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新西兰公共卫生系统中公立医院医学顾问的职业倦怠。

Burnout in hospital-based medical consultants in the New Zealand public health system.

作者信息

Surgenor Lois J, Spearing Ruth L, Horn Jacqueline, Beautrais Annette L, Mulder Roger T, Chen Peggy

机构信息

Department of Psychological Medicine, University of Otago at Christchurch, Christchurch, New Zealand.

出版信息

N Z Med J. 2009 Aug 7;122(1300):11-8.

Abstract

AIM

To assess the prevalence and severity of burnout in hospital-based medical consultants, and investigate associated demographic and professional characteristics.

METHOD

Utilising standardised measures of burnout (Maslach Burnout Inventory) and job satisfaction (Job Satisfaction Scale) this cross-sectional study recruited 267 consultants working in a large tertiary hospital in Christchurch, New Zealand.

RESULTS

Seventy-one percent of all eligible participants were recruited. The prevalence of burnout in each of the three dimensions was as follows: High Emotional Exhaustion=29.7%; High Depersonalisation=24.4%; Low Personal Accomplishment=31.2%. One in five consultants was assessed as having high overall burnout. Considered against the psychometric norms for medical workers, significantly more consultants than expected reported low Emotional Exhaustion (p<0.001) and low Depersonalisation (p<0.01). Working longer hours (p<0.01), lower job satisfaction (p<0.001), and shorter time in the current job (p<0.05) independently increased the risk of high Emotional Exhaustion. Working longer hours (p<0.05) and lower job satisfaction (p<.01) independently increased the risk of high Depersonalisation. Longer time in the same job increased the risk of low Personal Accomplishment (p<0.05). Longer hours worked (p<0.05), shorter vocational experience as a consultant (p<0.05), and lower job satisfaction (p<0.001) independently increased the risk of high overall burnout.

CONCLUSION

An unexpected proportion of consultants experience robust emotional well-being and healthy work engagement. However, for those experiencing high burnout, by severity or dimension, working long hours and low job satisfaction appear to be particularly contributory factors. Whilst remedial interventions should target the minority who experience significant burnout, studies using robust research designs are required to assess the meaningful clinical utility of these. The challenge remains to determine the optimal organisational practices to minimise burnout in this workforce.

摘要

目的

评估医院医学顾问职业倦怠的患病率及严重程度,并调查相关的人口统计学和职业特征。

方法

本横断面研究采用职业倦怠(马氏职业倦怠量表)和工作满意度(工作满意度量表)的标准化测量方法,招募了新西兰克赖斯特彻奇市一家大型三级医院的267名顾问。

结果

所有符合条件的参与者中有71%被招募。职业倦怠三个维度的患病率如下:高情绪耗竭=29.7%;高去个性化=24.4%;低个人成就感=31.2%。五分之一的顾问被评估为总体职业倦怠程度高。与医务人员的心理测量标准相比,报告情绪耗竭低(p<0.001)和去个性化低(p<0.01)的顾问明显多于预期。工作时间较长(p<0.01)、工作满意度较低(p<0.001)以及目前工作时间较短(p<0.05)会独立增加高情绪耗竭的风险。工作时间较长(p<0.05)和工作满意度较低(p<0.01)会独立增加高去个性化的风险。在同一工作岗位上工作时间较长会增加低个人成就感的风险(p<0.05)。工作时间较长(p<0.05)、担任顾问的职业经验较短(p<0.05)以及工作满意度较低(p<0.001)会独立增加总体职业倦怠程度高的风险。

结论

出乎意料的是,有一定比例的顾问情绪健康状况良好且工作投入度高。然而,对于那些职业倦怠程度高的人,无论是从严重程度还是维度来看,工作时间长和工作满意度低似乎是特别重要的促成因素。虽然补救干预措施应针对职业倦怠程度严重的少数人,但需要采用严谨研究设计的研究来评估这些措施的实际临床效用。如何确定最佳的组织措施以尽量减少这一群体的职业倦怠仍是一个挑战。

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