Workplace Violence and Turnover Intention Among Rural General Practitioners in China's National Compulsory Services Program: The Mediating Role of Psychosocial Factors.

IF 2.2 4区 医学 Q1 NURSING
Yanrong Du, Peicheng Wang, Yanrong He, Hange Li, Yanhua Chen, Jiming Zhu
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引用次数: 0

Abstract

Background: Workplace violence (WPV) against general practitioners (GPs) is a global issue, especially in rural regions. The National Compulsory Services Program (NCSP) was launched to address the primary care shortage in China. This study examines WPV prevalence and associated factors among NCSP GPs, its impact on turnover intention, and the mediating role of psychosocial factors.

Methods: 3,615 GPs from township health centers (THCs) across nine provinces were recruited between 2021 and 2022. Logistic regression identified socio-demographic and occupational characteristics associated with WPV. Mediation analysis tested pathways between WPV and turnover intention.

Findings: Among participants, 60.8% reported WPV in the past 12 months, with 60.3% experiencing verbal and 17.5% physical violence. WPV was associated with age (OR = 0.95, 95% CI [0.91, 0.99]), higher professional rank (OR = 1.26 [1.06, 1.50]), 2 years in practice (OR = 1.42 [1.18, 1.71]), monthly income > CNY 4,000 (OR = 1.25 [1.08, 1.45]), practicing in hometown (OR = 1.20 [1.05, 1.38]), serving in general practice (OR = 1.31 [1.14, 1.51]), and ≥ 55 weekly working hours (OR = 1.58 [1.34, 1.88]). WPV influenced turnover intention directly and indirectly through four psychosocial mediators: job satisfaction (indirect effect = 0.023, p < .001, 45.1% of the total effect), loneliness (0.019, p < .001, 37.3%), well-being (0.015, p < .001, 28.8%), and career choice regret (0.009, p < .001, 17.6%).

Conclusion: High WPV prevalence among rural Chinese GPs poses a threat to occupational safety and is associated with lower job and life satisfaction, greater loneliness and career choice regret, potentially threatening retention in THCs.Applications to Practice:Rural primary care systems should provide psychological counseling, group supervision, and career coaching as targeted psychosocial interventions to address these mediating pathways and strengthen rural GP retention.

工作场所暴力与农村全科医生离职意向:心理社会因素的中介作用
背景:针对全科医生的工作场所暴力(WPV)是一个全球性问题,特别是在农村地区。国家义务医疗服务计划(NCSP)的启动是为了解决中国的初级医疗短缺问题。本研究考察了NCSP全科医生的WPV患病率及其相关因素,对离职意向的影响,以及心理社会因素的中介作用。方法:在2021年至2022年期间,从9个省份的乡镇卫生院(thc)招募了3615名全科医生。Logistic回归确定了与WPV相关的社会人口统计学和职业特征。中介分析检验了WPV与离职倾向之间的通路。调查结果:在参与者中,60.8%的人报告在过去12个月内遭受过殴打,其中60.3%的人经历过语言暴力,17.5%的人经历过身体暴力。WPV与年龄(OR = 0.95, 95% CI[0.91, 0.99])、较高的专业级别(OR = 1.26[1.06, 1.50])、执业2年(OR = 1.42[1.18, 1.71])、月收入4000元(OR = 1.25[1.08, 1.45])、家乡执业(OR = 1.20[1.05, 1.38])、全科执业(OR = 1.31[1.14, 1.51])、每周工作时间≥55小时(OR = 1.58[1.34, 1.88])相关。工作满意度通过工作满意度(间接效应= 0.023,p < 0.001,占总效应的45.1%)、孤独感(0.019,p < 0.001, 37.3%)、幸福感(0.015,p < 0.001, 28.8%)和职业选择后悔(0.009,p < 0.001, 17.6%)四个社会心理中介直接或间接影响离职倾向。结论:中国农村全科医生的高WPV患病率对职业安全构成威胁,并与较低的工作和生活满意度、更大的孤独感和职业选择后悔有关,可能威胁到thc的保留。实践应用:农村初级保健系统应提供心理咨询、小组监督和职业指导,作为有针对性的社会心理干预措施,以解决这些中介途径,并加强农村全科医生的保留。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.70
自引率
3.80%
发文量
77
审稿时长
6-12 weeks
期刊介绍: Workplace Health & Safety: Promoting Environments Conducive to Well-Being and Productivity is the official publication of the American Association of Occupational Health Nursing, Inc. (AAOHN). It is a scientific peer-reviewed Journal. Its purpose is to support and promote the practice of occupational and environmental health nurses by providing leading edge research findings and evidence-based clinical practices. It publishes articles that span the range of issues facing occupational and environmental health professionals, including emergency and all-hazard preparedness, health promotion, safety, productivity, environmental health, case management, workers'' compensation, business and leadership, compliance and information management.
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