Abstract
BackgroundIn China, as the “gatekeepers”of rural residents’ health, the primary-level village doctors, play a very crucial role in ensuring and serving the health level of rural residents. However, the burnout of village doctors is gravely threatening the stability of rural primary medical system step by step. This study systematically evaluated the effects of personality, work engagement and alexithymia on burnout of village doctors, and further measured and assessed the mediating effect of alexithymia and work engagement in the association between personality and burnout.MethodsThe subjects were 2684 village doctors in Jining, Shandong Province, China, from May to June 2019. Sociodemographic characteristics, alexithymia, personality, work engagement and job burnout were quantitated by self-completed questionnaire and measured by Likert 5–7 scale. One-way ANOVA, Person correlation analysis, and Structural Equation Modelling (SEM) were used for statistical analysis and mediating effect evaluation.Results2693 questionnaires were collected in total, of which 2684 were valid, with an effective rate of 96.2%. 65.2% of village doctors were diagnosed with burnout, and 54.3% showed moderate to severe emotional exhaustion, 61.6% showed moderate to severe low sense of personal achievement, and 33.9% showed moderate to severe depersonalization burnout. Personality had a direct positive effect on work engagement (β = 0.50, p < 0.001), a direct negative effect on alexithymia (β = − 0.52, p < 0.001) and burnout (β = − 0.50, p < 0.001) respectively. Work engagement had a direct negative effect on burnout (β = − 0.10, p < 0.001), while alexithymia had a direct positive effect on burnout (β = 0.16, p < 0.001). In the path between personality and burnout, both work engagement 95%CI:(− 0.17)–(− 0.08), and alexithymia 95%CI:(− 0.36)–(− 0.09), have significant mediating effects. These results strongly confirm that personality, alexithymia, and work engagement are early and powerful predicators of burnout.ConclusionAccording to the results, medical administrators should pay attention to the personality characteristics of village doctors in vocational training, practice selection and job assignment, encourage village doctors to reflect on their own personality actively, and to reduce job burnout by obtaining necessary social support, constructing reasonable achievable career expectations, improving time management ability, and participating in psychological counselling programs.
Highlights
In China, as the “gatekeepers”of rural residents’ health, the primary-level village doctors, play a very crucial role in ensuring and serving the health level of rural residents
Demographic and working characteristics of participants Among the 2864 village doctors, their mean age was 44.64 ± 7.248 years, the maximum age was 87, and the minimum age was 21; Male doctors accounted for 64.4%, and age stratification showed that only 1.3% were under 30 years of age and only 2.6% were university and above; As many as 62.4% of village doctors failed to obtain the village doctors’ professional qualification, only 3.8% of them had middle and senior professional titles
The results showed that 65.2% of the village doctors were diagnosed with burnout, and in the three dimensions of job burnout, the proportion of village doctors’ low personal achievement was higher than that of the other two dimensions, there were 1300(48.3%) village doctors with a serious low personal achievement, 811 (30.1%) with severe emotional exhaustion, 599(22.2%) with severe depersonalization, which is similar to the findings of Lin Li et al ‘s survey on 759 village doctors in southern China, which showed that 88.67% of them had a serious low personal achievement, 24.38% had severe emotional exhaustion, and 12.12% had severe depersonalization [47]
Summary
In China, as the “gatekeepers”of rural residents’ health, the primary-level village doctors, play a very crucial role in ensuring and serving the health level of rural residents. As the most grass-roots and most widely existing medical service providers in rural areas, village doctors play an irreplaceable role in ensuring, protecting, and improving the health level of rural residents. In recent years, the situation of village doctors in China is facing severe challenges, including the difficulty of obtaining the qualification certificate of practicing doctors due to the low level of overall education, the poor level of wages and treatment, the difficulty of ensuring old-age insurance, the low social status, the difficulty of introducing young talents, and the overall instability of the ranks. Poor satisfaction leads to high job burnout among village doctors, 68.60% of village doctors have moderate or above burnout, and 45.3% of village doctors have high turnover intention [7]
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