茂名市基层卫生院医护人员职业状况及患者就诊满意度调查研究

A Survey Study on the Occupational Status and Patient Satisfaction of Medical Staff in Grassroots Health Centers in Maoming City

摘要: 目的：本研究旨在系统探究茂名市基层卫生院医护人员的职业状况与患者就诊满意度之间的内在关联性，通过量化分析工作满意度、工作压力、职业发展机会等核心维度，揭示影响医护人员职业体验的关键因素，并评估其对医疗服务质量及患者满意度的传导效应，为基层医疗体系优化提供实证依据。方法：采用混合研究设计，结合横断面问卷调查与深度访谈，对茂名市12所基层卫生院的320名医护人员及450例患者进行抽样调查，运用结构方程模型(SEM)和多元线性回归分析，构建医护人员工作满意度影响因素的理论框架，并通过克朗巴哈系数(Cronbach’s α)检验量表的信效度(α = 0.87)。同时，采用服务质量(SERVQUAL)量表评估患者满意度，并采用斯皮尔曼等级相关系数(ρ = 0.42, p < 0.01)分析二者间的关联性。结果：数据显示，茂名市基层医护人员工作满意度总体评分为(3.21 ± 0.63)分(5分量表)，其中职业发展机会维度得分最低(2.89 ± 0.71)，工作环境维度得分最高(3.58 ± 0.65)。多元回归分析表明，薪酬水平(β = 0.38, p < 0.001)、领导支持(β = 0.29, p < 0.01)和职业晋升机会(β = 0.25, p < 0.05)是影响工作满意度的显著预测因子。患者满意度评分为(3.45 ± 0.58)分，且与医护人员工作满意度呈显著正相关(r = 0.46, p < 0.001)。工作压力(OR = 1.82, 95% CI: 1.34~2.47)和医患沟通频率(β = −0.31, p < 0.01)是影响患者满意度的关键中介变量。结论：茂名市基层卫生院医护人员职业状况存在结构性失衡，职业发展支持不足与薪酬体系不完善是制约工作满意度的核心瓶颈。患者满意度与医护人员职业体验存在显著的正向关联，提示通过优化组织制度(如弹性排班机制)、强化职业培训(如继续教育学分制)及构建社会支持网络(如社区医患共治平台)，可有效提升双维度满意度，进而实现基层医疗服务质量的帕累托改进。

Abstract: Objective: This study aims to systematically explore the intrinsic correlation between the occupational status of medical staff in grassroots health centers in Maoming City and patient satisfaction with medical treatment. Through quantitative analysis of core dimensions such as job satisfaction, work pressure, and career development opportunities, the key factors affecting the professional experience of medical staff are revealed, and their transmission effects on medical service quality and patient satisfaction are evaluated, providing empirical evidence for optimizing the grassroots medical system. Method: A mixed study design was adopted, combined with cross-sectional questionnaire survey and in-depth interviews, to conduct a sampling survey of 320 medical and nursing staff and 450 patients from 12 primary health centers in Maoming City. Using structural equation modeling (SEM) and multiple linear regression analysis, a theoretical framework for the factors influencing job satisfaction among medical staff was constructed, and the reliability and validity of the scale were tested using Cronbach’s alpha coefficient (α = 0.87). At the same time, the SERVQUAL scale was used to evaluate patient satisfaction, and the Spearman rank correlation coefficient (ρ = 0.42, p < 0.01) was used to analyze the correlation between the two. Result: The data shows that the overall job satisfaction score of grassroots medical staff in Maoming City is (3.21 ± 0.63) points (5-point scale), with the lowest score in the dimension of career development opportunities (2.89 ± 0.71) and the highest score in the dimension of work environment (3.58 ± 0.65). Multiple regression analysis showed that salary level (β = 0.38, p < 0.001), leadership support (β = 0.29, p < 0.01), and career advancement opportunities (β = 0.25, p < 0.05) were significant predictive factors affecting job satisfaction. The patient satisfaction score is (3.45 ± 0.58) points, and it is significantly positively correlated with the job satisfaction of medical staff (r = 0.46, p < 0.001). Work pressure (OR = 1.82, 95% CI: 1.34~2.47) and frequency of doctor-patient communication (β = −0.31, p < 0.01) are key mediating variables that affect patient satisfaction. Conclusion: There is a structural imbalance in the occupational status of medical staff in grassroots health centers in Maoming City. Insufficient career development support and an imperfect salary system are the core bottlenecks that constrain job satisfaction. There is a significant positive correlation between patient satisfaction and the professional experience of medical staff, suggesting that optimizing organizational systems (such as flexible scheduling mechanisms), strengthening vocational training (such as continuing education credit systems), and building social support networks (such as community doctor-patient co governance platforms) can effectively improve dual dimensional satisfaction and achieve Pareto improvement in the quality of primary healthcare services.