Heinke W, Dunkel P, Brähler E, Nübling M, Riedel-Heller S, Kaisers U X
Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universität Leipzig, Deutschland.
Anaesthesist. 2011 Dec;60(12):1109-18. doi: 10.1007/s00101-011-1947-3. Epub 2011 Nov 11.
With the demands faced by anesthetists and intensive care physicians apparently increasing continuously in Germany, the increased risk of burnout in comparison with the general working population is discussed. This debate has previously been merely speculative because of the lack of studies comparing the burn-out risk of the German working population with anesthetists. Accordingly it was not certain whether anesthetists really are at greater risk of developing burnout as has often been suggested. Moreover, age, gender, function, workplace environment, e.g. working at a hospital compared to a general practitioner (GP) surgery, may influence the risk of burnout. Therefore, this study examined whether the risk for anesthetists in Germany suffering from burnout really is greater than in other occupations. In addition, factors influencing the burnout risks of anesthetists were analyzed.
A total of 3,541 questionnaires completed by German aaesthetists for a study on work satisfaction by the CBI (Copenhagen Burnout Inventory, part of the Copenhagen Psychosocial Questionnaire, COPSOQ) were analyzed. Apart from calculating the number of participants with a high risk of developing burnout syndrome, the data were used to calculate a generalized burnout score for all participants. The score was compared with data from both a random sample representing a wide variety of occupations from among the general population in Germany (n = 4,709) and a random sample of German hospital doctors (n = 616). In addition, subgroups were formed by gender, function (senior consultant, senior physician, specialist, junior doctor) and type and place of work (university hospital, public hospital, private clinic, GP surgery, freelance work) and the proportion of each group with a high risk of burnout syndrome was calculated. In addition, general burnout scores were compared statistically for differences among the various groups.
The proportion of study participants with a high risk of burnout was 40.1%. Differences were found to exist between genders (male 37.2% versus female 46%), qualifications (senior consultant 28.9%, senior physician 38%, specialist 41.5%, junior doctor 46.7%) and working in a hospital (41.3%) compared to a GP surgery (33.2%). The random sample of hospital doctors (n = 616) showed a burnout score of 49 ± 19 (mean ± standard deviation), compared to 44 ± 19 for a random sample of the German population (n = 4,709) and 42 ± 19 for anesthetists (p < 0.01). Of the subgroups formed, the highest score (49.1 ± 19) was recorded for female junior doctors working in anesthesia. The type of hospital did not influence the burnout score (university hospital 43.8 ± 19.8 versus public hospital 42.9 ± 19.1 versus private hospital 42.4 ± 18.7, p > 0.05). Working in a hospital was found to result in higher burnout scores than in a GP surgery or freelance work (43 ± 19.2 versus 38.1 ± 20.5; t(3531) = 5.0, p < 0.001)
Despite 40.1% of anesthetists being at high risk of burnout, generally speaking the risk of burnout among anesthetists was not higher than in other occupational groups in Germany. However, burnout risks for specific groups, such as female junior doctors in anesthesia, were higher and the possibility of providing social support in the workplace should be considered.
在德国,麻醉师和重症监护医生面临的需求显然在持续增加,人们开始讨论他们相较于普通劳动人口出现职业倦怠的风险增加的情况。此前,由于缺乏将德国劳动人口与麻醉师的职业倦怠风险进行比较的研究,这场讨论仅仅是推测性的。因此,不确定麻醉师是否真的如经常被认为的那样,面临更高的职业倦怠风险。此外,年龄、性别、职能、工作场所环境,例如在医院工作与在全科医生诊所工作相比,可能会影响职业倦怠的风险。所以,本研究调查了德国麻醉师患职业倦怠的风险是否真的高于其他职业。此外,还分析了影响麻醉师职业倦怠风险的因素。
对德国麻醉师填写的总共3541份关于工作满意度的调查问卷(哥本哈根职业倦怠量表,哥本哈根心理社会问卷COPSOQ的一部分,即CBI)进行了分析。除了计算患职业倦怠综合征高风险的参与者数量外,这些数据还用于计算所有参与者的综合职业倦怠得分。该得分与来自德国普通人群中代表各种职业的随机样本(n = 4709)以及德国医院医生的随机样本(n = 616)的数据进行了比较。此外,按性别、职能(高级顾问、主任医师、专科医生、初级医生)以及工作类型和地点(大学医院、公立医院、私立诊所、全科医生诊所、自由职业)形成亚组,并计算每组中患职业倦怠综合征高风险的比例。此外,对不同组之间的综合职业倦怠得分进行了统计学差异比较。
职业倦怠高风险的研究参与者比例为40.1%。发现性别(男性37.2%对女性46%)、资质(高级顾问28.9%、主任医师38%、专科医生41.5%、初级医生46.7%)以及在医院工作(41.3%)与在全科医生诊所工作(33.2%)之间存在差异。医院医生的随机样本(n = 616)的职业倦怠得分为49±19(平均值±标准差),相比之下,德国普通人群的随机样本(n = 4709)为44±19,麻醉师为42±19(p < 0.01)。在所形成的亚组中,麻醉科女性初级医生的得分最高(49.1±19)。医院类型未影响职业倦怠得分(大学医院43.8±19.8对公立医院42.9±19.1对私立医院42.4±18.7,p > 0.05)。发现与在全科医生诊所或自由职业相比,在医院工作导致更高的职业倦怠得分(43±19.2对38.1±20.5;t(3531) = 5.0,p < 0.001)
尽管40.1%的麻醉师面临高职业倦怠风险,但总体而言,德国麻醉师的职业倦怠风险并不高于其他职业群体。然而,特定群体,如麻醉科女性初级医生的职业倦怠风险更高,应考虑在工作场所提供社会支持的可能性。