Research On The Grassroots Medical Staff Occuption Identity And Stability Based On The Dynamic Model Of Staff Turnover

Objectives:The objectives of this study is to understand the current status of occupational identification and stability of rural medical staff in Hangzhou,Building a comprehensive influence factor model of professional identity and stability by using the motivation model of employee turnover,and analyze its related internal mechanism.On this basis,a constructive strategy for improving the professional identity and stability of medical staff at the grassroots level is proposed.It provides a theoretical basis for the construction and development of grassroots medical staff and health institutions,so as to fully enhance the sense of professional identity of grassroots medical staff and reduce the mobility of grassroots medical institutions.Methods:In this study,the community health service center and the township health centers of the 13 major administrative divisions of Hangzhou were selected,a simple random sampling method was used to conduct a questionnaire survey on 1493 grassroots medical staff.Using Cronbach 'a coefficient to test the questionnaire reliability,using exploratory factor analysis to test the validity of the questionnaire;Using the descriptive statistical method,T test and variance analysis,multiple linear regression to analysis the factors affecting occupational identity and stability of grassroots medical staff;Pearson correlation analysis and structural equation modeling were used to analyze the logical relationship and interaction mechanism between grassroots medical staff's general demographic characteristics,work status,professional identity and stability.Results:The overall Cronbach's ? coefficient of the career identity scale was 0.939,and the Cronbach's ? coefficient of the seven dimensions of the scale was above 0.86.The KMO value was 0.925(P<0.001).The total variance of the seven common factors extracted by factor analysis was 84.060% and the stability scale was 84.060%.The Cronbach's ? coefficient of the total volume was 0.876,and the KMO values of the three dimensions were all above 0.70(P<0.001).The results of multiple linear regression showed that the total variance of the three common factors cointerpretation scale extracted by factor analysis was 71.197%.The degree of influence on professional identity was as follows: job autonomy,job external applicability,social relations,leadership support,development space,environmental safety,average monthly income,job pressure,family support.The results of multiple linear regression showed that the degree of influence on stability was as follows: salary,negative emotion,family support,result fairness,sense of grasp,work organization,routine work,social relationship.(4)the total scores of work status,occupational identity,stability and the correlation coefficient between the three dimensions were statistically significant(P<0.001).(5)the work condition,social support and responsibility have direct influence on professional identity,the path coefficient is 0.18,0.43,and it has indirect effect on the possibility of quitting the job,the effect value is 0.02,0.04,and job experience has direct influence on stability,the path coefficient was 0.28.In the aspect of professional identity,it has a direct influence on the intention of job engagement,the motivation and possibility of obtaining external work,and the path coefficient is respectively 0.85,0.30,which has both direct and indirect effects on the possibility of quitting the job,and its total effect value is 0.34.Conclusions: The scale used in the study has good reliability and validity and is suitable for measuring the occupational identity and stability of grassroots medical personnel.The results showed that the general status of occupational identity and stability of primary medical workers in Hangzhou was higher than that in central and western China.The greater the work pressure and development space,the lower the degree of external applicability.The more harmonious the social relationship,the stronger the social support,the higher the degree of environmental safety and the monthly average income,the more abundant the content of work,the stronger the sense of professional identity,the higher the salary,the higher the sense of social status,the higher the sense of mastery and the sense of organizational influence.The less negative emotion,the stronger the fairness of family support and result,the more abundant the work content is,the more harmonious the social relationship is,the stronger the stability of the grassroots medical staff is,the more stable the work condition is,the more professional identity they are,the more they are working in the community health service center,the more abundant the work content is.Among them,job itself,social support and responsibility have a direct positive impact on professional identity,and indirect effects on the possibility of quitting their jobs.Job experience has a direct impact on the possibility of quitting a job;professional identity has a direct impact on the possibility of quitting a job.Professional identity and the motivation and possibility of obtaining external jobs have the greatest influence on the turnover intention of grassroots medical staff.