【作者】 任海燕；

【导师】 方鹏骞；

【作者基本信息】 华中科技大学 ， 社会医学与卫生事业管理， 2010， 博士

【摘要】 幸福既是抽象的又是具体的,它是个体对现实生活的体验和反映。幸福既同人们生活的现实环境与条件密切相关,又体现了人们对精神上的需求和价值。幸福,作为人生的目的和权利,具有恒久而常新的意义。幸福感是心理健康的一种表现,主观幸福感是心理学研究的一个领域,从20世纪90年代至今,主观幸福感的研究逐步受到广泛关注,主观幸福感的核心是人们对现实生活的反映和评价。幸福感是人们生活质量的体现,通过文献研究发现国内学者从20世纪80年代中期以后开始进行幸福感的研究,其对象主要涉及到一些特殊的群体,如教师,公务员,另外对弱势群体如老年幸福感研究很多,而对其他人群如学生、城市居民幸福感也有-些研究,但对医生这一特殊职业幸福感的研究并不多见。医生是知识型人才,是提供医疗服务,预防与保健,教学与科研,满足病人需求的特殊群体,了解医生的幸福感水平及影响因素,从而可以了解医生的心理健康状况与生活质量,了解广大医生的需求,为医院管理人员制订政策,留驻人才提供依据。随着医学模式的不断发展,以及医疗市场的竞争日益激烈,临床医生的工作幸福感对医生、患者及医疗单位三方都具有一定的影响。临床医生从工作中获得认同感、满意感、幸福感可增加他们的整体生活满意度,激发他们的工作热情,从而提供高效、高质量健康保健服务的主观能动性。通过对临床医生工作幸福感状况的研究,可以准确、及时地了解医生工作态度,工作价值观,工作体验,心理健康状态的信息并找出其影响因素,关心和爱护医务人员,调动她(他)们的积极性,激发医生的奉献精神,使他(她)们真心成为推进病人满意和忠诚的主力。目的：了解临床医生工作与生活状态,幸福感水平及其影响因素,分析其原因,从而了解医生心理健康状况,并进行有效的心理疏导与干预,为医院管理者对临床医生进行科学管理决策提供理论依据,促进医生的心理健康水平,稳定医生的队伍,提高其对医院的忠诚度,从而减少医学人才流失。方法：从2008年6月-2009年12月,采用整群抽样及问卷调查方法,访谈方法,对9所综合性医院的临床医生幸福感水平进行了现状调查并分析其影响因素。调查表分为三个部分,包括医生一般信息,总体幸福感得分情况,医生的工作特征对幸福感的影响。.通过探索性因子分析,将临床医生幸福感作为因变量,尝试利用多元回归分析的方法探索影响临床医生工作幸福感的主要因素和次要因素,分析人口学变量及工作特征对医生幸福感的影响。通过访谈了解医生对幸福的认知,对幸福的感受,对幸福的预测,并通过案例分析,了解医生幸福与不幸福的原因,及医生综合幸福感水平。结果：整理并挖掘出有关幸福,幸福感,工作幸福感,临床医生工作幸福感的相关概念。实证研究表明临床医生总体幸福感水平中等偏低,临床医生因不同年龄,不同文化程度,不同职称,不同工作年限,不同经济收入,其幸福感水平有差异。影响医生幸福感因素分别为学历状况、性格、居住状况、对上级的满意度、对工作感到力不从心、工作环境、同事关系、晋升机会等。研究表明：医生的人口学特征与工作特征与其幸福感具有相关性。如医生的发展前景,工作环境,晋升机会,工作安全性,工作喜欢程度,工作便捷性,同事关系,工作职责等方面与医生的总体幸福感之间具有相关性。结论：幸福感研究是积极心理学的一个研究领域和特定的内容,目前越来越受到研究者的重视和关注。幸福感水平的高低是衡量社会进步与发展的重要指标,幸福感水平的测量是衡量心理健康的一个重要方面,幸福学研究为人力资源管理提供了一个新的视角。医生的人口学特征与工作特征对其幸福感水平具有一定的影响。通过对综合性医院临床医生生存状况与幸福感状况的评价与研究,可以准确、及时地了解医生工作态度,工作价值观,工作体验,心理健康状态的信息并提出科学的管理策略。临床医生的工作幸福感对医生、患者及医疗单位三方都具有一定的影响。医生的幸福关系到患者的幸福,关系到全社会的幸福。医疗服务管理者应了解医生的幸福感水平与其主要影响因素,并进行积极的心理疏导,采用快乐管理模式,这对医院管理者制订人才留驻计划具有十分重要的意义。本研究的创新之处：将幸福学理论与管理学理论结合起来,研究当代医生幸福感水平与影响因素,为缓解医患矛盾,为医院管理者了解临床医生的心理健康状况,从而采取早期干预措施,制订人才留驻计划,具有十分重要的现实意义。医生的幸福关系到患者的幸福,关系到全社会的幸福。在研究方法上,采用综合性研究方法,既问卷调查与访谈相结合,定性与定量相结合的方法,评价医生幸福感水平与工作特征之间的相关性,较为真实地反映医生的心理健康状况,并提出快乐管理模式。研究工具上,采用国际通用的“总体幸福感”量表与典型案例分析,结合临床医生工作特征,对医生的幸福感的现状做了真实的评价,并分析了与医生工作相关的各个因素对其幸福感的影响,反映了医生的心理健康水平。更多还原

