研究背景：

健康是人民的基本需求，是经济社会发展的基础。公立医院是医疗卫生服务提供的主力军，公立医院医生在人民健康照护和诊疗服务中发挥关键作用。医生在工作中产生的情绪耗竭影响身心健康和医疗安全质量，也影响医生职业忠诚度和离职意愿，关注我国医生情绪耗竭具有重要的现实意义。我国医生情绪耗竭现状如何，主要影响因素有哪些，目前相关研究尚未清晰、全面地揭示。

本研究对情绪耗竭相关概念和理论进行文献研究，基于“全国改善医疗服务第三方评估”医护人员调查的数据，了解我国三级公立医院医生的情绪耗竭现状，分析影响医生情绪耗竭因素，从而为改善医生情绪耗竭问题，减轻工作压力，提高工作积极性，提出针对性和合理化的政策建议。

研究内容：

我国医生情绪耗竭的理论和文献研究，依据系统的文献综述，充分了解当前国内外医生情绪耗竭现状及影响因素，梳理医生情绪耗竭等相关理论。

我国三级公立医院医生情绪耗竭现状和影响因素分析，利用“全国改善医疗服务第三方评估”医护人员调查的数据，描述我国三级公立医院医生情绪耗竭的现状，构建多因素模型和混合效应模型，分析影响情绪耗竭发生的因素。

我国医生情绪耗竭的应对策略探寻，依据影响因素分析的结果，寻找医生职业倦怠问题的应对策略，提出合理化的政策建议。

研究方法：

采用文献分析法，以国内外文献数据库为基础，包括期刊、论文、书籍和相关政策文件，以“情绪耗竭”、“影响因素”、“医生”等为关键词进行检索，同时以工作要求和工作资源理论构建研究框架。

采用问卷调查法，基于全国最大样本的医护人员调查，即 “全国改善医疗服务第三方评估”（以下简称“三方”）医护人员调查，调查对象包括31个省级行政区（包括省、自治区、直辖市）以及新疆生产建设兵团。本研究资料来源于针对医护人员开展的第五次调查所得的数据。

采用数理统计法，对医生情绪耗竭及其影响因素进行统计分析，通过描述性分析，了解目前中国三级公立医院医生情绪耗竭的现状，通过单因素分析和多因素回归模型的构建，分析个人因素、工作因素和组织因素对医生情绪耗竭的影响。

研究结果：

本研究所调查的30125名医生情绪耗竭得分为11.00（5.00，20.00），其中情绪耗竭的发生率为14.41%，有6.40%的医生“每天都感到下班后整个人都没有精神”，5.04%的医生“每天在面对新的工作时，从早上起床就开始感觉疲乏”，8.93%的医生“每天都感到工作太辛苦了”。

影响医生情绪耗竭的因素有，个体因素，包括性别、年龄、子女数量；工作因素，包括医院类型、所在科室、职称、从业年限；组织因素，包括非临床任务、工作负荷、薪酬待遇和心理指导。

研究结论：

本研究首次对全国143家三级公立医院的医生情绪耗竭进行了调查，结果发现，有较高比例的医生每天都会出现情绪耗竭情况，整体上，我国三级公立医院医生整体的情绪耗竭情况不甚理想。

本研究发现，个体因素、工作因素和组织因素对我国三级公立医院医生情绪耗竭产生影响，其中，男性、未育、中等年资的医生更易发生情绪耗竭，综合医院、急诊科、肿瘤科的医生更易发生情绪耗竭，较轻的工作负荷、满意的薪酬待遇和有效的心理指导可以减轻医生情绪耗竭情况。

本研究提出，重点关注特殊群体，落实薪酬制度改革，减轻医生工作负荷，合理安排工作时长，改善医院工作环境，加强医生心理指导从根本上改善医生执业状况的政策建议。

Background:

Health is the basic need of China and the foundation of economic society. Public hospitals are the main force in the provision of medical and health services, and doctors in public hospitals play a key role in health care and diagnosis and treatment services. Burnout and emotional exhaustion of doctors at work affect physical and mental health and medical safety, and also affect doctors' professional loyalty and turnover intention. It is of great practical significance to pay attention to the emotional exhaustion of doctors in our country. What is the status quo of emotional exhaustion of doctors in my country and what are the main influencing factors? At present, relevant studies have not yet clearly and comprehensively revealed. Based on the data of "National Third Party Evaluation of Improving Medical Services", this study made a literature study on the concepts and theories related to emotional exhaustion, to understand the current situation of emotional exhaustion of doctors in public hospitals in China, and the factors affecting emotional exhaustion of doctors, so as to improve the emotional exhaustion of doctors, reduce work pressure, and improve work enthusiasm, and put forward targeted and reasonable policy recommendations.

