Dunwoodie D A, Auret K
Department of General Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
Intern Med J. 2007 Oct;37(10):693-8. doi: 10.1111/j.1445-5994.2007.01384.x. Epub 2007 May 21.
Medicine and particularly palliative care are considered to be stressful professions, with risks of psychological morbidity and burnout. There is little published work quantitatively documenting their prevalence among medical practitioners practising in palliative care.
Three questionnaires, including the General Health Questionnaire (GHQ-12) and the Maslach Burnout Inventory, were sent to palliative care practitioners in Western Australia.
Forty-one of 43 (95%) practitioners completed the questionnaires. The mean score on the GHQ-12 was 1.9 (range 0-8), with 11 (27%) scoring 4 or more. On the Maslach Burnout Inventory, mean scores on the emotional exhaustion (EE, mean 17.5, range 1-47) and depersonalization subscales (DP, 4.5, 0-24) fell within the low range, with scores for personal accomplishment (39, 32-46) falling within the average range. Ten respondents (24%) scored high on either the EE subscale or the DP subscale, meeting criteria for burnout. GHQ-12 scores were associated with hours of work per week in palliative care (P = 0.004). The EE (P = 0.024) and DP (P = 0.006) components of burnout were associated with years of work in palliative care. Specialist practitioners were more likely to score in the high category for GHQ-12 (odds ratio = 4.8, P = 0.036) and EE (odds ratio = 8.33, P = 0.031). GHQ (P = 0.038) and DP (P = 0.006) scores were higher in those working in tertiary institutions, with tertiary practitioners more likely to be in the high EE category (odds ratio = 7.5, P = 0.034).
Levels of psychiatric morbidity and burnout in palliative medicine are not higher than in other specialties.
医学尤其是姑息治疗被认为是压力较大的职业，存在心理疾病和职业倦怠的风险。关于姑息治疗从业者中这些情况的患病率，定量记录的已发表研究很少。
向澳大利亚西部的姑息治疗从业者发放了三份问卷，包括一般健康问卷（GHQ - 12）和马氏职业倦怠量表。
43名从业者中有41名（95%）完成了问卷。GHQ - 12的平均得分为1.9（范围0 - 8），11名（27%）得分4分及以上。在马氏职业倦怠量表上，情感耗竭（EE，平均17.5，范围1 - 47）和去个性化分量表（DP，4.5，0 - 24）的平均得分处于低水平，个人成就感得分（39，32 - 46）处于平均水平。10名受访者（24%）在EE分量表或DP分量表上得分较高，符合职业倦怠标准。GHQ - 12得分与每周从事姑息治疗的工作时长相关（P = 0.004）。职业倦怠的EE（P = 0.024）和DP（P = 0.006）成分与从事姑息治疗的工作年限相关。专科从业者在GHQ - 12（优势比 = 4.8，P = 0.036）和EE（优势比 = 8.33，P = 0.031）方面更有可能得高分。在三级医疗机构工作的人员的GHQ（P = 0.038）和DP（P = 0.006）得分更高，三级医疗机构的从业者更有可能处于高EE类别（优势比 = 7.5，P = 0.034）。
姑息医学中的精神疾病和职业倦怠水平并不高于其他专科。
