社区全科医生职业倦怠与焦虑情绪的关系：情绪取向应对和睡眠质量的链式中介作用

Analysis on the Association between Job Burnout and Anxiety among Chinese General Practitioners: The Chain Mediating Role of Emotion-Oriented Coping and Sleep Quality

摘要: 目的：探讨社区全科医生职业倦怠、焦虑的情况，分析情绪取向应对和睡眠质量在职业倦怠和焦虑之间的链式中介作用。方法：于2022年10月至2023年2月选取上海市浦东区、长宁区、虹口区3个区随机抽取290名社区医院的全科医生为调查对象。采用Maslach职业倦怠问卷(MBI-GS)、广泛性焦虑障碍量表(GAD-7)、压力情境应对量表(CISS)、匹兹堡睡眠质量指数(PSQI)评估社区全科医生的职业倦怠感、焦虑情绪、应对方式以及睡眠质量。结果：研究纳入290名社区全科医生，女性占比70.3%，男性占比29.7%；平均年龄39 ± 7岁。该群体至少存在一种维度症状的平均检出率为“38.74%”。情绪取向应对和睡眠质量的中介作用显著，中介效应值为0.079效应占比39.45%。情绪取向应对(效应值：0.033，效应占比：16.39%)，睡眠质量(效应值：0.036，效应占比：18.15%)，在职业倦怠与焦虑情绪之间各自的中介效应作用显著。情绪取向应对和睡眠质量在社区全科医生职业倦怠与焦虑情绪之间存在链式中介作用的效应(效应值：0.010，效应占比：4.91%)。结论：情绪取向应对和睡眠质量作为中介因素参与了社区全科医生群体职业倦怠相关的焦虑情绪。基于职业倦怠的焦虑情绪预防需同时考虑情绪取向应对和睡眠质量的贡献。

Abstract: Objective: To explore the job burnout and anxiety among Chinese general practitioners, and analyze the mediating role of emotion-oriented coping and sleep quality. Methods: From October 2022 to February 2023, 290 general practitioners from community hospitals randomly selected from three districts of Pudong District, Changning District and Hongkou District of Shanghai, were selected as the research subject. The Maslach Burnout Inventory-General Survey (MBI-GS), Generalized Anxiety Disorder 7-Item (GAD-7), Coping Inventory for Stressful Situations (CISS), Pittsburgh Sleep Quality Index (PSQI) were used to investigate the job burnout, anxiety, Coping Inventory for Stressful Situations, CISS, and sleep quality of primary care physicians. Model 6 in the Process V3.3plugin of SPSS 25.0 software was used to analyze the mediating effect of emotion-oriented coping and sleep quality between job burnout and anxiety. Results: The study included 290 community general practitioners (70.3% female and 29.7% male). The mean age was 39 ± 7 years. The average detection rate of at least one dimension of symptoms in this group was “38.74%”. The mediating effect between emotion-oriented coping and sleep quality was significant, with a mediating effect value of 0.079 accounting for 39.45% of the total effect. Emotion-oriented coping with a mediating effect value of 0.033, accounting for 16.39% of the total effect and sleep quality with a mediating effect value of 0.036, accounting for 18.15% of the total effect had significant mediating effects between job burnout and anxiety respectively. Meanwhile emotion-oriented coping and sleep quality have a chained mediation effect between job burnout and anxiety with a mediating effect value of 0.010, accounting for 4.91% of the total effect. Conclusion: Emotion-oriented coping and sleep quality, as mediating factors, are involved in the anxiety related to job burnout among community general practitioners. Job burnout-related anxiety prevention should consider the contributions of both emotion-oriented coping and sleep.