摘要目的:了解乡村全科医生职业倦怠现状，并对其影响因素进行分析。方法:2020年5月，采用多阶层随机抽样方法，选取山东省西南3个县区共2 805 名乡村全科医生作为研究对象。采用自制量表调查全科医生个人基本情况，采用职业倦怠量表-人类服务工作者版（MBI-HSS）调查其职业倦怠情况。采用百分比、频率等统计指标描述乡村全科医生工作倦怠的现状，通过Pearson χ2检验和二元logistic回归模型，分析乡村全科医生职业倦怠的影响因素。结果:回收有效问卷2 272份，有效率为81.0%。在情绪耗竭、去人格化倾向和个人成就感降低维度中，处于中高度职业倦怠的乡村全科医生中分别有1 251名（55.1%）、772 名（34.0%）和2 075 名（91.3%）。在二元logistic回归模型中发现，影响乡村全科医生情绪耗竭维度的危险因素包括平均每周工作时长≥60 h（ OR=1.341，95% CI：1.057~1.702）、平均每月夜班次数≥20次（ OR=1.434，95% CI：1.182~1.739）、平均每天接诊时长≥13 h（ OR=1.294，95% CI：1.055~1.589）、接诊患者数11~20例（ OR=1.317，95% CI：1.075~1.614）、不参与兼职（ OR=1.583，95% CI：1.201~2.087）、存在失眠症状（ OR=2.638，95% CI：2.225~3.128）、在工作中感到沮丧（ OR=3.170，95% CI：2.661~3.776）；影响乡村全科医生去人格化倾向维度的危险因素包括参与公共卫生服务（ OR=1.485，95% CI：1.155~1.910）、在婚（ OR=2.273，95% CI：1.198~4.313）、不参与兼职（ OR=1.677，95% CI：1.276~2.203）、存在失眠症状（ OR=1.487，95% CI：1.211~1.827）、在工作中感到沮丧（ OR=1.642，95% CI：1.339~2.015）；影响乡村全科医生个人成就感降低维度的危险因素包括平均每周工作时长≥60 h（ OR=2.089，95% CI：1.454~3.002）、平均每天接诊时长≥9 h（ OR=2.495，95% CI：1.748~3.561）、存在失眠症状（ OR=2.061，95% CI：1.519~2.796）、在工作中感到沮丧（ OR=1.894，95% CI：1.383~2.593）；其中保护因素包括月收入≥3 000元（ OR=0.589，95% CI：0.353~0.982）、平均每月夜班次数10~19次（ OR=0.581，95% CI：0.411~0.820），均 P<0.05。 结论:山东省西南地区乡村全科医生整体工作倦怠情况严重，尤其是去人格化倾向和个人成就感降低维度。建议提高乡村全科医生工资待遇，减少乡村全科医生工作强度，优化乡村全科医生工作时间，同时关注他们的身心健康的问题，从而缓解乡村全科医生职业倦怠的现状。

abstractsObjective:To survey the status quo of job burnout among rural general practitioners and to analyze its influencing factors.Methods:A total of 2 805 rural general practitioners in three counties in southwest Shandong province were enrolled in the study. The survey was conducted with a basic information questionnaire and the Maslach Burnout Inventory-Human Service Survey (MBI-HSS). The influencing factors of job burnout were analyzed by Pearson chi-square test (χ2) and binary logistic regression model.Results:A total of 2 272 rural general practitioners completed the survey with a completion rate of 81.0%. The rates of middle or high job burnout in the dimensions of emotional exhaustion, depersonalization and reduced personal sense of achievement were 55.1%(1 251/2 272), 34.0%(772/2 272) and 91.3%(2 075/2 272), respectively. Binary logistic regression model showed that working hours/week ≥ 60 h ( OR=1.341, 95 %CI:1.057-1.702, P<0.05), monthly shift times ≥20 ( OR=1.434, 95 %CI:1.182-1.739, P<0.05), daily consultation time≥13 h ( OR=1.294, 95 %CI:1.055-1.589, P<0.05), daily consultation of 11-20 patients ( OR=1.317, 95 %CI:1.075-1.614, P<0.05), no part-time job ( OR=1.583, 95 %CI:1.201-2.087, P<0.05), insomnia ( OR=2.638, 95 %CI:2.225-3.128, P<0.05), feeling depressed at work ( OR=3.170, 95 %CI:2.661-3.776, P<0.05) were risk factors for emotional exhaustion; participation in public health services ( OR=1.485, 95 %CI:1.155-1.910, P<0.05), being married ( OR=2.273, 95 %CI:1.198-4.313), no part-time jobs ( OR=1.677, 95 %CI:1.276-2.203, P<0.05), insomnia ( OR=1.487, 95 %CI:1.211-1.827, P<0.05), and feeling depressed at work ( OR=1.642, 95 %CI:1.339-2.015, P<0.05) were risk factors for depersonalization; working hours/week ≥ 60 h ( OR=2.089, 95 %CI:1.454-3.002, P<0.05), daily consultation time ≥ 9 h ( OR=2.495, 95 %CI:1.748-3.561, P<0.05), insomnia ( OR=2.061, 95 %CI:1.519-2.796, P<0.05), and feeling depressed at work ( OR=1.894, 95 %CI:1.383-2.593, P<0.05) were risk factors for reduced personal achievement. Protective factors included monthly income ≥3 000 Yuan ( OR=0.589, 95 %CI: 0.353-0.982, P<0.05) and monthly shift of 10-19 times ( OR=0.581, 95 %CI:0.411-0.820, P<0.05). Conclusion:The overall job burnout among rural general practitioners in southwest Shandong province is serious, especially the depersonalization and the reduction of personal sense of achievement. It is suggested to improve the salary, reduce the working intensity, optimize the working hours, and pay attention to their physical and mental health for rural general practitioners to alleviate the current situation of their occupational burnout.