Stf hai long do'i vdi cong viec cua can bo y te xa tai huyen Binh Luc va Kim Bang, tinh Ha Nam, nam 2012 Nguyen Hi?u Thing', Tran Thi Nga Nghiin cdu nhdm ddnh gid mdc dg hdi long vd x
Trang 1Stf hai long do'i vdi cong viec cua can bo y te xa
tai huyen Binh Luc va Kim Bang,
tinh Ha Nam, nam 2012
Nguyen Hi?u Thing', Tran Thi Nga
Nghiin cdu nhdm ddnh gid mdc dg hdi long vd xdc dinh rngt sdyeu id liin quan den sif hdi long ddi vdi cdng viic cia cdn bd y te (CBYT) xd, huyen Btnh Luc vd Kim Bdng tinh Hd Nam ndm 2012 Nghiin cdu sddung phuongphdp md id cdt ngang tren 201/227 (88,5%) CBYTxd bdng cdch trd ldi
bg cdu hdi tff dien cia Paul E Speclor vdi cht so Cronbach's alpha = 0,76 Ki't qud: 56.9% CBYT
xd cia huyfn Kim Bdng vd Binh Luc hdi long ddi vdi cdng viec vd sif hdi long dgt d mdc irung binh (2,83 diem) Nhiing yiu tdcd ty If cdn bd hdi long chua cao Id: quy chi ca quan thdng tien khen thudng vd phic lai ngodi luang Suhdi long cua CBYT liin quan cd v nghta thd'ng ki vdi cdc yiu to: trinh do chuyin mdn cd ngffdi sd'ng phu thugc vaphdn logi lao dgng CBYT trong bien chi'hdi long gd'p 4.8 Idn cdn bg hap ddng CBYT cd ngffdi sd'ng phu thude hdi long gdp 3,2 Idn so vdi CBYT khdng
cd ngffdi sd'ng phu thugc vd cdn bd li y si hdi long gdp 3 ldn cdn bg Id bdc si
Td khda: Sff hdi long, nhdn life y ti CBYTxd, TrgmYlexd
Job satisfaction of health workers at commune health stations in Binh Luc and Kim Bang districts, Ha Nam province, 2012
Nguyen Huu Thang', Tran Thi Nga
A cross-sectional study was conducted to measure job satisfaction, and to determine its associated factors among health workers in commune health stations (CHCsi Binh Luc and Kim Bang districts
Ha Nam province in 2012 A total of 201/227 (88.5%) self-administered questionnaires of Paul E Spector Job Satisfaction Survey with Cronbach's Alpha = 0.76 were distributed Results: 56.9% of CHC staff in Kim Bang and Binh Luc districts satisfied with their work and job satisfaction level was moderate (2.83 points) Factors receiving satisfaction at low level from commune health workers (CHWs) are: institutional intemal regulations, promotion, rewards and extra-salary benefits There was a statistically significant relationship between professional qualifications, having dependants, employment status and health workers fob satisfaction Full-time/permanent CHWs have their level
of job satisfaction as much as 4.8 times higher than thot of contracted CHWs Health workers who
Tap chi Y (e Cong cOng, 9.2014, SS 33 21
Trang 2have dependents have their level of job satisfaction as much as 3.2 limes higher than that of CHWs having no dependents: and assistant doctors have 3 limes higher in job satisfaction level than doctors Keywords: job satisfaction; human resource: commune health station; commune health worker
