Eckleberry-Hunt Jodie, Lick David, Boura Judith, Hunt Ronald, Balasubramaniam Mamtha, Mulhem Elie, Fisher Cynthia
Behavioral Medicine, William Beaumont Hospital Family Medicine Residency Program, Sterling Heights, Michigan, USA.
Acad Med. 2009 Feb;84(2):269-77. doi: 10.1097/ACM.0b013e3181938a45.
Physicians have a higher rate of burnout compared with the general population, and burnout's origin can be traced to residency training. Little evidence exists documenting the causes of burnout, and there is even less evidence on protective factors. The goal of this exploratory study was to determine which resident-identified stressors are associated with the presence of burnout and which resident-identified wellness factors are associated with the absence of burnout.
In the fall of 2006, residents from 13 specialties completed a demographics questionnaire, a survey of factors that promote burnout and wellness, and the Maslach Burnout Inventory.
From a pool of 395 residents, 150 (38%) completed the questionnaires. Of 32 burnout factors, 27 were significantly associated with at least one burnout scale. Pessimism was the only burnout factor associated with all three burnout scales; 11 other burnout factors were associated with at least two burnout scales. Of 29 wellness factors, 25 were significantly associated with at least one burnout scale, indicating a lack of burnout. Use of prescription medications was the only wellness factor associated with all three burnout scales, indicating low burnout. Thirteen other wellness factors were associated with at least two of the scales.
Significantly more research is needed to further define and measure wellness. Program directors should consider multiple burnout and wellness factors associated with burnout (or its absence) when designing treatment interventions. The aim should be to identify and bolster wellness factors that protect from burnout while minimizing the stressors that cause it.
与普通人群相比，医生职业倦怠的发生率更高，而职业倦怠的根源可追溯到住院医师培训阶段。几乎没有证据记录职业倦怠的成因，关于保护因素的证据则更少。这项探索性研究的目的是确定住院医师所识别的哪些压力源与职业倦怠的存在相关，以及哪些住院医师所识别的健康因素与无职业倦怠相关。
2006年秋季，来自13个专业的住院医师完成了一份人口统计学调查问卷、一份关于促进职业倦怠和健康的因素的调查，以及马氏职业倦怠量表。
在395名住院医师中，150名（38%）完成了问卷。在32个职业倦怠因素中，27个与至少一个职业倦怠量表显著相关。悲观是与所有三个职业倦怠量表都相关的唯一职业倦怠因素；其他11个职业倦怠因素与至少两个职业倦怠量表相关。在29个健康因素中，25个与至少一个职业倦怠量表显著相关，表明无职业倦怠。使用处方药是与所有三个职业倦怠量表都相关的唯一健康因素，表明职业倦怠程度低。其他13个健康因素与至少两个量表相关。
需要进行更多的研究来进一步定义和衡量健康状况。项目主任在设计治疗干预措施时，应考虑与职业倦怠（或无职业倦怠）相关的多种职业倦怠和健康因素。目标应该是识别并强化能预防职业倦怠的健康因素，同时尽量减少导致职业倦怠的压力源。