【Abstract】 Happiness is the main body of the subjective reflection of real life, which is closely related to objective life conditions, but also represents the people’s needs and values. As the purpose of life and rights, happiness has a long-lasting and fresh significance. Subjective well-bell (SWB) refers to how people evaluate their lives, and includes variables such as life satisfaction, lack of depression and anxiety, and positive moods and emotions.Subjective well-being (SWB) is a field of psychology that attempts to understand people’s evaluations of their lives. Being an old philosophic topic, the origin of happiness can be traced back to Aristotle and even Plato era. Economics, sociologist and psychologist have shown a widely interest in research of happiness with the economic development of Western society. Psychological research of subjective well-being (SWB) emerged in United State during 1950’s, and gradually expanded a world-wide direction in late 1960’s. Subjective well-being became an important general psychological indicator for evaluating the quality of life and mental health. Subjective well-being research is conducive to enhancing people’s understanding of mental health and provides a new method to study the mechanism of psychological obstacle. There existed a large limitation of comprehending definition and measures of mental health, which was usually confined to absence of mental disorder in the past. Based on the cognition that defining mental health should inspected and evaluated the mental status from various aspects, assessment of subjective well-being leads a trend in diagnosis and treatment of mental health, widely applied by researchers. More and more scholars consider subjective well-being as a positive indicator and dimension for mental health, or as an element of mental health. Therefore, subjective well-being research thoroughly reveals the essence of mental health and provides a new look on psychology and human resources management greatly.Clinicans well-being level has great influence on themselves, patients and their hospitals. Clinicans can get content from their work and provide high quality severvice to patients. As health administrator can know clinicans work attitude and work experience, so that they can take early intervention to improve clinicans psychological health level.Objective:The aim of this thesis is to explore the level of doctors’well-being and the influencing factors, the reasonable method to improve the level of doctors’ wellbeing.Methods:Refer to GWB level scales, we designed a well being level scales for clinicians, which had a good reliability confirmed by experts’examination, preliminary experiment and statistical analysis. The questionnaire is used to investigate the status of subjective well-being level for nine general hospitals’doctors.Results:The level of well-being is lower and the main factors to influence clinical doctors’wellbeing are respectively education background, temperament and personality, living condition, content to supervisors, promotion, ect.Conclusion:The level of subjective well-being is one of the indicators to reflect personal psychological health status. The medical administrators should pay attention to clinical doctors’wellbeing level and influencing factors. The model of happy management can be used to improve doctors’psychological health. It is an essential policy to retain doctors in the hospital. The study shows that clinicians have different SWB level due to various ages, working experience, education background and income. For example, the clinicians in 26 to 30-year-old group have a higher SWB level, while those whose age are over 41 have a lower SWB level. The total SWB level for clinic doctors is lower medium. The main influencing factors consist of academic qualification, temperament, living condition, satisfaction to supervisors, difficulty in work, promotion opportunity and so forth. Being a doctor is at high risk and highly tense. They feel great pressure from work and their mental health is affected, so it is necessary to pay attention to their psychological status and take actions to help them. The clinical doctors should improve their professional psychological quality and be stable and be optimistically the time during clinical practice. Meanwhile, the administrators should provide a satisfactory working environment, especially a favorable psychological environment. We should concern and care medical personnel, arouse their enthusiasm, inspire their dedication, make them becoming main force of promoting patient’s content and loyalty.更多还原