Tdc gia;
1 Nguyin Hilu Tbiing, Bd mdn T6 chtfc va Quan IJ Y ti, Vi?n dao lao Y bgc dtf pbdng va Y le Cdng cdng,
trtfdng Dai boc YHa Ndi Di^n thoai: 0915313175 E.mail: tbangtcyt@gmail.com
1 D $ t vSi'n d l
Nguon n h a n Itfc 1^ yeu lo ccJ b a n cho moi thanh
ttfu y rfi" [ 1 2 ] Stf hai long doi vdi cfing viec la y e u
t6' quan irpng co anh htfdng tdi chS't Itfdng va hi?u
suat cong vi^c [6], dSc biet doi vdi cong vi^c cua
C B Y T vi dSy la cong v i e c nhay c a m cham soc siJc
k h o e U€n q u a n den tinb m a n g con ngtfdi Stf h^i
long do'i vdi cong vi?c di cSp d^n "suy nghi va c a m
n h a n ciia n h a n vign v l moi trtfdng v l d i l u kien l i m
vi$c c u a minh" [9] HiSn co nhieu c^c nghien ctfu
vi siJ h l i 16ng dd^i vdi c6ng viec cua CBYT, song
h a u het dtfdc tien hanh tai cac b$nh vien vdi cac doi
ttfdng chuyen m o n rieng biet nhtf b4c si, dieu dtfdng
nhtfng c6n thi^u nhiJng nghien ci?u v l stf hai long
doi vdi c 6 n g vi6c cda cdn b 6 l i m viSc tai tram y t ^
xa Vi vSy chiSng tdi ti^n h l n h nghidn ctfu nay vdi
m u c tieu: D a n h gi^ mtfc dp hai long d m vdi cdng
v i e c va x a c dinh cdc yeu td h e n quan den sif bai
ldng do'i vdi cdng vi$c cua C B Y T xa, huyen Binb
Luc v l Kim Bang, tinh Ha Nam nSm 2012 TiJf ket
q u a n g h i e n cii'u dtfa ra mot s d k i e n ngbi n b a m n a n g
cao mu'c dp h a i long ddi vdi cdng vi$c cua can bd y
t e ' x a huy$n B m h Lyc va Kim B a n g
2 PhuTcTng p h ^ p n g h i g n cihi
2.1 Bdi ti^mg nghien cdu: C B Y T hien d a n g
cdng tac tai c a c tram y td xa tflf 1 thang 7 de'n 3 0
t h i n g 7 n a m 2012
2.2 Bia diem nghiin cdu: tl't ca 4 0 t r a m y te'xa:
21 t r a m y t d x a / t h i tra'n huyen Binh Luc v l 19 tram
y te xa/thi Iran huygn Kim B a n g , tinh H I N a m
2.3 Thii't ke nghien cdu: Nghien ctfu md ta cat
ngang
2.4 Cd mdu va cdch chgn mdu: Chpn t o i n bd
C B Y T hien d a n g cdng tac tai c a c t r a m y te^ x a , huyen Binh Luc va Kim B a n g , d n h Ha N a m T y le can b p tham gia ngbien cii^i la 201/227, dal 8 8 , 5 %
2.5 Phuongphdp, ky thudt thu thdp sd'lidu: S d
lieu dtfdc thu t h a p qua bd cSu hoi ttf d i l n vd stf h a i Idng cua Paul E Spector [9] dtfdi stf htfdng d i n va giam sat cua c a c giang vien V i e n D a o tao Y h p c dtf phdng va Y t d C d n g cdng, trtfdng Dai hpc Y Ha Ndi
Bd c l u hoi ttf d i l n bao gdm 9 yd'u td: t i l n ltfdng, stf thang tie'n, ddng nghidp-giam sat cua cS!'p t r e n , quy
c h e cd quan, p h d c ldi ngoai Itfdng, khen thtfdng, quy c h e cdng vide v l thdng tin ndi bd- Bd cau hoi dtfdc dich sang tie'ng Vidt [10] va thiJ n g h i e m vdi chi s d Cronbach's alpha = 0,76 Thang do md'c dp
