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英国重症监护病房医生的压力。

Stress in UK intensive care unit doctors.

作者信息

Coomber S, Todd C, Park G, Baxter P, Firth-Cozens J, Shore S

机构信息

Addenbrooke's Hospital NHS Trust, Hills Road, Cambridge CB2 2QQ, UK.

出版信息

Br J Anaesth. 2002 Dec;89(6):873-81. doi: 10.1093/bja/aef273.

Abstract

BACKGROUND

Doctors have long been considered at risk of occupational stress.

METHODS

A postal survey of all members of the Intensive Care Society using validated instruments.

RESULTS

Eight-five per cent of members returned questionnaires and 70% were eligible for the study. Twenty-nine per cent were suffering General Health Questionnaire-12 (GHQ-12) identified distress and 12% Symptom Checklist-Depression (SCL-D) defined depression. There were no significant age or sex differences between staff suffering distress or depression and those who did not. Dissatisfaction with career correlated highly with both distress and depression (P<0.01). Twenty doctors (3%) were bothered by suicidal thoughts. The most stressful aspects of work were bed allocation, being over-stretched, effect of hours of work and stress on personal/family life, and compromising standards when resources are short. Logistic regression revealed mental health problems were predicted by five stressors: 'lack of recognition of one's own contribution by others'; 'too much responsibility at times'; 'effect of stress on personal/family life'; 'keeping up to date with knowledge'; and 'making the right decision alone'.

CONCLUSIONS

Nearly one in three ICU doctors appeared distressed (GHQ), and one in 10 depressed (SCL-D); this is no greater than that reported in other specialities. Perceived stressors reveal some key areas of concern for the employer and the specialty.

摘要

背景

长期以来,医生一直被认为面临职业压力风险。

方法

使用经过验证的工具对重症监护协会的所有成员进行邮寄调查。

结果

85%的成员返回了问卷,70%符合研究条件。29%的人在一般健康问卷-12(GHQ-12)中显示有困扰,12%的人在症状自评量表-抑郁(SCL-D)中被定义为抑郁。在有困扰或抑郁的工作人员与没有困扰或抑郁的工作人员之间,年龄或性别没有显著差异。对职业的不满与困扰和抑郁都高度相关(P<0.01)。20名医生(3%)受到自杀念头的困扰。工作中压力最大的方面是床位分配、过度劳累、工作时间和压力对个人/家庭生活的影响,以及资源短缺时降低标准。逻辑回归显示,心理健康问题由五个压力源预测:“他人对自己贡献的认可不足”;“有时责任过重”;“压力对个人/家庭生活的影响”;“跟上知识更新”;以及“独自做出正确决策”。

结论

近三分之一的重症监护病房医生似乎有困扰(GHQ),十分之一的人有抑郁(SCL-D);这并不比其他专业报告的情况更严重。感知到的压力源揭示了雇主和该专业关注的一些关键领域。

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