需求、价值观和倦怠：对医生的相关性。
Demands, values, and burnout: relevance for physicians.
机构信息
Acadia University, Centre for Organizational Research and Development, 24 Highland Ave, Wolfville, NS B4P 2R6.
出版信息
Can Fam Physician. 2009 Dec;55(12):1224-1225, 1225.e1-6.
OBJECTIVE
T o explore the interaction between workload and values congruence (personal values with health care system values) in the context of burnout and physician engagement and to explore the relative importance of these factors by sex, given the distinct work patterns of male and female physicians.
DESIGN
National mailed survey.
SETTING
Canada.
PARTICIPANTS
A random sample of 8100 Canadian physicians (response rate 40%, N = 3213); 2536 responses (from physicians working more than 35 hours per week) were analyzed.
MAIN OUTCOME MEASURES
Levels of burnout, values congruence, and workload, by sex, measured by the Maslach Burnout Inventory-General Scale and the Areas of Worklife Scale.
RESULTS
Results showed a moderate level of burnout among Canadian physicians, with relatively positive scores on exhaustion, average scores on cynicism, and mildly negative scores on professional efficacy. A series of multiple regression analyses confirmed parallel main effect contributions from manageable workload and values congruence. Both workload and values congruence predicted exhaustion and cynicism for men and women (P = .001). Only values congruence provided a significant prediction of professional efficacy for both men and women (P = .001) These predictors interacted for women on all 3 aspects of burnout (exhaustion, cynicism, and diminished efficacy). Howevever, overall levels of the burnout indicators departed only modestly from normative levels.
CONCLUSION
W orkload and values congruence make distinct contributions to physician burnout. Work overload contributes to predicting exhaustion and cynicism; professional values crises contribute to predicting exhaustion, cynicism, and low professional efficacy. The interaction of values and workload for women in particular has implications for the distinct work-life patterns of male and female physicians. Specifically, the congruence of individual values with values inherent in the health care system appeared to be of greater consequence for women than for men.
目的
探讨工作负荷与价值观一致性（个人价值观与医疗系统价值观）在倦怠和医生敬业度方面的相互作用，并探讨这些因素在性别方面的相对重要性，因为男女医生的工作模式明显不同。
设计
全国邮寄调查。
地点
加拿大。
参与者
对 8100 名加拿大医生进行了随机抽样（响应率为 40%，N=3213）；分析了 2536 名（每周工作超过 35 小时的医生）的回复。
主要观察指标
倦怠、价值观一致性和工作负荷的水平，按性别划分，由 Maslach 倦怠量表一般量表和工作生活领域量表测量。
结果
结果显示，加拿大医生的倦怠程度处于中等水平，在精疲力竭方面的得分相对较高，在愤世嫉俗方面的得分平均，在专业效能方面的得分略低。一系列多元回归分析证实了可管理的工作量和价值观一致性的平行主要效应贡献。工作量和价值观一致性均预测了男性和女性的精疲力竭和愤世嫉俗（P=0.001）。只有价值观一致性对男性和女性的专业效能提供了显著预测（P=0.001）。这些预测因素在女性的所有 3 个倦怠指标（精疲力竭、愤世嫉俗和效能降低）上都存在交互作用。然而，倦怠指标的整体水平仅略有偏离规范水平。
结论
工作量和价值观一致性对医生倦怠有不同的贡献。工作超负荷有助于预测精疲力竭和愤世嫉俗；职业价值观危机有助于预测精疲力竭、愤世嫉俗和职业效能低下。价值观和工作量对女性的相互作用，特别是对男女医生不同的工作生活模式有影响。具体而言，个人价值观与医疗系统内在价值观的一致性对女性的影响似乎比男性更大。
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