挑战性-阻碍性压力对高校附属医院医师创新行为的影响:工作投入与职业召唤的链式中介作用OA

Objective:This study aimed to clarify the associations between challenge stress,hindrance stress,and physi-cians' innovative behavior in university-affiliated hospitals,and to assess whether work engagement and career calling oper-ate as sequential mediators.Methods:A questionnaire survey was conducted among 450 physicians from five university-affiliated hospitals in a certain region using the challenge-hindrance stress scale,work engagement scale,career calling scale,and innovative behavior scale.Results:Correlation analyses showed that challenge stress was positively associated with work engagement,career calling,and innovative behavior(r=0.35 to 0.41,all P＜0.001),whereas hindrance stress was negatively associated with these variables(r=-0.35 to-0.28,all P＜0.001).Mediation analysis indicated that the direct ef-fect of challenge stress on innovative behavior remained significant(effect=0.18),while the indirect effect through work en-gagement was also significant(indirect effect=0.116,95％bootstrap CI:0.071 to 0.169),suggesting a partial mediating role of work engagement.Further chain mediation analysis showed that both challenge stress and hindrance stress were indi-rectly associated with innovative behavior through the sequential pathway of work engagement and career calling,with indi-rect effects of 0.056 and-0.047,respectively.The corresponding 95％bootstrap CIs were 0.035 to 0.082 and-0.071 to-0.028,respectively.Conclusion:Challenge stress was directly and indirectly associated with higher levels of physicians' innovative behavior through work engagement and career calling,whereas hindrance stress was mainly indirectly associated with lower innovative behavior through reduced work engagement and subsequent career calling.