Doppia M-A, Estryn-Béhar M, Fry C, Guetarni K, Lieutaud T
Samu 14-Smur, réanimation chirurgicale, pôle d'anesthésie, CHRU de La-Côte-de-Nacre, avenue de La-Côte-de-Nacre, 14033 Caen cedex, France.
Ann Fr Anesth Reanim. 2011 Nov;30(11):782-94. doi: 10.1016/j.annfar.2011.05.011. Epub 2011 Oct 5.
Burnout is one of the main chronic health problems with negative consequences on health care givers but also on quality of care. The main goal of Physician Health Survey was to study the frequency of burnout among salaried physicians and pharmacists and to compare anesthesiologists and intensivists (AI) with other practitioners (OP). The secondary end points were to analyze risk factors of burnout in each group.
An anonymous, self-administered questionnaire was diffused via a specific website. Burnout was measured using the Copenhagen Burnout Inventory (CBI). Several different factors were examined: work/family conflict, salary satisfaction, quality of teamwork, interpersonal relationships, workplace influence, workload and perceived health. The role of each factor was calculated by multivariate logistic regression and comparisons were made between AI and OP.
Among the 3196 responses, CBI revealed an elevated score of burnout in 38.4% in AI and in 42.4% in OP. In each group, a great gap was displayed between the CBI results and the self-assessment of burnout (15%). Among AI, risk factors of burnout were high quantitative demand (ORadj=3.40; CI(95) 1,34-8,63), Work/family conflict (ORadj=; 3.12 CI(95) 1.60-6.08), low quality of teamwork (ORadj=1.99; CI(95)1.14-3.47) and tense Relation within team (ORadj=1.92; CI(95) 1.25-2.95). All these factors are observed also among OP. Female gender, young age and dissatisfaction with pay have significant influence but different in the two groups. Claims of recurrent harassment by superiors is a risk factor for burnout only for the AP (adj.OR=1.83; CI(95) 1.04-3.22).
Burnout affected near one about two salaried physicians and pharmacists in France. AI were not more concerned by burnout than OP but all of whom have difficulty identifying their own levels of psychological stress and burnout. Decreasing the level of different risk factors i.e. by improving the quality of teamwork should lead to reduce burnout frequency.
职业倦怠是主要的慢性健康问题之一，不仅会对医护人员的健康产生负面影响，还会影响医疗服务质量。医师健康调查的主要目的是研究受薪医生和药剂师中职业倦怠的发生率，并比较麻醉师和重症监护医生（AI）与其他从业者（OP）。次要终点是分析每组中职业倦怠的风险因素。
通过一个特定网站发放一份匿名的自填式问卷。使用哥本哈根职业倦怠量表（CBI）来测量职业倦怠。研究了几个不同因素：工作/家庭冲突、薪资满意度、团队合作质量、人际关系、工作场所影响、工作量和自我感知健康状况。通过多变量逻辑回归计算每个因素的作用，并对AI和OP进行比较。
在3196份回复中，CBI显示AI中有38.4%的人职业倦怠得分升高，OP中有42.4%的人得分升高。在每组中，CBI结果与职业倦怠自我评估之间存在很大差距（15%）。在AI中，职业倦怠的风险因素包括高工作量要求（ORadj=3.40；CI(95) 1.34 - 8.63）、工作/家庭冲突（ORadj=3.12；CI(95) 1.60 - 6.08）、团队合作质量低（ORadj=1.99；CI(95) 1.14 - 3.47）以及团队内部关系紧张（ORadj=1.92；CI(95) 1.25 - 2.95）。在OP中也观察到了所有这些因素。女性、年轻以及对薪酬不满有显著影响，但在两组中情况不同。上级反复骚扰的投诉仅是AP职业倦怠的一个风险因素（调整后OR=1.83；CI(95) 1.04 - 3.22）。
在法国，近一半的受薪医生和药剂师受到职业倦怠的影响。AI并不比OP更容易出现职业倦怠，但他们都难以识别自己的心理压力和职业倦怠水平。降低不同风险因素的水平，即通过提高团队合作质量，应该会导致职业倦怠发生率降低。
