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挪威医生职业倦怠的咨询服务:一项为期一年的队列研究。

Counselling for burnout in Norwegian doctors: one year cohort study.

作者信息

Rø Karin E Isaksson, Gude Tore, Tyssen Reidar, Aasland Olaf G

机构信息

Research Institute, Modum Bad, NO-3370 Vikersund, Norway.

出版信息

BMJ. 2008 Nov 11;337:a2004. doi: 10.1136/bmj.a2004.

Abstract

OBJECTIVE

To investigate levels and predictors of change in dimensions of burnout after an intervention for stressed doctors.

DESIGN

Cohort study followed by self reported assessment at one year.

SETTING

Norwegian resource centre.

PARTICIPANTS

227 doctors participating in counselling intervention, 2003-5.

INTERVENTIONS

Counselling (lasting one day (individual) or one week (group based)) aimed at motivating reflection on and acknowledgement of the doctors' situation and personal needs.

MAIN OUTCOME MEASURES

Levels of burnout (Maslach burnout inventory) and predictors of reduction in emotional exhaustion investigated by linear regression.

RESULTS

185 doctors (81%, 88 men, 97 women) completed one year follow-up. The mean level of emotional exhaustion (scale 1-5) was significantly reduced from 3.00 (SD 0.94) to 2.53 (SD 0.76) (t=6.76, P<0.001), similar to the level found in a representative sample of 390 Norwegian doctors. Participants had reduced their working hours by 1.6 hours/week (SD 11.4). There was a considerable reduction in the proportion of doctors on full time sick leave, from 35% (63/182) at baseline to 6% (10/182) at follow-up and a parallel increase in the proportion who had undergone psychotherapy, from 20% (36/182) to 53% (97/182). In the whole cohort, reduction in emotional exhaustion was independently associated with reduced number of work hours/week (beta=0.17, P=0.03), adjusted for sex, age, and personality dimensions. Among men "satisfaction with the intervention" (beta=0.25, P=0.04) independently predicted reduction in emotional exhaustion.

CONCLUSIONS

A short term counselling intervention could contribute to reduction in emotional exhaustion in doctors. This was associated with reduced working hours for the whole cohort and, in men, was predicted by satisfaction with the intervention.

摘要

目的

调查对压力过大的医生进行干预后职业倦怠各维度的水平及变化预测因素。

设计

队列研究,随后在一年后进行自我报告评估。

地点

挪威资源中心。

参与者

2003年至2005年参与咨询干预的227名医生。

干预措施

咨询(持续一天(个体咨询)或一周(团体咨询)),旨在促使医生反思并认识自身状况和个人需求。

主要观察指标

职业倦怠水平(马氏职业倦怠量表)以及通过线性回归研究的情感耗竭减轻的预测因素。

结果

185名医生(81%,88名男性,97名女性)完成了一年的随访。情感耗竭的平均水平(1 - 5分制)从3.00(标准差0.94)显著降至2.53(标准差0.76)(t = 6.76,P < 0.001),与从390名挪威医生中抽取的代表性样本中发现的水平相似。参与者每周工作时长减少了1.6小时(标准差11.4)。全时病假的医生比例大幅下降,从基线时的35%(63/182)降至随访时的6%(10/182),同时接受心理治疗的医生比例相应增加,从20%(36/182)增至53%(97/182)。在整个队列中,情感耗竭的减轻与每周工作时长的减少独立相关(β = 0.17,P = 0.03),并对性别、年龄和人格维度进行了校正。在男性中,“对干预的满意度”(β = 0.25,P = 0.04)独立预测了情感耗竭的减轻。

结论

短期咨询干预有助于减轻医生的情感耗竭。这与整个队列工作时长的减少相关,在男性中,与对干预的满意度有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91f8/4787112/7906cc8a2e6a/isak581330.f1.jpg

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