调查南非两省的医生、专业护士和康复治疗师中多重职业的程度、形式和影响因素：一项横断面研究。

Examining the extent, forms and factors influencing multiple job holding among medical doctors, professional nurses and rehabilitation therapists in two South African provinces: a cross-sectional study.

机构信息

Centre for Health Policy & South African Research Chairs Initiative (SARChI), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa

Centre of Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

BMJ Open. 2023 Dec 20;13(12):e078902. doi: 10.1136/bmjopen-2023-078902.

DOI:10.1136/bmjopen-2023-078902

PMID:38128938

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10748886/

Abstract

OBJECTIVE

Multiple job holding (MJH), or working in more than one paid job simultaneously, is a common characteristic of health labour markets. The study examined the extent (prevalence), forms and factors influencing MJH among public sector medical doctors, professional nurses and rehabilitation therapists in two South African provinces.

DESIGN

A cross-sectional, analytical study.

SETTING

29 public sector hospitals in the Gauteng and Mpumalanga provinces of South Africa.

PARTICIPANTS

Full-time public sector medical doctors, professional nurses and rehabilitation therapists.

RESULTS

We obtained an overall response rate of 84.3%, with 486 medical doctors, 571 professional nurses and 340 rehabilitation therapists completing the survey. The mean age was 39.9±9.7 years for medical doctors, 43.7±10.4 years for professional nurses and 32.3±8.7 years for rehabilitation therapists. In the preceding 12 months, the prevalence of MJH was 33.7% (95% CI 25.8% to 42.6%) among medical doctors, 8.6% (95% CI 6.3% to 11.7%) among professional nurses and 38.7% (95% CI 31.5% to 46.5%) among rehabilitation therapists. Medical doctors worked a median of 20 (10-40) hours per month in their additional jobs, professional nurses worked 24 (12-34) hours per month and rehabilitation therapists worked 16 (8-28) hours per month. Private practice was the most prevalent form of MJH among medical doctors and rehabilitation therapists, compared with nursing agencies for professional nurses. MJH was significantly more likely among medical specialists (OR 4.3, p<0.001), married professional nurses (OR 2.4, p=0.022) and male rehabilitation therapists (OR 2.4, p=0.005).

CONCLUSION

The high prevalence of MJH could adversely affect the care of public sector patients. The study findings should inform the review and revision of existing MJH policies.

摘要

目的

兼职工作（MJH），即在多个有偿工作中同时工作，是卫生劳动力市场的一个常见特征。本研究调查了南非两个省份的公立部门医生、专业护士和康复治疗师中 MJH 的程度（流行率）、形式和影响因素。

设计

横断面、分析性研究。

地点

南非豪登省和姆普马兰加省的 29 家公立医院。

参与者

全职公立部门医生、专业护士和康复治疗师。

结果

我们获得了 84.3%的总体回复率，486 名医生、571 名专业护士和 340 名康复治疗师完成了调查。医生的平均年龄为 39.9±9.7 岁，专业护士为 43.7±10.4 岁，康复治疗师为 32.3±8.7 岁。在过去的 12 个月中，医生兼职工作的流行率为 33.7%（95%CI 25.8%至 42.6%），专业护士为 8.6%（95%CI 6.3%至 11.7%），康复治疗师为 38.7%（95%CI 31.5%至 46.5%）。医生在额外工作中每月平均工作 20（10-40）小时，专业护士每月工作 24（12-34）小时，康复治疗师每月工作 16（8-28）小时。与护理机构相比，私人执业是医生和康复治疗师中最常见的 MJH 形式。与专业护士相比，医学专家（OR 4.3，p<0.001）、已婚专业护士（OR 2.4，p=0.022）和男性康复治疗师（OR 2.4，p=0.005）更有可能兼职工作。