h l i long dtfdc tham k h a o tbeo thang diem Likert, 4 md'c dp "boan loan khdng ddng y", "khdng d d n g y",
"ddng y" va "hoan toan ddng y" cbo phii b d p vdi nghien cdu
2.6 Xdl^ vaphdn tich sd'lifu: S d l i g u sau khi
l i m sach dtfdc n h a p vao may tinh vdi phan m e m Epi
D a t a 3.1 v l dtfdc xtf ly bang p h a n m e m Stata phidn ban 10.0 Phan loai h a i ldng dtfdc tham k h a o t h e o Best W John [4] cbo thang d i e m Likert 4 mtfc dp:
Bang I Phdn logi mdc dg hdi long doi vdi cong viec
Biem Imng binh cac ye'u ti
1,00-2,00 2,01 - 3,00 3,01 - 4,00
X^p loai hai long Thap
Tmng binh Cao
Trang 33 Ktt qua
3.1 Bgc diem ciia dot tiUfng nghien citu
Bdng 2 B4c diem cua dot tii^g nghien ciiu
D ) c d l ^ M l tiWng
T i i ^ i l n m o = 5D>
G H J I
- N O "
•nnh irang hfln nhSn
Tilnh no chuyin man
- D w c »f/tluac li
NOW sum
- Di£ii dirang
- Khac
ThSi g»ii cBng He:
T G « 1 0 r a m
- T G ^ I O n l l m
- BISD tiii
Hu
*"
1 •'•"
^7
94
12
13
29
3
63
13
JO
8 7 J
» 8
11.7
43,8
88 3
11.7
K - b n R i l »
• I T J K I * )
37.69 19,48
65
";
28
I I
SO
16
73.1
7.9
13.5
18.0
S6.2
82 0 IS.0
Cb
1 Tjlf
1 1*1
38,06 J 9 94
57
176
34
118
113
171
2K.6
89 3 10.7
30.5
n
2
i6.2
R5,5
3.2 SIX hai long doi vdi cdng vi^c cOa CBYT xa
sa hai long cua CBYT xa doi vdi cong vi6c d
mtfc do trung Mnh (2,83 diem) Trong dd, bon ySii
to dat d mtfc do hai long cao: giam sat, nhan xit cila
cap tren, quy che cong viec, d&g nghiep vS thdng tin noi bo Nam yen to' dat d mtfc do hai long tnmg binh la: yeu td' tien ltfdng, Sll thang tien, khen thtfdng, phtfc ldi ngoai ltfdng va quy che co quan
Tu6i trung binh cua CBYT xa la 39 tiong do
tha'p nh^t la 21 va cao nha't lii 60 tudi Ty le ni! gidi
chiem tren 70% Hau hei cic CBYT xa cd gia dinh
(89,3%) Cin bO cd trlnh d0 y sJ chie'm tJ 1$ cao
nhat d cJ hai huyen (30,5%), dieu dtfdng (22,5%),
bic sy chi cd 10,8% Tuy nhien, phan bd trlnh do
chuyen mdn cua hai huyen cd stf khic nhau, ty le
CBYT la y sT van chidm nhidu nha't, nhtfng dtfng Ihtf
hai 6 huydn Binh Luc la didu dtfdng (26,1%) trong
khi d Kim Bang 14 dtfcic si trung hoc/duac ti
(23,6%) Sd CBYT cd thdi gian cdng tic tren 10
nam chidm ty Id cao (56,2%) va hSu het cin bg
ttong bidn che (88,3%)
Bdng 3 Miic do hdi long cua CBYTxd huy^n
Binh Luc va Kim Bang
9 i « o i i r
Tliu iWng
SiTlhinglrfn
C i i n i kit nhfn i f i c u j
Phdc Itf 1 ngoli tutnig
Khcnihiidtig
O u i c w r c a i u i i
D«ng nghiep
Q u i c t r f c 6 n j n » t
Thpng un nfti W
Uatctat
D i ^ t n m g M d l
2,68
2.60
3.16
237
2.59
2J6
3.1 <
••.14
1.07
va
D t K c h d u f n 0.*2
065
0 J 4
067
0 59
0.52
OM
0.14 0J9
M d t ai> U i lAug
Trung binh TnmpWnh Cao Tnjng Bnh Trung hlnh Tnmg bmh Coo
Cao Tnuigblnh
^ ^
'• ^-^^T"n !
" '' !^"
1 •
• H B ^ !
