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

摘要： 背景　随着社会的不断发展、经济和生活水平的不断提高、医疗技术的不断进步，高度信息化和智能化的医疗服务模式相继出现，我国全科医生的工作正面临着全新的挑战，工作压力与日俱增。研究中国社区全科医生工作压力现状及影响因素，有利于探索缓解全科医生工作压力的方法，为稳定全科医生队伍提供参考。目的　了解我国社区全科医生工作压力现状和来源，分析影响我国社区全科医生工作压力的主要因素。方法　于2017年10月至2018年2月，采用分层随机抽样方法在我国东、中、西部随机抽取3 244例社区卫生服务机构的全科医生，使用自行编制的“全科医生职业吸引力调查表”对全科医生进行微信问卷调查，运用χ2检验比较不同特征全科医生工作压力状况和来源的分布，采用多元有序多分类Logistic回归分析全科医生工作压力的主要影响因素。结果　共发放问卷3 244份，回收有效问卷3 236份，有效回收率为99.75%。58.56%（1 895/3 236）的全科医生工作压力较高。全科医生工作压力来源的前3位分别是工资低或购房压力（经济压力）〔76.17%（2 465/3 236）〕、难以达到考核目标〔42.37%（1 371/3 236）〕、缺乏职业认同感〔41.84%（1 354/3 236）〕。Logistic回归分析结果显示，地区、性别、年龄、日均工作时间、加班频率是全科医生工作压力的主要影响因素（P<0.05）。结论　我国全科医生工作压力较大，影响全科医生工作压力的因素复杂，最主要的来源是工资低或购房压力（经济压力）。建议提高全科医生的工资待遇，减少全科医生的工作量，优化全科医生的工作分配和福利保障制度，重视全科医生的心理健康，从而减少全科医生的工作压力。

关键词: 全科医生, 职业压力, 压力来源, 影响因素分析