Relationships between Perceived Workplace Violence by Patients, Psychological Capital, and Professional Identity among General Practitioners in China

doi:10.12114/j.issn.1007-9572.2022.0394

Chinese General Practice ›› 2022, Vol. 25 ›› Issue (31): 3949-3954.DOI: 10.12114/j.issn.1007-9572.2022.0394

Special Issue: 心理健康最新文章合辑；全科医学教育专题研究；全科医生最新文章合辑

• Article·Focus on General Practice Education • Previous Articles Next Articles

Relationships between Perceived Workplace Violence by Patients, Psychological Capital, and Professional Identity among General Practitioners in China

1.Wuchang District Shouyilu Subdistrict Community Health Center, Wuhan 430060, China
2.School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

Received:2022-06-01 Revised:2022-07-27 Published:2022-11-05 Online:2022-09-01
Contact: GAN Yong
About author:
YU M Y, FENG J, ZHENG Y L, et al. Relationships between perceived workplace violence by patients, psychological capital, and professional identity among general practitioners in China [J] . Chinese General Practice, 2022, 25 (31) : 3949-3954.

中国全科医生对工作场所患者源暴力的感知、心理资本与职业认同的关系研究

1.430060　湖北省武汉市，武汉市武昌区首义路街社区卫生服务中心
2.430030　湖北省武汉市，华中科技大学同济医学院公共卫生学院

通讯作者: 甘勇
作者简介:
余旻毅，冯晶，郑艳玲，等.中国全科医生对工作场所患者源暴力的感知、心理资本与职业认同的关系研究[J].中国全科医学，2022，25（31）：3949-3954.[www.chinagp.net] 作者贡献：余旻毅负责文章的构思与设计、论文撰写；冯晶负责问卷设计、数据分析、论文修订；郑艳玲、雷子辉、申鑫负责文献及相关资料的收集与整理；李欣妍、屈歌负责文章内容的质量控制和数据校对；甘勇负责文章的可行性分析、英文的修订、审校，并对文章进行整体把握、监督管理。
基金资助:
中央高校基本科研业务费资助项目(HUST（2020kfyXJJS059）)

Abstract

Abstract:

Background

Social environment and psychological factors have a notable impact on professional identity. Currently, there are no available studies on relationships between perception of workplace violence (WPV) by patients, psychological capital (PsyCap) , and professional identity among general practitioners (GPs) in China.

Objective

To investigate the relationships between perceived WPV by patients, PsyCap, and professional identity among GPs in China.

Methods

A self-administered electronic questionnaire survey was conducted with 4 632 GPs selected by use of stratified multistage random sampling from eastern, central, and western China between March and May 2021. The survey was used for collecting data mainly consisting of GPs' basic demographics, perceived WPV by patients, PsyCap, and professional identity. Spearman's correlation was used to analyze relationships between perceived WPV by patients, PsyCap, and professional identity. Hierarchical multiple regression analysis was used to analyze the effects of perceived WPV by patients and PsyCap on professional identity.

Results

Altogether, 94.47% of the GPs (4 376/4 632) who handed in responsive questionnaires were included for analysis. Six hundred and twenty-four (14.26%) GPs had experienced WPV by patients in the past year. The average total scores of PsyCap and professional identity were (102.89±16.94) and (33.93±8.95) , respectively. The increase in the score of perceived WPV by patients was correlated with a decrease in the scores of PsyCap and its dimensions, and in the score of professional identity (P<0.01) . The increase in the scores of PsyCap and its dimensions was correlated with increased score of professional identity (P<0.01) . Hierarchical multiple regression analysis showed that the frequency of WPV by patients had a negative predictive effect on professional identity (low frequency, b=-0.071; intermediate frequency, b=-0.054; high frequency, b=-0.042; P<0.001) . PsyCap had a positively predicted effect on professional identity (b=0.330, P<0.001) , and it played a partial mediating role between perceived WPV by patients and professional identity.

Conclusion

The GPs' perceived WPV by patients, PsyCap, and professional identity are interrelated, and PsyCap plays a partial mediating role between perceived WPV by patients and professional identity. Great importance should be attached to the professional work environment, occupational status, and mental health among Chinese GPs.

