Lee F Joseph, Stewart Moira, Brown Judith Belle
Centre for Family Medicine, 25 Joseph St, Kitchener, ON N2G 4X6.
Can Fam Physician. 2008 Feb;54(2):234-5.
To ascertain Canadian family physicians' levels of stress and burnout and the strategies they use to reduce these problems.
Census survey.
Kitchener-Waterloo, an urban area with a population of approximately 300 000 in southwestern Ontario.
Family physicians.
Scores on the Family Physician Stress Inventory, scores on strategies to reduce personal stress, scores on strategies to reduce stress on the job, and scores on the Maslach Burnout Inventory.
Participation rate was 77.8% (123 of 158 surveys returned). About 42.5% of participants had high stress levels. Burnout was defined by 3 components: emotional exhaustion, depersonalization (going through the day like an "automaton"), and perceived lack of personal accomplishment. Many respondents scored high on the burnout inventory, and almost half had high levels of emotional exhaustion and depersonalization (47.9% and 46.3%, respectively). No demographic factors were associated with high scores on these components. Use of strategies to reduce personal and occupational stress was associated with lower levels of burnout. Scores on the Family Physician Stress Inventory correlated highly with scores on the Maslach Burnout Inventory.
Regardless of demographic factors, family physicians are at risk of having high levels of stress and burnout. Classic burnout is related to stress brought on by factors such as too much paperwork, long waits for specialists and tests, feeling undervalued, feeling unsupported, and having to abide by rules and regulations. Common strategies for reducing personal stress included eating nutritiously and spending time with family and friends. Common strategies for reducing stress on the job included valuing relationships with patients and participating in continuing medical education. Stress and burnout are related to the desire to give up practice and are, therefore, a human resources issue for the entire health care system.
确定加拿大家庭医生的压力和职业倦怠水平以及他们用以减轻这些问题的策略。
普查。
安大略省西南部的基奇纳 - 滑铁卢市，一个人口约30万的市区。
家庭医生。
家庭医生压力量表得分、减轻个人压力策略得分、减轻工作压力策略得分以及马氏职业倦怠量表得分。
参与率为77.8%（共收回158份调查问卷中的123份）。约42.5%的参与者压力水平较高。职业倦怠由三个部分定义：情感耗竭、去人格化（如“机器人”般度过一天）以及个人成就感缺失。许多受访者在职业倦怠量表上得分较高，近一半的人情感耗竭和去人格化水平较高（分别为47.9%和46.3%）。这些部分的高分与任何人口统计学因素均无关联。使用减轻个人和职业压力的策略与较低的职业倦怠水平相关。家庭医生压力量表得分与马氏职业倦怠量表得分高度相关。
无论人口统计学因素如何，家庭医生都有面临高压力和职业倦怠的风险。典型的职业倦怠与诸如过多文书工作、等待专科医生和检查的时间过长、感觉未得到重视、感觉缺乏支持以及必须遵守规章制度等因素带来的压力有关。减轻个人压力的常见策略包括营养饮食以及与家人和朋友共度时光。减轻工作压力的常见策略包括重视与患者的关系以及参与继续医学教育。压力和职业倦怠与放弃行医的意愿相关，因此是整个医疗保健系统的人力资源问题。
