Panagopoulou Efharis, Montgomery Anthony, Benos Alexis
Medical School, Aristotle University, Thessaloniki, Greece.
Eur J Intern Med. 2006 May;17(3):195-200. doi: 10.1016/j.ejim.2005.11.013.
Burnout poses a substantial problem for physicians' well-being and for the quality of health care. The role of workload in comparison to subjective work characteristics has been rarely studied. The purpose of this study was to explore the associations of burnout with workload and subjective work characteristics in internal medicine specialists and residents.
A cross-sectional study using an anonymous mailed survey was used. Some 103 specialists and 143 residents participated in the study. Burnout was measured using the Maslach Burnout Inventory. Subjective work characteristics included perceived job demands in terms of time pressure, mental effort and emotional labor. Workload was assessed in terms of average number of hours worked per week.
Emotional exhaustion in medical specialists was only predicted by perceived job demands [odds ratio 3.7 (CI 1.7-7.9), P<0.001]. Emotional exhaustion in medical residents was only predicted by emotional labor [odds ratio 1.9 (CI 1.2-3.0), P=0.003]. Depersonalization among medical specialists was only predicted by emotional labor [odds ratio 2.7 (CI 1.1-6.7), P=0.032], while depersonalization among medical residents was only predicted by number of hours worked per week [odds ratio 1.1 (CI 1.1-1.2), P=0.007].
Perceived working conditions were more important than workload in explaining the variance in burnout. In addition, burnout in medical specialists and residents was linked to different characteristics of their working environment.
职业倦怠对医生的幸福感和医疗保健质量构成了重大问题。与主观工作特征相比，工作量的作用很少被研究。本研究的目的是探讨内科专科医生和住院医师的职业倦怠与工作量及主观工作特征之间的关联。
采用匿名邮寄调查进行横断面研究。约103名专科医生和143名住院医师参与了研究。使用马氏职业倦怠量表测量职业倦怠。主观工作特征包括在时间压力、脑力劳动和情感劳动方面感知到的工作需求。工作量根据每周平均工作小时数进行评估。
医学专科医生的情感耗竭仅由感知到的工作需求预测[比值比3.7（可信区间1.7 - 7.9），P<0.001]。医学住院医师的情感耗竭仅由情感劳动预测[比值比1.9（可信区间1.2 - 3.0），P = 0.003]。医学专科医生的去个性化仅由情感劳动预测[比值比2.7（可信区间1.1 - 6.7），P = 0.032]，而医学住院医师的去个性化仅由每周工作小时数预测[比值比1.1（可信区间1.1 - 1.2），P = 0.007]。
在解释职业倦怠的差异方面，感知到的工作条件比工作量更重要。此外，医学专科医生和住院医师的职业倦怠与他们工作环境的不同特征有关。