Key words: General practitioners, Workplace violence, Psychological capital, Professional identity, Mediation analysis

摘要：

背景

社会环境和心理因素会对职业认同产生明显影响，目前尚无关于中国全科医生对工作场所患者源暴力的感知、心理资本与职业认同关系的研究。

目的

了解中国全科医生对工作场所患者源暴力的感知、心理资本与职业认同现状及三者之间的关系。

方法

于2021年3—5月，在中国东、中、西部地区采用多阶段分层随机抽样的方法抽取4 632例全科医生进行电子问卷调查，调查问卷内容主要包括全科医生的基本情况、工作场所患者源暴力、心理资本、职业认同。采用Spearman秩相关分析工作场所患者源暴力、心理资本与职业认同的关系；采用多元分层回归分析工作场所患者源暴力、心理资本对职业认同的影响。

结果

共回收4 376份有效问卷（94.47%）。4 376例全科医生中，624例（14.26%）过去1年中遭受过工作场所患者源暴力，全科医生心理资本总得分为（102.89±16.94）分，职业认同总得分为（33.93±8.95）分。Spearman秩相关分析结果显示，全科医生工作场所患者源暴力与心理资本及其各维度、职业认同呈负相关，心理资本及其各维度与职业认同呈正相关（P<0.01）。多元分层回归分析结果显示，工作场所患者源暴力对职业认同有负向预测作用（低频度，b=-0.071；中频度，b=-0.054；高频度，b=-0.042；P均<0.001），心理资本对职业认同有正向预测作用（b=0.330，P<0.001），心理资本在工作场所患者源暴力与职业认同之间起部分中介作用。

结论

中国全科医生工作场所患者源暴力、心理资本与职业认同之间存在相关关系，心理资本在工作场所患者源暴力和职业认同之间起部分中介作用，未来应重视全科医生的职业环境、职业现状和心理健康。

关键词: 全科医生, 工作场所暴力, 心理资本, 职业认同, 中介分析

YU Minyi,FENG Jing,ZHENG Yanling, et al. Relationships between Perceived Workplace Violence by Patients, Psychological Capital, and Professional Identity among General Practitioners in China[J]. Chinese General Practice, 2022, 25(31): 3949-3954. DOI: 10.12114/j.issn.1007-9572.2022.0394.
余旻毅,冯晶,郑艳玲等. 中国全科医生对工作场所患者源暴力的感知、心理资本与职业认同的关系研究[J]. 中国全科医学, 2022, 25(31): 3949-3954. DOI: 10.12114/j.issn.1007-9572.2022.0394.

Figures/Tables 3

References 21

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特征		例数	职业认同得分	F（t）值	P值	特征		例数	职业认同得分	F（t）值	P值
地区				2.697	0.067	年收入（万元）				1.364	0.256
	东部	2 016	33.71±8.65				<10	2 930	34.05±9.30
	中部	1 184	34.44±9.43				10~<15	1 001	33.52±8.27
	西部	1 176	33.79±8.96				≥15	445	34.08±8.05
年龄（岁）				57.840	<0.001	每周工作时间（h）				4.373	0.013
	<30	471	31.42±9.30				<40	2 018	34.35±8.23
	30~<40	1 509	32.47±8.51				40~<50	1 324	33.45±9.14
	40~<50	1 684	34.69±8.89				≥50	1 034	33.73±9.98
	≥50	712	36.89±8.76			日均诊疗量（人次）				14.745	<0.001
性别				-0.075^a	0.940		<20	1 322	34.19±9.44
	男	1 778	33.92±9.40				20~<40	1 649	34.61±8.84
	女	2 598	33.94±8.64				≥40	1 405	32.90±8.52
民族				0.156^a	0.876	人均诊疗时间（min）				13.606	<0.001
	汉族	4 065	33.94±8.91				<10	2 942	33.48±8.94
	少数民族	311	33.86±9.52				10~<20	1 053	35.15±8.90
婚姻状况				-5.335^a	<0.001		≥20	381	34.03±8.89
	非在婚	564	32.06±9.27			每周行政管理事务时间占比（%）				4.339	0.013
	在婚	3 812	34.21±8.87				<10	2 671	33.97±8.83
文化程度				76.476	<0.001		10~<20	810	34.53±8.75
	大专及以下	1 103	36.77±8.88				≥20	895	33.26±9.46
	本科	2 974	32.98±8.81			加班频率				19.772	<0.001
	硕士及以上	299	32.90±8.41				从不	81	36.89±9.47
工作年限（年）				14.272	<0.001		偶尔	2 058	34.66±8.45
	<10	1 984	33.37±8.93				经常	2 237	33.16±9.30
	10~<20	1 442	33.85±8.81			家访频率				1.970	0.140
	≥20	950	35.24±9.10				从不	210	32.76±9.82
执业地点				-3.184^a	0.001		偶尔	1 525	33.92±8.58
	城市	3 335	33.67±8.61				经常	2 641	34.03±9.09
	农村	1 041	34.76±9.92			工作量				37.601	<0.001
任职方式				4.349^a	<0.001		较小	43	31.84±10.55
	合同制	1 072	34.96±8.95				一般	1 405	35.61±8.42
	正式在编	3 304	33.60±8.93				较大	2 928	33.16±9.06
职称				2.589	0.075	工作压力				60.636	<0.001
	初级及以下	1 647	34.05±9.36				较小	74	36.78±11.35
	中级	1 964	33.63±8.69				一般	1 488	35.85±8.35
	副高级及以上	765	34.46±8.69				较大	2 814	32.84±9.01
行政职务				3.843^a	<0.001	职业发展机会				184.725	<0.001
	有	1 048	34.86±8.94				较少	1 732	31.15±9.68
	无	3 328	33.64±8.94				一般	2 116	35.05±7.88
							较多	528	38.56±7.53

