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主要语言和文化背景作为医学专业住院医生职业倦怠的影响因素:在美国一个双语城市的研究

Primary language and cultural background as factors in resident burnout in medical specialties: a study in a bilingual US city.

作者信息

Afzal Khalid I, Khan Farhan M, Mulla Zuber, Akins Ralista, Ledger Elizabeth, Giordano Frank L

机构信息

Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA.

出版信息

South Med J. 2010 Jul;103(7):607-15. doi: 10.1097/SMJ.0b013e3181e20cad.

Abstract

OBJECTIVE

The aim of this study was to identify the degree of burnout among resident physicians enrolled in seven postgraduate training programs at Texas Tech University Health Sciences Center (TTUHSC), Paul L. Foster School of Medicine, El Paso, Texas, as it related to residents' age, gender, marital status, number of hours worked per week, primary language, race/ethnicity, and cultural background.

METHOD

: The Maslach Burnout Inventory Human Service Survey (MBI) was administered to measure the level of burnout according to the prevalence of emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA).

RESULTS

: Eighty-one percent of the residents at TTUHSC participated in the study. Residents raised in the United States or Canada comprised 28% and 35% of the study, and all reported English as their primary language. The EE scale was significant for obstetrics/gynecology (OB/GYN) residents (prevalence odds ratio [POR] = 13.55, P = 0.02) and psychiatry (PSY) residents (POR = 6.50, P = 0.03). Emergency medicine (EM) residents (POR = 23.35, P = 0.002), OB/GYN (POR = 10.89, P = 0.02), and general surgery (GS) (POR = 6.24, P = 0.03) residents had high DP. Internal medicine (IM) residents (primarily Spanish-speaking) reported significantly low EE (POR = 0.22, P = 0.03) and PA (POR = 0.09, P = 0.001) scores. Residents from the United States or Canada who reported English as their primary language and noted their race as white, had high EE (POR = 3.06, P = 0.03; POR = 5.61, P = 0.0001; POR = 2.91, P = 0.004), DP (POR = 3.19, P = 0.02; POR = 8.34, P < or = 0.0001; POR = 4.70, P < or = 0.0001) and PA (POR = 2.61, P = 0.02; POR = 2.35, P = 0.05, POR 0.29, P = 0.3) scores.

CONCLUSION

Using valid measures, this pilot study identified a statistically significant relationship between burnout and residents' race/ethnicity, primary language, and cultural background. Larger studies with similar focus would be necessary to generalize these findings. At-risk residents in bilingual locations should be provided with cultural awareness workshops, language assistance programs, as well as senior resident and faculty mentors.

摘要

目的

本研究旨在确定德克萨斯理工大学健康科学中心(TTUHSC)保罗·L·福斯特医学院(位于德克萨斯州埃尔帕索)七个研究生培训项目中的住院医师职业倦怠程度,及其与住院医师的年龄、性别、婚姻状况、每周工作时长、母语、种族/族裔和文化背景之间的关系。

方法

采用马氏职业倦怠量表-人类服务调查(MBI),根据情感耗竭(EE)、去个性化(DP)和个人成就感降低(PA)的发生率来衡量职业倦怠水平。

结果

TTUHSC的81%住院医师参与了本研究。在美国或加拿大长大的住院医师分别占研究对象的28%和35%,且均报告英语为其母语。EE量表对妇产科(OB/GYN)住院医师(患病率比值比[POR]=13.55,P=0.02)和精神科(PSY)住院医师(POR=6.50,P=0.03)具有显著意义。急诊医学(EM)住院医师(POR=23.35,P=0.002)、妇产科(POR=10.89,P=0.02)和普通外科(GS)(POR=6.24,P=0.03)住院医师的DP水平较高。内科(IM)住院医师(主要讲西班牙语)报告的EE(POR=0.22,P=0.03)和PA(POR=0.09,P=0.001)得分显著较低。以英语为母语且种族为白人的美国或加拿大住院医师,其EE(POR=3.06,P=0.03;POR=5.61,P=0.0001;POR=2.91,P=0.004)、DP(POR=3.19,P=0.02;POR=8.34,P≤0.0001;POR=4.70,P≤0.0001)和PA(POR=2.61,P=0.02;POR=2.35,P=0.05,POR=0.29,P=0.3)得分较高。

结论

通过有效的测量方法,本初步研究确定了职业倦怠与住院医师的种族/族裔、母语和文化背景之间具有统计学意义的关系。需要开展更多类似重点的研究来推广这些发现。对于处于双语环境中有职业倦怠风险的住院医师,应提供文化意识培训、语言援助项目,以及资深住院医师和教员导师。

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