sections on the overall well-being scores(P<0.01). Public health is the highest, while obstetrics and gynecology are the lowest.(9)Burnout scores of high Well-being group are significantly lower than the low well-being group(P<0.01).5. General self-efficacy of medical staff in border areas with minorities and the impact on job burnout(1)General self-efficacy scores were significantly lower than the general area(P <0.01).(2)General self-efficacy scores have significant age differences(P<0.01). The older the ages are, the higher the general self-efficacy scores are.(3)Married group’s self-efficacy scores were significantly higher than the unmarried group’s(P<0.01).(4)General self-efficacy scores have significant differences in length of service(P <0.01). The longer the length of service are, the higher the scores are.(5)Physician’s self-efficacy scores were significantly higher than nurses’(P<0.05).(6)Burnout scores of high self-efficacy group are significantly lower than the low self-efficacy group(P<0.01).6. Researches on relationships amont burnout and mental health, general self-efficacy, subjective well-being and social support in boder areas with minoritiesBurnout total score and SCL-90 score have a significant positive correlation(P <0.05). Burnout total score and social support and general well-being, general self-efficacy total scores have a significant negative correlation(P<0.05).Conclusion:1. Medical staffs in border areas with minorities have a certain extent of job burnout. Their general self-efficacy are lower than population in general areas, Wherein the burnout of highly educated, high-grade hospitals, short length of services, Female medical staff are the most obvious.2. Medical staff’s job burnout is significantly related with mental health, general well-being, self-efficacy and social support. |
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