特征		例数	职业认同得分	F（t）值	P值	特征		例数	职业认同得分	F（t）值	P值
地区				2.697	0.067	年收入（万元）				1.364	0.256
	东部	2 016	33.71±8.65				<10	2 930	34.05±9.30
	中部	1 184	34.44±9.43				10~<15	1 001	33.52±8.27
	西部	1 176	33.79±8.96				≥15	445	34.08±8.05
年龄（岁）				57.840	<0.001	每周工作时间（h）				4.373	0.013
	<30	471	31.42±9.30				<40	2 018	34.35±8.23
	30~<40	1 509	32.47±8.51				40~<50	1 324	33.45±9.14
	40~<50	1 684	34.69±8.89				≥50	1 034	33.73±9.98
	≥50	712	36.89±8.76			日均诊疗量（人次）				14.745	<0.001
性别				-0.075^a	0.940		<20	1 322	34.19±9.44
	男	1 778	33.92±9.40				20~<40	1 649	34.61±8.84
	女	2 598	33.94±8.64				≥40	1 405	32.90±8.52
民族				0.156^a	0.876	人均诊疗时间（min）				13.606	<0.001
	汉族	4 065	33.94±8.91				<10	2 942	33.48±8.94
	少数民族	311	33.86±9.52				10~<20	1 053	35.15±8.90
婚姻状况				-5.335^a	<0.001		≥20	381	34.03±8.89
	非在婚	564	32.06±9.27			每周行政管理事务时间占比（%）				4.339	0.013
	在婚	3 812	34.21±8.87				<10	2 671	33.97±8.83
文化程度				76.476	<0.001		10~<20	810	34.53±8.75
	大专及以下	1 103	36.77±8.88				≥20	895	33.26±9.46
	本科	2 974	32.98±8.81			加班频率				19.772	<0.001
	硕士及以上	299	32.90±8.41				从不	81	36.89±9.47
工作年限（年）				14.272	<0.001		偶尔	2 058	34.66±8.45
	<10	1 984	33.37±8.93				经常	2 237	33.16±9.30
	10~<20	1 442	33.85±8.81			家访频率				1.970	0.140
	≥20	950	35.24±9.10				从不	210	32.76±9.82
执业地点				-3.184^a	0.001		偶尔	1 525	33.92±8.58
	城市	3 335	33.67±8.61				经常	2 641	34.03±9.09
	农村	1 041	34.76±9.92			工作量				37.601	<0.001
任职方式				4.349^a	<0.001		较小	43	31.84±10.55
	合同制	1 072	34.96±8.95				一般	1 405	35.61±8.42
	正式在编	3 304	33.60±8.93				较大	2 928	33.16±9.06
职称				2.589	0.075	工作压力				60.636	<0.001
	初级及以下	1 647	34.05±9.36				较小	74	36.78±11.35
	中级	1 964	33.63±8.69				一般	1 488	35.85±8.35
	副高级及以上	765	34.46±8.69				较大	2 814	32.84±9.01
行政职务				3.843^a	<0.001	职业发展机会				184.725	<0.001
	有	1 048	34.86±8.94				较少	1 732	31.15±9.68
	无	3 328	33.64±8.94				一般	2 116	35.05±7.88
							较多	528	38.56±7.53

变量		工作场所患者源暴力	职业认同	心理资本
变量		工作场所患者源暴力	职业认同	总得分	自我效能	希望	韧性	乐观
工作场所患者源暴力		1.000	—	—	—	—	—	—
职业认同		-0.177^a	1.000	—	—	—	—	—
心理资本		-0.091^a	0.417^a	1.000	—	—	—	—
	自我效能	-0.052^a	0.324^a	0.893^a	1.000	—	—	—
	希望	-0.088^a	0.415^a	0.923^a	0.828^a	1.000	—	—
	韧性	-0.074^a	0.357^a	0.904^a	0.728^a	0.783^a	1.000	—
	乐观	-0.123^a	0.411^a	0.810^a	0.591^a	0.668^a	0.743^a	1.000

