Study On The Career Well-being And Influencing Factors Of Clinicians In A Tertiary AGeneral Hospital In Shandong Province

BackgroundWith the sustained and healthy development of China's social economy in the new period,peopl's living standards have been significantly improved,and"well-being" has become the focus of attention.The particularity of medicine determines that the well-being of clinicians is the soul of their profession,which will lead the development of medicine and the inheritance of medical ethics.Since the new medical reform in 2009,the state has repeatedly issued letters emphasizing the optimization of the professional environment of clinicians and enhancing the professional honor of clinicians.The career well-being of clinicians is the foundation of harmonious doctor-patient relationship,which is directly related to the efficiency and quality of medical services.As a long-term professional group engaged in rescuing the dead and helping the wounded,as well as the main force in the development of China's medical and health undertakings and the important human capital in the development of hospitals,the career well-being of clinicians is a realistic problem that medical and health management departments and hospital managers must pay attention to.However,at present there is no unified theoretical system and method for the research on the career well-being of clinicians.It still needs to be discussed in many aspects to lay the foundation for understanding the internal structure of career well-being and improving the theoretical model of career well-being of clinicians.It has important theoretical value and practical guiding significance to realize the refinement of hospital human resources management and effectively improve the career well-being of clinicians.ObjectiveThis study is based on the theoretical framework constructed,and aims to understand the status and influencing factors of clinicians' professional well-being through on-site investigations.Provide a reference for the hospital to enhance the professional well-being of clinicians.Provide the basis for decision-making for the hospital to attract excellent medical talents and teams and stabilize the team of clinicians.Provide scientific basis and policy recommendations for health management departments and hospital human resource management.MethodsThe data of this study are mainly from documents,reports,policy documents,on-site survey data and interview data.The subjects of the questionnaire survey were clinicians in a tertiary A general hospital in Shandong province,with a total of 422 cases were finally included in the analysis.The basic information of clinicians was collected by questionnaire survey,and the level of career well-being of clinicians was measured from both positive and negative perspectives by personal well-being index(PWI)and the Maslach Burnout Inventory--Human Service Survey(MBI-HSS).A total of 15 individuals participated in the in-depth interviews,mainly to understand the influencing factors of clinicians' professional well-being and how to improve hospital human resource management,create a better professional environment,and achieve a long-term mechanism of well-being.Based on the data obtained from the survey,using single factor analysis and multi-factor analysis to analyze the current status of clinicians'career well-being,combined with the information obtained from interviews to analyze the factors that affect clinicians' career well-being,and explore the methods to improve clinicians' career well-being.Data collation and analysis are mainly completed through Epidata 3.1,Microsoft Excel 2019 and SPSS 21.0 software.Results(1)Investigating the basic condition of clinicians:Among the 422 subjects,men and women accounted for the same proportion;The highest proportion of junior titles is 39.8%,followed by intermediate level is 33.9%,deputy senior level is 17.1%,senior level is 9.2%;Official editors accounted for 82.5%,and outside editors accounted for 17.5%;The clinicians' depression score was 8.79±7.98,anxiety score was 7.94±7.90,stress score was 11.73±8.00,and 40.28%,41.71%and 24.88%of clinicians had different degrees of depression,anxiety and stress state,respectively;Depression and anxiety are the most common negative emotions for clinicians.In addition,clinicians' mental health status is negatively correlated with career well-being.Depression is the main influencing factor of career well-being and has a negative predictive effect(2)Investigating the level of career well-being of clinicians:The positive measurement results show that the self-cognition score of clinicians' career well-being is 69.53 ± 15.05,and the actual measurement score is 63.24 ± 15.72,which are all at a general level.And the difference between self-cognition and actual measurement results is statistically significant.Among them,the social participation dimension has the lowest score,and the interpersonal relationship dimension has the highest score.The reverse measurement results show that the total score of clinician's job burnout is 50.21 ± 16.17,which is in a state of moderate burnout.The emotional exhaustion dimension score was 2.43 ± 1.00,the depersonalization dimension score was 1.24 ±1.07,and both were in a state of moderate burnout;the low sense of achievement dimension score was 2.77 ± 0.94,which was in a state of severe burnout.The detection rate of occupational burnout of clinicians is as high as 90.05%,of which mild burnout accounts for 28.44%,moderate burnout accounts for 40.28%,and severe burnout accounts for 21.33%.The detection rates of emotional exhaustion and low sense of accomplishment were as high as 69.67%and 79.86%,and the detection rate of depersonalization was relatively low at 23.46%(3)Investigating the influencing factors of clinicians'career well-being:The results showed that the level of career well-being of the clinicians surveyed will be different due to their different demographic and sociological characteristics and basic work information,and most of the differences were statistically significant.The results of multiple linear regression analysis showed that depression(?=-5.687,P=0.000),professional identity(?=3.186,P=0.003),and social support(?=2.811,P=0.007)were the main influencing factors and predictors of clinicians' career well-being.Conclusions and SuggestionsThe two methods used in this study can better measure the career well-being of clinicians from the positive and negative perspectives.The career well-being of the surveyed clinicians is at the general level,and the self-cognitive well-being is different from the actual measurement results.The depression of clinicians has a negative effect on their career well-being,while professional identity and social support have a positive effect on their career well-being.Based on the results of this study,we propose the following suggestions:(1)Establish a scientific,systematic and comprehensive evaluation system of career well-being;(2)Strengthen hospital occupational management consciousness,pay attention to clinician career well-being;(3)Clinicians should focus on improving their personal quality and enhancing their own well-being experience;(4)Actively promote and implement the reform of medical system and mechanism;(5)Strengthen the construction of respecting medical culture and maintain a healthy medical environment.