Popa Florian, Raed Arafat, Purcarea Victor Lorin, Lală Adrian, Bobirnac George
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
J Med Life. 2010 Jul-Sep;3(3):207-15.
The specificity of the emergency medical act strongly manifests itself on account of a wide series of psycho-traumatizing factors augmented both by the vulnerable situation of the patient and the paroxysmal state of the act. Also, it has been recognized that the physical solicitation and distress levels are the highest among all medical specialties, this being a valuable marker for establishing the quality of the medical act.
We have surveyed a total of 4725 emergency medical workers with the MBI-HSS instrument, receiving 4693 valid surveys (99.32% response rate). Professional categories included Emergency Department doctors (M-EMD), ambulance doctors (M-AMB), ED doctors with field work in emergency and resuscitation (including mobile intensive care units and airborne intensive care units) (D-SMU), medical nurses in Emergency Departments (N-EMD), medical nurses in the ambulance service (N-AMB), ED medical nurses with field activity in emergency and resuscitation (N-SMU), ambulance drivers (DRV) and paramedic (EMT). The n values for every category of subjects and percentage of system coverage (table 3) shows that we have covered an estimated total of 29.94% of the Romanian emergency medical field workers.
MBI-HSS results show a moderate to high level of occupational stress for the surveyed subjects. The average values for the three parameters, corresponding to the entire Romanian emergency medical field were 1.41 for EE, 0.99 for DP and 4.47 for PA (95% CI). Average results stratified by professional category show higher EE average values (v) for the M-SMU (v=2.01, 95%CI) and M-EMD (v=2.21, 95% CI) groups corresponding to higher DP values for the same groups (vM-EMD=1.41 and vM-SMU=1.22, 95% CI). PA values for these groups are below average, corresponding to an increased risk factor for high degrees of burnout. Calculated PA values are 4.30 for the M-EMD group and 4.20 for the M-SMU group.
Of all surveyed groups, our study shows a high risk of burnout consisting of high emotional exhaustion (EE) and high depersonalization (DP) values for Emergency Department doctors, Emergency, and Resuscitation Service doctors (M-SMU). Possible explanations for this might be linked to high patient flow, Emergency Department crowding, long work hours and individual parameters such as coping mechanisms, social development and work environment.
急诊医疗行为的特殊性因一系列心理创伤因素而强烈显现，这些因素因患者的脆弱状况和行为的阵发性而加剧。此外，人们已经认识到，身体负荷和压力水平在所有医学专科中是最高的，这是衡量医疗行为质量的一个重要指标。
我们使用MBI-HSS工具对总共4725名急诊医疗工作者进行了调查，共收到4693份有效调查问卷（回复率99.32%）。专业类别包括急诊科医生（M-EMD）、救护车医生（M-AMB）、在急诊和复苏领域有现场工作经验的急诊科医生（包括移动重症监护病房和空中重症监护病房）（D-SMU）、急诊科护士（N-EMD）、救护服务护士（N-AMB）、在急诊和复苏领域有现场工作经验的急诊科护士（N-SMU）、救护车司机（DRV）和护理人员（EMT）。每个类别的受试者数量（n值）和系统覆盖百分比（表3）表明，我们估计覆盖了罗马尼亚急诊医疗领域工作者总数的29.94%。
MBI-HSS结果显示，被调查对象的职业压力处于中高水平。对应于整个罗马尼亚急诊医疗领域的三个参数的平均值，情感耗竭（EE）为1.41，去人格化（DP）为0.99，成就感降低（PA）为4.47（95%置信区间）。按专业类别分层的平均结果显示，M-SMU组（v = 2.01，95%置信区间）和M-EMD组（v = 2.21，95%置信区间）的EE平均值较高（v），同一组的DP值也较高（vM-EMD = 1.41和vM-SMU = 1.22，95%置信区间）。这些组的PA值低于平均水平，对应于高度倦怠的风险增加因素。M-EMD组的计算PA值为4.30，M-SMU组为4.20。
在所有被调查的组中，我们的研究表明，急诊科医生、急诊和复苏服务医生（M-SMU）存在由高情感耗竭（EE）和高去人格化（DP）值组成的高度倦怠风险。对此的可能解释可能与高患者流量、急诊科拥挤、长时间工作以及应对机制、社会发展和工作环境等个体参数有关。
