关键词: 全科医生, 职业压力, 压力来源, 影响因素分析

Abstract: Background　Chinese general practitioners（GPs） are facing challenges to improve residents' quality of life via satisfying their healthcare needs rising with the social and economic development，and to learn and use new medical technologies as well as continuously developed highly informationized and intelligent healthcare delivery patterns，and their work stress is ever-increasing. Studying the work stress and its influencing factors among GPs in China could help to identify effective methods to relieve the work stress of GPs，benefiting the stabilization of GPs workforce. Objective　To investigate the status，sources and associated factors of work stress in Chinese GPs. Methods　The study was carried out between October 2017 and February 2018. By use of multistage stratified random sampling，3 244 GPs were selected from eastern，central and western China to attend a WeChat-based survey using a self-complied questionnaire named Attractiveness of Occupation as a General Practitioner. The chi-square test was used to compare the difference in prevalence and sources of work stress among GPs with different characteristics. Ordinal multinomial Logistic regression analysis was used to explore the major determinants associated with work stress. Results　Altogether，99.75% of the GPs（3 236/3 244） who returned responsive questionnaires were finally included. The results showed that 58.56% of the GPs（1 895/3 236） had relatively high work stress. The top three sources of work stress were economic factors（low income or inability to buy an apartment）〔76.17%（2 465/3 236）〕，difficulty in achieving performance goals〔42.37%（1 371/3 236）〕 and lack of professional identity〔41.84%（1 354/3 236）〕. Logistic regression analysis indicated that male，working in eastern China，aged between 30-50 years old，longer average daily working hours and high frequency of working overtime were main factors associated with work stress among GPs（P<0.05）. Conclusion　In general，the prevalence of work stress among Chinese GPs is high，which is associated with multiple factors，and the most important are economic factors（low income or inability to buy an apartment） . To reduce GPs' work stress，it is suggested to improve the salary and reduce the workload of GPs appropriately，modify the workload allocation and welfare benefits system for GPs，and pay more attention to improve the mental health of GPs.

Key words: General practitioners, Occupational stress, Source of stress, Root cause analysis