刘晶，李思茹北京协和医院，北京　00730

公立医院医务人员离职情况与心理契约违背分析

刘晶1，李思茹1
北京协和医院，北京100730

目的 通过考察公立医院医务人员离职情况与心理契约违背现状，探讨稳定医务人员对策。方法 以某公立医院225名离职医务人员为对象，采用心理契约违背量表调查并对离职报告分析。结果 本市公立医院、出国、外资医院是公立医院医务人员的主要离职去向；不同年龄段的医务人员心理契约违背得分存在显著性差异。结论 公立医院应采取系统措施改善医务人员特别是青年医务人员对医院履行职责的感知，减少其心理契约违背的发生。

公立医院；医务人员；离职；心理契约

［Abstract］Objective To study the measures of stabilizing the medical staff by exploring the resignation status and psychological contract violation in medical staff in the public hospital.Methods 225 cases of resignation medical staff in some public hospital were selected as the objects and the resignation report was surveyed and analyzed by the psychological contract violation scale.Results The public hospital in our city，going abroad and foreign-capital hospital were the main places where the medical staff in the public hospital had gone，and there were obvious differences in the psychological contract violation scores between the medical staff of different ages.Conclusion The public hospital should take systematical measures to improve the perception of performing the hospital's duties of medical staff especially the young medical staff and reduce the occurrence of psychological contract violation.

［Key words］Public hospital；Medical staff；Resignation；Psychological contract

心理契约是指组织与员工双方之间内隐的、不成文的相互责任的心理约定，即双方对对方应该得到什么和应该付出什么的一种主观期望。心理契约是人们在内心中，以社会规范和价值观为基础进行的相应衡量和对比［1］。心理契约违背是指员工因组织违背心理契约而产生的一种短期的、相对激烈的情绪或情感反应。员工的心理契约中如果感知到组织对他们的承诺没有兑现，或者感知到双方对组织承担的责任存在认知差异，就会产生“心理契约违背感”［2］。心理契约违背发生后，员工的反应基本上可以概括为四类：一是离职；二是降低职务内绩效；三是降低职务外绩效；四是出现破坏行为［3］。可见，心理契约违背后，员工的一种极端行为表现就是离职。……