| Objectives: To investigate occupational stress, explore the influencing factors of occupational stress, physical and mental health of medical staff who work in third grade class A hospitals in Xinjiang Uygur Autonomous Region, and systematically explore the influence of occupational stress on physical and mental health, work ability, job burnout,personal coping resources and job involvement by means of questionnaire survey,Consequently, to establish basic data for the occupational health research of medical staff in Xinjiang and provide government and related departments with evidence for further policy formulation. Methods: 6162 samples from 10 third grade class A hospitals were selected by means of stratified cluster random sampling. Epidemic and distribution characteristics, the influencing factors of occupational stress, personal coping resources,job burnout, job involvement and mental health were analyzed. Moreover, Structural Equation Model(SEM) was established in order to systematically explore the influence of occupational stress on work ability, physical and mental health, which includes CPHI,coping, burnout and job involvement. Results: Medical staff from third grade class A hospitals in Xinjiang endured with occupational stress factors from 10 dimensions and three aspects, which covered Adjusting Demand(RR), Possibility of Regulation(RP) and Adjustment of Problems(RPs) and included Complexity(AK), Variability(VA),Cooperation Possibilities(KSP), Task Control(HS), Time Control(ZS), Possibility of Cooperation(KSP), Organization Problems(AOP), Unreasonable Position Demand(EBA), Mission Risk(UG) and Tightness of Cooperation(KOP). Average scores of the above factors were all higher than normal model of mental workers from the city of Urumqi. In addition, Uncertainty of Task(UN) and Work Interference(AUB) were another two influencing factors for medical staff. The average scores of Occupational Roles Questionnaires(ORQ), Personal Strain Questionnaires(PSQ) and Personal Resources Questionnaires(PRQ) of medical staff in Xinjiang were 182.12±25.47,103.01±21.37 and 122.05±23.29 respectively, of which scores of ORQ and PSQ were higher than normal model of southwest region and scores of each dimension were significantly different from normal model in the Southwest region. Among three dimensions of ORQ, PSQ and PRQ, scores of male were higher than those of female and minority nationalities were higher than those of Han nationality. Scores of ORQ and PRQ of groups with bachelor degree were higher and scores of PSQ of groups with graduate experience were higher. Comparing with other professional and technical staff, ORQ and PSQ of physicians were higher, but PRQ of physicians were lower. Scores of ORQ and PRQ increased with the rise of professional title, working life, physical training, but those of PSQ takes the opposite. Among all medical staff, samples with high degree occupational stress accounted for 3.13%, the proportions of middle, moderate and low degree were 9.79%, 74.44% and 12.64% respectively. The proportions of male, minority,physicians, senior professional title with high and moderate degree occupational stress were 17.84%, 17.13%, 16.47% and 16.23% respectively. Logistic Regression Model results revealed that male medical stuff, those who held senior professional title, minority nationalities medical staff together with doctors and nurses were inclined to undergo more occupational stress. The mental health of medical staff in 3A hospital in Xinjiang area in conditional level of I(accounting for 6.82%) and II(58.94%) was lower than the national norm, while the proportion of grade III(30.75%) and grade IV(3.49%) was higher than the national norm, indicating the mental health status of medical staff in Xinjiang was worse than that of the general population. There was no significant difference in the mental health index of different gender and ethnic background, but the mental health index of different marital status, education, job category, working age, title and physical exercise were statistically different. The higher the title was, the higher the index got; the higher the education background was, the lower the score was on cognition efficiency. On the aspect of emotional experience, people with higher professional title got the higher score. The score of female self-cognition was higher than that of male whereas the score of male was higher than that of female on interpersonal communication.On the aspect of adaptive ability, medical staffs who were Han obtained higher score than minorities. Moreover, people who do more physical exercises achieved higher scores in mental health, cognitive efficiency, emotional experience, self-cognition, interpersonal communication and adaptive ability than people lack of physical exercises. There were statistically significant differences in mental health index, cognitive performance,emotional experience, self-cognition, interpersonal relationship and adaptive abilitybetween the medical staff and the degree of occupational stress. Scores of the mental health index of the high degree occupational stress groups were lowest. The scores of cognitive performance, self-cognition and adaptive ability decreased with the increase of the degree of occupational stress. Except rational treatment, the scores of individual medical staff response to resources and leisure, self-health, social support was lower than the norm. The percentage of high, medium, moderate and low shortage level of individual coping resources among 3A hospitals in Xinjiang were 2.29%, 11.54%, 71.45%, and14.72% respectively. The differences of mental