Self-rated Health And Influencing Factors Of Medical Staffs In 144 Tertiary Hospitals In China

[Objective]To understand the current status and influencing factors of self-rated health of medical personnel in 144 tertiary public hospitals in China,and to provide a basis for formulating strategies and measures to improve the health status of medical personnel.[Methods]From March 18 to April 9,2019,The project team of the fourth "Chinese Healthcare Improvement Evaluation Survey(CHIES)”carried out questionnaire surveys and evaluations in 144 tertiary public hospitals from 31 provinces,autonomous regions,municipalities and Xinjiang Production and Construction Corps.In this study,clinicians and clinical nurses in 144 sample hospitals surveyed by the CHIES were selected as the research object,and at least 150 clinicians and 150 clinics were determined in each sample hospital according to the "stratified equidistant sampling" method.Nurses participated in a questionnaire survey(fill in the questionnaire online via mobile phone)to measure their self-rated health level and information on possible influencing factors.The research uses Likert 5 rating item "How do I feel about my health?" to evaluate the self-rated health status of medical staffs.The cases of "very good" and"good" are defined as "healthy",and the cases of "very poor" and "poor" are defined as "unhealthy".According to the characteristics of the data,"mean ± standard deviation","median and Quartile Range "and "rate or proportion" are used for statistical description.Spearman rank correlation is used for correlation analysis.The difference in the distribution of different self-rated health levels(five categories)between doctors and nurses was compared by the rank sum test(Mann-Whitney U test),and the difference in the proportion of self-rated "health" was compared by the chi-square test.Chi-square test was used for the single factor analysis of self-rated health influencing factors and binary classification and multifactor logistic regression was used for the multivariate analysis.The independent variables were screened by stepwise regression,and the screening variable ware tested by the likelihood ratio test of maximum partial likelihood estimation.[Results]In this survey,a total of 24,529 valid questionnaires filled by doctors and 28,910 valid questionnaires filled by nurses were obtained.The proportions of doctors’self-rated health as "very good","good","general","poor" and "very poor" were 3.61%,16.69%,60.62%,16.81%,and 2.27%,respectively,and nurses were 7.12%.,21.80%,55.18%,13.37%and 2.53%,the overall distribution difference was statistically significant(P<0.05).The proportion of nurses who rated themselves as"healthy,was 28.92%,and that of doctors was 20.30%.The difference was statistically significant(P<0.05).The results of the two-category multi-factor Logistic regression model show that the factors that affect doctors’ self-rated health status include six sociodemographic factors(P<0.05)of gender,age,marital status,whether they have administrative positions,average monthly income after tax,and hospital type.As well as DASS stress level,job burnout,Minnesota job satisfaction,identification with "I feel that the hospital-patient relationship is improving in the past three years," and "I feel that my current workload is too heavy" 9 factors including attitude,average weekly working hours,average daily sleep time,the number of chronic diseases,and whether the hospital provided psychological guidance for the staff of the hospital(P<0.05).The results of the two-category multi-factor Logistic regression model show that the factors that affect nurses’ self-rated health status include seven sociodemographic factors(P<0.05)of gender,age,current job title,whether they have administrative positions,average monthly after-tax income,where they belong,as well as DASS stress level,job burnout,Minnesota job satisfaction,recognition of "I feel that the hospital’s doctor-patient relationship is improving in the past three years",and"I feel that my current workload is too heavy" 10 factors including the attitude of identification,the average weekly working hours,the average daily sleep time,the average number of night shifts per month,the number of chronic diseases,and whether the hospital provided psychological guidance for the staff of the hospital(P<0.05).[Conclusion]Among the 144 sample hospitals,the proportions of doctors and nurses who rated themselves as"healthy" were 20.30%and 28.92%respectively.Compared with the self-rated health status of the general population and medical staff in developed countries,the health status of the medical staff in this survey is relatively worse.The possible influencing factors of self-rated health by medical staff in tertiary public hospitals the third level are workload,working hours,sleep time,job burnout,salary and treatment,job satisfaction,doctor-patient relationship,work pressure,the number of chronic diseases,whether the hospital provided psychological guidance for staffs and some sociodemographic factors.