Relationship Between Doctor-patient Relationship And Doctors’ Job Burnout And Work-family Conflict:An Analysis Of Structural Equation Model

Objective:To examine the relationship between doctor-patient relationship and work-family conflict of physicians,and to provide new evidence and suggestions for improving the quality of work and life of physicians.Methods:A stratified cluster sampling was conducted in 77 hospitals 528departments across 7 provinces in China between July 2014 and April 2015,and 3333effective sample were involved in the current study.Research variables include sociological demographic characteristics,doctor-patient relationship,job burnout,work-family conflict,etc.The analysis methods include descriptive statistical analysis,correlation analysis,χ~2-test and analysis of variance.The structural equation model is used to analyze the relationship between doctor-patient relationship and doctor’s job burnout and work-family conflict,and sensitivity analysis is performed to exclude samples from secondary hospitals.Results:65.31%of the respondents reported poor doctor-patient relationship,54.79%reported high job burnout,and 55.36%reported great work-family conflict.Among them,the doctor-patient relationship between age groups presents the"U"characteristics of high boundary(good)and low middle(bad),while job burnout presents the"∩"shape characteristics of low boundary(low burnout degree)and high middle(high burnout degree).The analysis results based on structural equation model showed that the doctor-patient relationship had a direct effect on work-family conflict,and the estimated point of direct effect was-0.104(95%CI:-0.147,-0.056),accounting for 27.08%of the total effect.Job burnout plays a partial mediating role in the impact of doctor-patient relationship on work-family conflict.The estimated indirect effect point of doctor-patient relationship on work-family conflict through job burnout is-0.280(95%CI:-0.311,-0.251),accounting for 72.92%of the total effect.The only-one child plays a moderating role in the doctor-patient relationship to job burnout,and the path coefficient between the doctor-patient relationship and job burnout for the only child is-0.481(P<0.001),and that for the non-only child is-0.452(P<0.001),namely only-one child is more likely to feel job burnout because of the doctor-patient relationship.The sensitivity analysis results showed that the estimated point value of the direct effect of doctor-patient relationship on work-family conflict was-0.104(95%CI:-0.152,-0.054),accounting for 26.94%of the total effect,and the estimated point value of the indirect effect was-0.282(95%CI:-0.314,-0.250),accounting for 73.06%of the total effect.Structural equation model showed that the impact of doctor-patient relationship on work-family conflict also focused on the indirect impact of job burnout.Sensitivity analysis further tested the robustness of the results.Conclusions:Based on a nationally sample,the current study reveals that strained doctor-patient relationships not only directly affect doctors’work-family conflict,but also indirectly affect doctors’work-family conflict through the mediating role of doctor job burnout by structural equation modeling.Given the seriousness of the doctor-patient relationship and the social factors outside the hospital that it represents,the related intervention strategies for improving doctors’job burnout and work-family conflict may need to be extended from the factors inside hospital to the social factors outside hospital,such as positively publicize and report to the public about hospitals and medical staff,especially public hospitals.