1 1
1 1 ••
0 0 lO.D 20.0 30J)
4 9 0
49 5
4 " S
« l ^ S30 6t
^ • 1 ^ 1 1
13 1
0 7 0 0 wa
Bieu do I Ty If hdi ldng cua can bg trgm y tixd
Ty \i can bp hai Idng vdi cong vi#c chi flat
56,9%, trong dd nhUng nhom yen to' cd ty 1? cdn b6 hai long chtfa cao la: quy che cd quan, thang ti6'n, khen thtfdng va phiic ldi ngoii Itfdng
3.3 Md'i lien quan giiia cdc ddc diem cd nhdn va sif hai long chung dd'i vdi cdng vi$c cua CBYTxd
Bdng 4 Mdi lien quan gida dgc diem cd nhdn vd sff hdi long ddi vdi cong vifC
Y^u 1^ v^ XB h^l va Dhfln khiu/ Phin lo^i lui long
KfaOng bai long Hk\ long
OR (9S?t CI) NgifM s^ng phif t h u ^
C6 Khang
15
7
144
21 3,2 11.2-8-81 Trinh ri^ rhiivfn rafin
Bacsy
•V^>
DUi^c sy/difijc t^
Nif hO sinh Didu dilSng
14
'
ta
22
8
38
16
20
30
1 3.0 (1.1-8.3)
3J
(1.0-11.8) 1.9 (0.7-5.7) 2,4 (0,9-6.7)
l.r)ai hnAlfnf^
Hdp flong Bien che
13
38
10
139 4.8 [1.9-11.7)
Trang 4KS't qua cho thay, sif hai long doi vdi cong viec
cua CBYT xa c6 moi lien quan vdi mdt stf yeii to:
co ngrfdi sd'ng phu thupc, trinh dd chuySn mdn va
phan loai lao ddng
CBYT trong bien che* hai ldng gap 4,8 lan cin
bo hdp dong, CBYT cd ngrfdi stfng phu thupc hai
ldng ga'p 3,2 tan can bd khong cd ngrfdi stfng phu
thude vl cdn b0 la y sT hli ldng ga'p 3 lan c^n bp la
bac Sl
4 Ban lu^n
4.1 Suhdi long do'i vdi cdng vifc cua CBYT
xa huyfn Binh Luc va Kim Bdng
Srf hai long dd'i vdi cdng vi^c cua nhan vien y
te la mpt cau tnic da chieu gdm nhieu yeu to: srf hd
trd ciia dong nghiep va lanh dao, ddi hinh lim vi$c
v l trao ddi thdng tin, yen cau cdng viec va quyen
ra quyet dinh, dac di^m ciSa cd quan/to chiJc, cham
sdc benh nhan, lrfdng vl phiic \<3i, dao tao vl phat
trien nhan vien, an trfdng chung ve cd quan/to chdc,
nhffng y^u ttf vl nhan khau, xa hdi [5] Dd'i vdi
CBYT xa huy?D Binb Luc vl Kim Bang, chiing tdi
md ta mdc dp hai Idng vdi 9 ytfu to theo khung IJ
thuyet cda Paul E Spector, dd 11: tien lrfdng, srf
thang tien, giim sat-nhSn x^t cua ca'p tren, phiic ldi
ngoli lrfdng, khen thrfdng, quy chtf cd quan, dong
nghiep, quy chtf cdng vide vl thdng tin npi bp [11]
Ket qua cua nghiSn crfu cho tha'y, CBYT xa huydn
Binh Luc vl Kim Bang hai ldng vdi cdng vide d mdc
dtf trung binh (80,9%) trfdng trf nhrf ket qua nghidn
crfu cua tic gia Nguyin Hffu Th^ng thrfc hien d
benh vi^o da kboa huydn Tan Lac, tmh Hda Binh
nam 2012 [8] Ty Id CBYT dat mrfc hai long cao dtfi
vdi cdng vi^c chiem 16,4% vl hai long tha'p chi cd
2,7% cao hdn ket qua trong nghien cdrf cua tic gia
Dd Thi Phiic vl srf bai ldng dd'i vdi cdng vi$c ciia
can bd tram y te' quan Ha Ddng va huyfn Thanh
Oai Ha N^i, nam 2009 (58,3%) [1], trfdng difdng
vdi ktft qua nghidn crfu cua Le Thanh Nhuan va Le
Crf Linh ve srf hli long dtfi vdi cdng viec ciia nhan
