| Objectives:To explore medical staff state of three 3A hospitals in Yunnan Province.Based on the "health ecologic model",the study has explored the different factors dividing into upstream factors,middle factors and downstream factors of affecting medical staff health state.Finally,provide a basis for making intervention measures.Methods:By random sampling,663 doctors of three 3A hospitals were chosen as investigation objects and collected health examination data.A questionnaire about the basic information,habits&customs,workload,work pressure and medical environment was used in the study.Quantitative methods,such as descriptive statistics,t-test,analysis of variance,principal component analysis,multiple linear regression were used to analyze the data with the help of SPSS.Results:1.The average score of the doctors and medical technicians’ physical health was 48.20±7.03,the highest score of 63.02,the lowest score of 22.08.The physical health status of 119 were good,and the detection rate was 17.95%.General physical health were 431,and the detection rate was 65.01%.Poor physical health were 113,and the detection rate was 17.04%.The average score of the doctors and medical technicians,mental health was 44.95±8.37,the highest score of 61.69,the lowest score of 14,70.The mental health status of 119 were good,and the detection rate was 17.27%.General physical health were 465 and the detection rate was 67.49%.Poor physical health were 105,and the detection rate was 15.24%.2.29 factors that affect the physical health of doctors and medical technicians were selected(p<0.05).Using the health ecology model,29 influencing factors were classified at different levels.Among the 29 related physical health factors,there were 19 factors assigned to the upstream,7 factors assigned to the middle and 3 factors assigned to the dowmstream.19 factors were classified as upstream factors.Including marital status(t=4.045,p<0.001),child status(t=3.499,p<0.001),income satisfaction(t=6.349,p<0.001),the compilation of employment(t=3.135,p=0.002),to undertake teching and research work(t=-3.019,p=0.003),hosopital(F=9.307,p<0.001),professional qualification(F=4.494,p=0.001),the number of years of medical treatment(F=3.682,p=0.026),main medical work contents(F=7.759,p<0.001),clinical hours per week(F=14.395,p<0.001),outpatients(F=2.627,p=0.034),work pressure(F=19.982,p<0.001),internal input(F=14.448,p<0.001),life pressure(F=32.748,p<0.001),work-family conflict(F=18.102,p<0.001),job burnout(F=61.347,p<0.001),medical safety requirements(F=9.254,p<0.001),physical violence(F=10.933,p<0.001),language violence(F=18.344,p<0.001).7 factors were classified as middle factors,including sleep disorders(F=30.48,p<0.001),sleep time on the night shift(F=7.204,p=0.001),exercise frequency(F=6.747,p<0.001),smoking frequency(F=3.951,p=0.004),eat fatty food frequency(F=2.432,p=0.046),eat salty food frequency(F=2.441,p=0.046),regular diet(F=17.688,p<0.001).2 factors were classified as downstream factors,including nationalities(t=-2.553,p=0.011),age group(F=10.498,p<0.001),3.27 factors that affect the mental health of doctors and medical technicians were selected(p<0.05).Using the health ecology model,27 influencing factors were classified at different levels,Among the 27 related mental heaith factors,there were 18 factors assigned to the upstream,7 factors assigned to the middle and 2 factors assigned to the dowmstream.18 factors were classified as upstream factors.Including marital status(t=3.330,p=0.001),child status(t=2.3589,p=0.019),income satisfaction(t=7.527,p<0.001),the compilation of employment(t=2.753,p=0.006),to undertake teching and research work(t=-3.219,p=0.001),patient complaints(t=-3.257,p=0.001),hospital(F=9.307,p<0.001),hospital department(F=4.672,p<0.001),main medical work contents(F=6.185,p=0.002),clinical hours per week(F=24.930,p<0.001),work pressure(F=32.302,p<0.001),internal input(F=48.627,p<0.001),life pressure(F=38.115,p<0.001),work-family conflict((F=43.665,p<0.041),job burnout(F=156.614,p<O.001),medical safety requirements(F=22.807,p<0.001),physical violence(F=17.849,p<0.001),language violence(F=28.578,p<0.001).7 factors were classified as middle factors,including sleep disorders(F=3 7.681,p<0.001),sleep time on the night shift(F=14.449,p<0.001),exercise frequency(F=12.765,p<0.001),smoking frequency(F=2.416,p=0.048),eat fatty food frequency(F=4.337,p=0.002),regular diet(F=20.039,p<0.001),seek counseling(F=40.802,p<0.001).2 factors were classified as downstream factors,including nationalities(t=-3.392,p=0.001),age group(F=8.055,p<0.001).4.The Principal Component Anaiysis was used,58.09%information of 29 related factors could be explained by the 9 principal components before in physical health.The first principal component include age,marital status,child status,the compilation of employment,the number of years of medical treatment.The Principal Component Anaiysis was used,57.38%information of 27 related factors could be explained by the 9 principal components before in mental health.The first principal component include age,marital status,child status,the compilation of employment.In addition to age,the first principal component was mainly composed of upstream factors.5.The multiple linear regression was used,the results showed there were 6 variables in the physical health regression equqtion(p<0.05),including sleep disorder,exercise frequency,regular diet,clinical hours per week,life pressure,job burnout.The multiple linear regression was used,the results showed there were 7 variables in the mental health regression equqtion(p<0.05),including hospital department,exercise frequency,seek counseling,clinical hours per week,internal input,life pressure,job burnout.The pearson correlation was founded,The more the risk factors,the worse the physical health.The more the risk factors,the worse the mental health(p<0.001).Conclusions:1.The doctors and medical technicians of three 3 A hospitals were not optimistic about their physical and mental health.2.Among the influencing factors of doctors’ physical health,the most influential factors were age group,marital status,child status,the compilation of employment and the number of years of medical treatment.The second most influencing factor were all kinds of stress,burnout and most living habits.The least impact on the job were the characteristics of the work and the safety of the medical environment.The factors were mainly concentrated in the upstream level.3.Among the influencing factors of doctors’ mental health,the most influential factors were age group,marital status,child status,the compilation of employment.The second most influencing factor were all kinds of stress,job burnout,the characteristics of the work and the safety of the medical environment.The least impact on the living habits.The factors were mainly concentrated in the upstream level.4.The more the risk factors,the worse the physical health.The more the risk factors,the worse the mental health.Suggestion:We should combine the various influences of different aspects to make three-level prevention of physical and mental health of doctors and partial medical technicians of three 3 A hospitals.To control of the number of risk factors.At the same time,the prevention of upstream factors is emphasized.The primary prevention is to take the government as the lead,we should increase the investment and the resources to deal with,reduce the work burden of doctors and medical technicians,and create a good medical environment.Secondary prevention is that doctors and medical technicians should establish awareness of health and cultivate habits of health.Third-level prevention is that doctors and medical technicians should receive active treatment and regular psychological counseling. |
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