Self-rated Mental Health And Influencing Factors Among Medical Staff In 136 Tertiary Public Hospitals In China

[Objective]To understand the status and analyze the influencing factors of self-rated mental health among medical staff in 136 tertiary public hospitals in China.[Methods]In this study,136 tertiary public hospitals nested in the "Third-party Evaluation of the National Health-Care Improvement Initiative"(the third round)were used as sample hospitals.In sample hospitals,a two-stage stratified and equidistant sampling method was used to conduct to select sampling medical staff,and a self-filled questionnaire was used to evaluate their self-rated mental health.The question "What do you think of your mental health status?(including 'very bad' 'poor' 'general' 'good' 'very good'5 options)" was used to measure the status of mental health of medical staff.When the answer is "very poor" or "poor",the medical staff is defined as "unhealthy" on mental health.The study further analyze the influencing factors of self-rated mental health,which mainly focusing on perceived pressure,workload,doctor-patient relationship,professional identity,satisfaction with the current medical environment and hospital related systems.The study uses rank sum test to evaluated the differences of self-rated mental health among doctors and nurses.When analyzing the influencing factors,the single factor analysis was performed by chi-square test,and the multiple-factor analysis was performed by two-category multivariate logistic regression analysis(forward:LR method).[Results]20,786 doctors and 27,575 nurses completed the questionnaire and provided valid data.The results showed that the proportion of doctors whose mental health are"unhealthy" was 16.21%,which was higher than the that of nurses(10.76%).Doctors being male,"30 to 39 years old" or "40 to 49 years old",divorced or widowed,intermediate or deputy senior title,no administrative position,average monthly income after tax is lower than 10,000 yuan,pediatric or emergency department,local hospital,in the western region or with chronic diseases,have a higher proportion of unhealthy mental health status.Moreover,nurses being "30 to 39 years old",divorced or widowed,junior title,no administrative position,average monthly income after tax is 7,000 yuan and below,pediatric or emergency department,local hospital,in the western region,and nurses with chronic diseases,have a higher proportion of unhealthy mental health status.Among the medical staff,perceived stress level is medium or high pressure,having late night shift "5 times and above" last month,having experienced medical disputes in the past year,having experienced violence from the patient in the past year,low level of satisfaction in the medical environment are possible risk factors for the unhealthy mental health.Recognition attitude of "it can be a good balance between work and family" "high cooperation and trust among colleagues in this hospital" "the occupations are socially recognized and respected" "the income distribution plan of the hospital plays an incentive role" "the promotion system of the hospital is reasonable" is "disagree" or "general" are also possible risk factors for unhealthy mental health.Average daily sleep time is "6-7 hours","7-8 hours" or "?8 hours" are possible protective factors for self-rated mental health.[Conclusions]The proportion of doctors whose mental health are unhealthy is higher than that of nurses.The proportion of medical staff whose mental health is unhealthy is different in different ages,marital status,education level,professional title,administrative position,monthly average income after tax,department,hospital type and region.There is a difference in the proportion of self-rated mental health among doctors of different genders,while it doesn't appear among nurses.Perceived pressure,frequency of night shifts in the past month,average daily sleep time,whether have experienced medical disputes in the past year,whether have experienced violence from patient in the past year,satisfaction with the current domestic medical environment,and the recognition attitude of "it can be a good balance between work and family" "there is a high degree of cooperation and trust between colleagues in the hospital" "the occupation is socially recognized and respected" "the income distribution plan of the hospital plays an incentive role" and"the promotion system of the hospital is reasonable" are possible influencing factors for self-rated mental health among medical staff.