vienyttfcdsd(71,l%)[2]
4.2 Cdc yi'u tdlien quan din sU hdi long ddi
vdi cdng vifc cua CBYTxd huyen Binh Luc
vd Kim Bdng, tinh Hd Nam
Ke't qua nghien crfu cho thl'y khdng cd mtfi lidn
quan c6 J nghia thtfng ke giffa srf hai long ciia
CBYT vdi cdc ytfu ttf nhrf: gidi, nhdm tutfi, tinh
trang hdn nhan, thdi gian cdng tic, thu nh|p trung binh/thIng, drfdc tap huS^n trong nam qua Trong khi nghien crfu ciia tac gia Tran Quy cho thS'y srf hai long dd'i vdi nghe nghidp cua can bd dilu drfdng co mtfi hdn quan theo chieu hrfdng tang dan khi tutfi cang tang [3] Md'i lidn quan cd J nghia thtfng ke giffa srf bii ldng dd'i vdi cdng viec ciia CBYT xa drfdc tim tbS'y vdi mpt sd' ye'u ttf nhrf: trinh dp chuyen mdn, ngrfdi sd'ng phu thupc va phin loai lao ddng CBYT trong bien che hai long gap 4,8 lan can
bo hdp dong, CBYT cd ngrfdi stfng phu thupc hai Idng g^p 3,2 lln can b$ khdng cd ngrfdi stfng phu tbudc va cln bd la y si hli Idng gap 3 lan cln bd 11 bac Sl Nghien cdu ciia tic gia Le Thanh Nhuan cho thay srf hai long doi vdi cdng viec cua CBYT cd mtfi Uen quan dd'i vdi lrfdng vl phdc ldi, cd s6 v§t chat, kitfn thrfc, ky ning vl kd't qua cdng vide, mtfi lien quan vdi lanh dao, md'i lidn quan vdi ddng nghidp [2] Dieu nay cho thay Nha nrfdc va Bd Y td'cin cd chinh sich dai ngd tot doi vdi nhffng can b$ cdng tac tai myen xa/phrfdng d^ thu but va giiip cln bd yen tam cdng tac lau dli dam bao muc tidu 100% tram
y te' xa c6 bac sT
Nghidn crfu nay tuy khdng tim ra srf khic biet
cd J nghia thd'ng ke vl mrfc dO hli ldng theo ytfu ttf gidi tinh nhrfhg ro rang tJ Je nff gidi vln cao hdn nam gidi rat nhieu Theo Lyn L Henderson, vi nff gidi chitfm phan ldn trong nghe y, dieu quan trpng phai xem xet cac nhu clu khac nhau cua nhan vien
y ttf Dff khi phat tne'n cic ye'u to' thiic dly ddng cd
lim vide Lam vide bin thdi gian hay thdi gian linh hoat, nghi phep hoac nghi ll linh ddng cham sdc con cai vl hpc tap cua con; tam nghi vide theo kd'hoach
la mot vii yd'u to ddng vidn quan trong doi vdi ngudn lao ddng nff [7]
Tuy nhien, nghien crfu nay drfdc thrfc hidn 6 hai huydn thupc vung ddng b^ng Sdng Hong nen ke't qua nghidn crfu khdng phan Inh cho cac vung dia ly vdi boi canh van hda, kinh te', xa bpi khic nhau trong toan qud'c Ben canh dd, nghien crf^ ddn thuln
la dinh lrfdng nen chrfa di sau drfdc vio nguydn nhan ciia srf chrfa hli Idng Do dd, cln titfp mc nghien crfu vdi cd mlu ldn hdn, dai difn hdn, ket hdp nghidn crfu dinh tinh vl dinh lrfdng trong bdi cdnh chung ciia Vidt Nam
Tdm lai, 56,9% CBYT xa ciia huyen Kim Bang va Binh Luc hai long dd'i vdi cdng vifc vl
srf hli Idng dat d mrfc trung binh (2,83 diem)
Nhffng yen ttf co ty le cln bp bai ldng chrfa cao la:
Trang 5quy chtf cd q u a n , t h i n g titfn, k h e n thrfdng va phuc