Content: 

The theory and literature research of doctors' emotional exhaustion in our country. According to the research goal and content, systematically search the literature, define the connotation of doctors' emotional exhaustion and other concepts. Fully understand the current situation and influencing factors of emotional exhaustion of doctors at home and abroad, and sort out the relevant theories of emotional exhaustion of doctors.

The current situation and influencing factors of emotional exhaustion of doctors in public hospitals in my country. Using the data of the "National Third-Party Evaluation of Improving Medical Services" survey of medical staff, describe the current situation of emotional exhaustion of doctors in public hospitals in my country, build a multi-factor model and a mixed effect model, and influence the factors of emotional exhaustion.

Explore the coping strategies of doctors' emotional exhaustion in our country. According to the results of the influencing factors, find the coping strategies of doctors' job burnout and put forward reasonable policy suggestions.

Methods:

Using literature method, based on domestic and foreign literature databases, focusing on literature retrieval, including journals, papers, books and relevant policy documents, with "emotional exhaustion", "influencing factors", "doctors" as key words, and Maslow's hierarchy of needs theory, resource preservation theory, match-mismatch theory, job requirements and job resources as the theoretical basis of data.

Using the questionnaire survey method, based on the largest sample of medical staff survey in the country, that is, the "National Third-Party Evaluation of Improving Medical Services" （hereinafter referred to as the "Tripartite"） medical staff survey, covering 31 provinces （autonomous regions, municipalities directly under the Central Government） and Xinjiang Production 143 public hospitals of the Construction Corps, the data of this study comes from the data of the fifth survey of medical staff.

Using the mathematical statistics method, to make statistics on the emotional exhaustion of doctors and its influencing factors, through descriptive, to understand the current situation of medical emotional exhaustion in China. Through the construction of single-factor and multi-factor regression models, the author analyzed the impact of sociodemographic characteristics and work-related characteristics on the emotional exhaustion of doctors.

Results:

The score of emotional exhaustion of 30125 doctors surveyed in this research is 11.00 （5.00, 20.00）, among which the incidence of emotional exhaustion is 14.41%, 6.40% of doctors "feel that they have no spirit after work every day", 5.04% of doctors "feel tired from getting up in the morning when facing a new job every day", 8.93% of doctors "feel that they work too hard every day".

The factors that affect doctors' emotional exhaustion include sociodemographic characteristics, including gender, age, number of children; The influencing factors of job characteristics, including the type of hospital, the department, the professional title, and the number of years of employment; Factors affecting practice, including non-clinical tasks, workload, remuneration and psychological guidance.

Conclusion:

This study investigated the emotional exhaustion of doctors in 143 public hospitals across the country for the first time. The results found that the emotional exhaustion score of 30125 doctors was 11.00 （5.00, 20.00）, and the incidence of emotional exhaustion was 14.41%. 6.40% of the doctors "feel that they are not energetic after work every day", 5.04% of the doctors "feel tired from getting up in the morning when facing a new job every day", and 8.93% of the doctors "feel that they work too hard every day". The population of this study mainly comes from hospitals across the country, and the overall practice status is relatively relative. It can be seen that the overall emotional exhaustion of doctors in our country is not very good.

The results of this study show that sociodemographic characteristics, work characteristics and practice factors have an impact on the emotional exhaustion of doctors in public hospitals in China. Among them, the emotional exhaustion of doctors in males, childless, and middle-aged doctors is more serious, and the emotional exhaustion of doctors in general hospitals, emergency departments, and oncology departments is more serious. Lighter work load, satisfactory salary and effective psychological guidance can reduce the emotional exhaustion of doctors.

Based on the above findings, this study puts forward policy suggestions to focus on special groups, implement salary system reform, reduce doctors' workload, arrange working hours reasonably, improve hospital work, and strengthen doctors' psychological guidance to fundamentally improve doctors' practice conditions.