关键词: 社会弹性, 职业认同, 家庭医生, 影响因素分析

Abstract: Background　Doctor turnover is becoming increasingly common.As to family doctors，the health stewards of the community，turnover may influence their professional development，and may be detrimental to the implementation of national health promotion program.Currently，the duties of domestic family doctors are implemented mainly by general practitioners in primary care.They need to deliver home-based services besides hospital services，leading to increased risk of job burnout.Strengthening their professional self-identity is essential to avoid the turnover.Objective　To explore the impact of social resilience on the professional self-identity in family doctors，with a view to providing high-quality medical services for patients in primary care via improving professional self-identity in family doctors，and promoting the sustainable development of the family doctor system.Methods　This cross-sectional study was conducted in Zhejiang Province between October 2018 and June 2019.Participants were 2 500 family doctors from 321 primary health centers selected by development level from 8 cities （Hangzhou，Ningbo，Wenzhou，Jinhua，Huzhou，Zhoushan，Taizhou and Lishui） sampled by both administrative division and economic development level.A survey was implemented to collect participants’ data concerning demographics and professional self-identity using a questionnaire consisting of demographic part and Family Physician Professional Self-identity Scale （FPPSS）.Stepwise multiple linear regression was adopted to analyze the association of social resilience with dimensions of the FPPSS.Results　Among the 2 319 cases returning the questionnaire，2 261 were found to be appropriate respondents，indicating that the survey obtained a response rate of 90.44%.The mean scores of the FPPSS and its 5 dimensions，professional expectation，professional sense of belonging，professional value，professional perception，and professional behavior were （3.6±0.7），（3.0±1.0），（3.4±1.3），（4.1±1.2），（3.5±1.0），（4.1±1.1），respectively.Stepwise multiple linear regression analysis showed that innovation capacity，psychological resilience，community tolerance，equal opportunity，and social support were associated with professional self-identity（P<0.05）.And these 5 factors were also associated with professional sense of belonging （P<0.05）.Innovation capacity and equal opportunity were found to be associated factors for professional expectation（P<0.05）.Psychological resilience，community tolerance，equal opportunity，and social support were associated with professional value （P<0.05）.Innovation capacity，community tolerance，and social support were associated with professional perception （P<0.05）.Innovation capacity，psychological resilience，and community tolerance were associated with professional behavior （P<0.05）.Conclusion　In Zhejiang Province，the overall level of professional self-identity in family doctors is above the average，but there is still room for improvement.The professional self-identity level may be influenced by social resilience，including innovation capacity，psychological resilience，community tolerance，equal opportunity，and social support，with equal opportunity as the foremost.

Key words: Social resilience, Professional identity, Family doctor, Root cause analysis