health index, cognitive efficiency,emotional experience, self-cognition, interpersonal communication and adaptive ability of the medical staff were statistically different. The mental health index increased with the rise of individual response to resources, and the scores of cognitive performance,emotional experience, self-cognition, interpersonal communication and adaptive ability increased while individual coping resources grew. Among all medical staff with job burnout, the proportion of samples whose emotional exhaustion higher than critical value was 26.86%, and the proportions of personality disintegration and achievement were55.16% and 70.87% respectively. The proportions of samples with zero, low, moderate and high job burnout were 10.24%, 34.26%, 47.87% and 7.63% respectively, and medical staff with one or more symptoms of burnout accounted for 89.76%. Scores of CHPI,cognitive performance, emotional experience, self-cognition, interpersonal communication, adaptive ability established statistic difference in different job burnout degrees: as job burnout degree expanded, scores of each sector mentioned above diminished. The average score of job involvement of medical staff was 24.50±13.57, of which vigor dimension was 8.12±4.68, dedication dimension was 8.27±5.06,concentration dimension was 8.11±5.09. Job involvement was divided into four levels according to quartile points, and average score of low job involvement was 7.70±4.21;inferior level, moderate level and high level were 19.83±2.87, 28.92±2.80 and42.93±5.66. Scores of CHPI, cognitive performance, emotional experience, self-cognition,interpersonal communication, adaptive ability were statistically different in different job involvement degrees and all scores increased with the rise of job involvement degrees.Multiple linear regression model results demonstrated that occupational stress and job burnout were negatively related to mental health while PRQ and job involvement were positively correlated with mental health, of which job burnout was the strongest influencing factor, followed by PRQ. Logistic Regression Model results showed that ORQ, PRQ, job burnout, job involvement and individual social and demographiccharacteristics were influencing factors for mental health, of which gender, education,marital status, physical training, PRQ, job involvement were protective factors, as occupational stress and job burnout were risk factors of mental health. The average WAI(Work Ability Index) of medical staff was 35.84±5.68, of which the score of bad WAI was 24.56±2.57, accounting for 8.50%; the score of moderate WAI was 32.66±2.52,accounting for 41.50%; the score of good WAI was 9.58±1.88, accounting for 42.76%;the score of the best WAI was 45.22±1.42, accounting for 7.24%. Samples with different ethnic, education, position sort, professional title, and physical training presented statistic difference in WAI, and samples with different ethnic, education, position sort, working life, professional title, and physical training showed statistic difference in work ability degrees. WAI increased with the rise of mental health level, PRQ and job involvement;however, it decreased with the growth of occupational stress and job burnout. Multiple linear regression model results illustrated occupational stress, job burnout were negatively correlated with work ability, but personal response resources, job involvement,and mental health were positively correlated with work ability, among which job burnout,followed by the job involvement, had the greatest impact on the work ability. Logistic Regression Model results revealed that personal response resources and job involvement were protective factors for work ability while minority nationalities, Less than 10 years of work experience, occupational stress and job burnout were risk factors. The results of SEM showed the influence of occupational stress on work ability, job burnout, job involvement, and mental health, individual social and demographic characteristics had been verified, and job burnout, job involvement and mental health were stronger influencing factors. Conclusions: Scores for occupational stress of medical staff from third grade class A hospitals in Xinjiang were higher than those of the norm of mental workers in the city of Urumqi. Especially, physicians endured severe occupational stress.Scores for Occupational Role Questionnaire(ORQ) and Personal Strain Questionnaire(PSQ) of medical staff from third grade class A hospitals in Xinjiang were higher than scores of normal model in southwest region. Being male, minority nationalities, doctors and nurses, as well as senior professional title were risk factors for occupational stress in medical staff. Comparing with national level, the proportions of medical staff with good and normal mental health were lower in third grade class A hospital in Xinjiang. There are severe occupational stress and job burnout. Education background, marital status,physical training, PRQ, and job involvement were protective factors for mental health while occupational stress and job burnout were risk factors. In the WAI(Work AbilityIndex) of medical staff in three grade class A hospitals, the proportion of samples with moderate degree and above accounted for 91.5%. Personal response resources, job involvement and mental health were protective factors for work ability while occupational stress and job burnout were risk factors. The results of SEM on the variables that affected work ability showed that job burnout, job involvement and mental health were stronger influencing factors. |
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