Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Ann Surg Oncol. 2011 May;18(5):1236-42. doi: 10.1245/s10434-011-1623-5. Epub 2011 Mar 12.
We showed in a companion paper that the prevalence of burnout among surgical oncologists at a comprehensive cancer center was 42% and psychiatric morbidity 27%, and high quality of life (QOL) was absent for 54% of surgeons. Here we examine modifiable workplace factors and other stressors associated with burnout, psychiatric morbidity, and low QOL, together with interest in interventions to reduce distress and improve wellness.
Study-specific questions important for morale, QOL, and stressors associated with burnout were included in an anonymous Internet-based survey distributed to the surgical faculty at Memorial Sloan-Kettering Cancer Center.
Among the 72 surgeons who responded (response rate of 73%), surgeons identified high stress from medical lawsuits, pressure to succeed in research, financial worries, negative attitudes to gender, and ability to cope with patients' suffering and death. Workplace features requiring greatest change were the reimbursement system, administrative support, and schedule. Work-life balance and relationship issues with spouse or partner caused high stress. Strongest correlations with distress were a desire to change communication with patients and the tension between the time devoted to work versus time available to be with family. Surgeons' preferences for interventions favored a fitness program, nutrition consultation, and increased socialization with colleagues, with less interest in interventions conventionally used to address psychological distress.
Several opportunities to intervene at the organizational level permit efforts to reduce burnout and improve QOL.
我们在一篇相关论文中表明，在一家综合性癌症中心，外科肿瘤学家的倦怠发生率为 42%，精神疾病发病率为 27%，54%的外科医生生活质量较差。在这里，我们研究了与倦怠、精神疾病和生活质量较低相关的可改变的工作场所因素和其他压力源，以及对减少痛苦和改善健康的干预措施的兴趣。
在一项基于互联网的匿名调查中，向纪念斯隆-凯特琳癌症中心的外科教员分发了专门研究士气、生活质量和与倦怠相关压力源的问题。
在 72 名回应的外科医生中（回应率为 73%），外科医生确定了高医疗法律诉讼压力、在研究中取得成功的压力、财务担忧、对性别持消极态度以及应对患者痛苦和死亡的能力。需要最大改变的工作场所特征是报销制度、行政支持和时间表。工作与生活的平衡以及与配偶或伴侣的关系问题造成了很大的压力。与困扰相关性最强的是改变与患者沟通的愿望以及工作时间与与家人相处的时间之间的紧张关系。外科医生对干预措施的偏好包括健身计划、营养咨询和增加与同事的社交活动，而对传统用于解决心理困扰的干预措施兴趣较低。
在组织层面上有几个干预机会，可以努力减少倦怠和提高生活质量。
