Dutch Doctor's Association, Groningen, The Netherlands.
Psychol Health Med. 2009 Dec;14(6):654-66. doi: 10.1080/13548500903311554.
Burnout is a work-related syndrome that may negatively affect more than just the resident physician. On the other hand, engagement has been shown to protect employees; it may also positively affect the patient care that the residents provide. Little is known about the relationship between residents' self-reported errors and burnout and engagement. In our national study that included all residents and physicians in The Netherlands, 2115 questionnaires were returned (response rate 41.1%). The residents reported on burnout (Maslach Burnout Inventory-Health and Social Services), engagement (Utrecht Work Engagement Scale) and self-assessed patient care practices (six items, two factors: errors in action/judgment, errors due to lack of time). Ninety-four percent of the residents reported making one or more mistake without negative consequences for the patient during their training. Seventy-one percent reported performing procedures for which they did not feel properly trained. More than half (56%) of the residents stated they had made a mistake with a negative consequence. Seventy-six percent felt they had fallen short in the quality of care they provided on at least one occasion. Men reported more errors in action/judgment than women. Significant effects of specialty and clinical setting were found on both types of errors. Residents with burnout reported significantly more errors (p < 0.001). Highly engaged residents reported fewer errors (p <or= 0.01). Overall residents disclosed that in their perception they regularly make errors throughout their residency. Steps should be taken to help residents minimize the number of perceived errors made. Therefore, it is important to prevent residents from developing burnout and to keep residents engaged in their work.
burnout 是一种与工作相关的综合征,可能不仅对住院医师产生负面影响。另一方面,敬业度已被证明可以保护员工;它也可能对住院医师提供的患者护理产生积极影响。关于住院医师自我报告的错误与倦怠和敬业度之间的关系知之甚少。在我们包括荷兰所有住院医师和医师在内的全国性研究中,共收回 2115 份问卷(回应率为 41.1%)。住院医师报告了倦怠(Maslach 倦怠量表-卫生和社会服务)、敬业度(乌得勒支工作投入量表)和自我评估的患者护理实践(六项,两个因素:行动/判断失误,因缺乏时间而导致的错误)。94%的住院医师报告在培训期间曾犯过一次或多次错误,但对患者没有产生负面影响。71%的人报告实施了他们认为自己没有受过适当培训的程序。超过一半(56%)的住院医师表示他们犯了一个有负面后果的错误。76%的人认为他们至少有一次在提供护理质量方面做得不够。男性报告的行动/判断错误多于女性。专业和临床环境对这两种类型的错误都有显著影响。报告倦怠的住院医师报告的错误明显更多(p < 0.001)。高度敬业的住院医师报告的错误较少(p < 0.01)。总体而言,住院医师表示他们在住院期间经常认为自己犯了错误。应采取措施帮助住院医师尽量减少感知到的错误数量。因此,重要的是要防止住院医师出现倦怠,并保持他们对工作的投入。