变量		工作场所患者源暴力	职业认同	心理资本
变量		工作场所患者源暴力	职业认同	总得分	自我效能	希望	韧性	乐观
工作场所患者源暴力		1.000	—	—	—	—	—	—
职业认同		-0.177^a	1.000	—	—	—	—	—
心理资本		-0.091^a	0.417^a	1.000	—	—	—	—
	自我效能	-0.052^a	0.324^a	0.893^a	1.000	—	—	—
	希望	-0.088^a	0.415^a	0.923^a	0.828^a	1.000	—	—
	韧性	-0.074^a	0.357^a	0.904^a	0.728^a	0.783^a	1.000	—
	乐观	-0.123^a	0.411^a	0.810^a	0.591^a	0.668^a	0.743^a	1.000

变量		模型1		模型2		模型3		变量		模型1		模型2		模型3
变量		b	P值	b	P值	b	P值	变量		b	P值	b	P值	b	P值
年龄（岁，以<30为参照）								人均诊疗时间（min，以<10为参照）
	30~<40	0.097	<0.001	0.094	<0.001	0.097	<0.001		10~<20	0.045	0.002	0.043	0.003	0.035	0.010
	40~<50	0.243	<0.001	0.234	<0.001	0.209	<0.001		≥20	0.007	0.649	0.006	0.665	0.015	0.266
	≥50	0.248	<0.001	0.238	<0.001	0.209	<0.001	每周行政管理事务时间占比（%，以<10为参照）
性别（以男为参照）									10~<20	0.003	0.861	0.004	0.774	0.002	0.901
	女	0.043	0.004	0.030	0.041	0.036	0.009		≥20	-0.068	<0.001	-0.064	<0.001	-0.074	<0.001
婚姻状况（以非在婚为参照）								加班频率（以从不为参照）
	在婚	0.042	0.007	0.041	0.008	0.029	0.042		偶尔	-0.071	0.177	-0.061	0.240	-0.064	0.190
文化程度（以大专及以下为参照）									经常	-0.109	0.042	-0.091	0.088	-0.094	0.058
	本科	-0.105	<0.001	-0.104	<0.001	-0.098	<0.001	工作量（以较小为参照）
	硕士及以上	-0.066	<0.001	-0.064	<0.001	-0.060	<0.001		一般	0.241	0.001	0.249	0.001	0.186	0.006
执业地点（以城市为参照）									较大	0.211	0.004	0.221	0.003	0.146	0.034
	农村	0.057	<0.001	0.051	0.001	0.033	0.024	工作压力（以较小为参照）
任职方式（以合同制为参照）									一般	-0.111	0.049	-0.119	0.034	-0.055	0.296
	正式在编	-0.036	0.020	-0.036	0.019	-0.028	0.052		较大	-0.201	0.001	-0.203	<0.001	-0.107	0.050
职称（以初级及以下为参照）								职业发展机会（以较少为参照）
	中级	-0.055	0.002	-0.050	0.005	-0.047	0.005		一般	0.216	<0.001	0.205	<0.001	0.185	<0.001
	副高级及以上	-0.064	0.001	-0.058	0.003	-0.069	<0.001		较多	0.295	<0.001	0.284	<0.001	0.235	<0.001
行政职务（以有为参照）								工作场所患者源暴力（以零频度为参照）
	无	-0.043	0.014	-0.041	0.020	-0.026	0.109		低频度	—	—	-0.089	<0.001	-0.071	<0.001
每周工作时间（h，以<40为参照）									中频度	—	—	-0.069	<0.001	-0.054	<0.001
	40~<50	-0.025	0.104	-0.025	0.104	-0.035	0.017		高频度	—	—	-0.053	<0.001	-0.042	0.001
	≥50	0.001	0.961	0.005	0.766	-0.018	0.282	心理资本（以实际得分纳入）		—	—	—	—	0.330	<0.001
日均诊疗量（人次，以<20为参照）								F值		27.260	<0.001	27.429	<0.001	45.528	<0.001
	20~<40	0.031	0.065	0.035	0.039	0.014	0.371	R²		0.189	—	0.202	—	0.301	—
	≥40	-0.015	0.452	0.000	0.996	0.007	0.719	ΔR²		0.189	<0.001	0.013	<0.001	0.099	<0.001

Relationships between Perceived Workplace Violence by Patients, Psychological Capital, and Professional Identity among General Practitioners in China

中国全科医生对工作场所患者源暴力的感知、心理资本与职业认同的关系研究

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