ldi n g o l i lrfdng
Srf hai Idng ciia C B Y T lien quan cd J nghia
thd'ng kd vdi c a c ytfu ttf: trinh dp chuydn mdn, cd
ngrfdi stfng pbu thupc v l phan loai lao ddng CBYT
trong bien chtf h l i long g a p 4,8 lan can bp hdp dong
C B Y T cd ngrfdi stfng phu thupc hai long g a p 3,2 lan
so vdi C B Y T khong cd ngrfdi stfng phu thude v l can
b p II y Sl hai long gap 3 l l n can bd 11 b a c si
D e cai thidn mrfc dp h a i long doi vdi cdng vifc eiia cac e l n b p dang cdng l i e tai tram y ttf xa Ihudc
h u y e u Binh Luc va Kim Bang c i c n h i q u a n l j can:
1 H o l n thidn quy chtf cd q u a n , chtf df khen
thrfdng cho phii h d p ddng Ihdi cd nbrfog giai p h i p tang t h e m thu n h a p n g o l i lrfdng va c d htf i t h i n g tien cho can bd
2 Cd k e hoach dao tao n a n g c a o trinh dp chuyen mdn cho can bd dang cdng t i e tai tram y ttf x l
T l i li^u tham khio
TieTng Vi«l
1 D5 Th) Phiic (2009), Sif hai 16ng doi vdi c6ng vi?c ciia
nhSii vien tram y tg'qugn HI Dong v^ Huygn Thanh oai, HI
NOi-nam 2009, LuSn van iSt Dgbi?p thac sy y tS' c6ng cong,
D?i bpc y HI N^i
2 L6 Thanh Nhugn va L6 Cuf Linh (2009), "Sir h^i 16ng a6i
V(Ji cftng vi^c ciia nhSn vi6n y te ctJ sd", Tap chl Y te Cong
cOng 13(13), ir 51-56
3 Tdn Quy vl cSc cOng sir (2005), "Sir hSi long ngh^
nghi$p cda di^u drfclng h^nb vi^n vi y^u tS li€n quan", K^
yfi'u 6i tli Dghicn cifu dilu dudng to^u qud'c lln thit II, Nhi
xutft bia Giao lh6ng V3n lii Hi Ngi tr 33-42
Tie'ng Anb
4 John W Best (1977), "Education Reseach"
5 Krueger, P., Brazil, K., Lohfeld, L., et al (2002),
"Organizauon speciflc predictors of job satisfaction:
findings from a Canadian muIti-site quality of work life
cross-sectional survey", BMC Health Serv Res 2(1), p 6
6 Lamarcbe Klmberley and Susan TuUai-McGuinness (2009), Canada Nurse Practitioner Job Satisfaction, accessed 5-11-2012, from htlp://www ncbi.nlm.nih.gov/pubmed/19521160
7 Lyn N.Henderson and Jim Tulloch (2008), "Incentives for retaining and motivating health workers in Pacific and Asian countries" Human Resources for Health 2008 6(18)
8 Nguyen Huu Thang (2012), Workforce satisfaction in Tan Lac general district hospital, Hoa Binh province, Viet Nam, Mahidol University
9 Paul E Spector (1997), "Job satisfaction: Application, assessment, cause and consequences", Sage Publications
10 Phan Thi Luyen (2009), Factors affecting job satisfaction of the staff io Can Tho University of Medicine and Pharmacy Viet Nam, Mahidol University
11 Spector, accessed 12-6-2012, from http://shell.cas.usf.edu/-pspector/scales/jssscore.htnil
12 WHO (2006), The World health report 2006: Working together for health WHO press, Geneva, accessed
16-10-2012, from http://www who int/whr/2006/en