Service de Réanimation Médicale, CHU Dijon, Dijon, France.
Intensive Care Med. 2012 Jan;38(1):55-61. doi: 10.1007/s00134-011-2413-z. Epub 2011 Nov 30.
Burnout syndrome (BOS) has frequently been reported in healthcare workers, and precipitating factors include communication problems in the workplace and stress related to end-of-life situations. We evaluated the effect of an intensive communication strategy on BOS among caregivers working in intensive care (ICU).
Longitudinal, monocentric, before-and-after, interventional study. BOS was evaluated using the Maslach Burnout Inventory (MBI) and depression using the Centre for Epidemiologic Studies Depression Scale (CES-D) in 2007 (period 1) and 2009 (period 2). Between periods, an intensive communication strategy on end-of-life practices was implemented, based on improved organisation, better communication, and regular staff meetings.
Among 62 caregivers in the ICU, 53 (85%) responded to both questionnaires in period 1 and 49 (79%) in period 2. We observed a significant difference between periods in all three components of the MBI (emotional exhaustion, p = 0.04; depersonalization p = 0.04; personal accomplishment, p = 0.01). MBI classified burnout as severe in 15 (28%) caregivers in period 1 versus 7 (14%) in period 2, p < 0.01, corresponding to a 50% risk reduction. Symptoms of depression as evaluated by the CES-D were present in 9 (17%) caregivers in period 1 versus 3 (6%) in period 2, p < 0.05, corresponding to a risk reduction of almost 60%.
The implementation of an active, intensive communication strategy regarding end-of-life care in the ICU was associated with a significant reduction in the rate of burnout syndrome and depression in a stable population of caregiving staff.
burnout 综合征（BOS）在医护人员中经常被报道，其诱发因素包括工作场所的沟通问题和与临终情况相关的压力。我们评估了在重症监护病房（ICU）工作的护理人员中强化沟通策略对 BOS 的影响。
纵向、单中心、前后对照、干预研究。在 2007 年（第 1 期）和 2009 年（第 2 期）使用 Maslach 倦怠量表（MBI）和抑郁中心流行病学研究量表（CES-D）评估 BOS。在两个时期之间，实施了基于改善组织、更好的沟通和定期员工会议的强化临终实践沟通策略。
在 ICU 的 62 名护理人员中，有 53 名（85%）在第 1 期和 49 名（79%）在第 2 期对两个问卷都有反应。我们观察到 MBI 的所有三个组成部分在两个时期之间都有显著差异（情感衰竭，p = 0.04；去人性化，p = 0.04；个人成就感，p = 0.01）。MBI 在第 1 期将 15 名（28%）护理人员分类为严重倦怠，而在第 2 期则为 7 名（14%），p < 0.01，风险降低 50%。CES-D 评估的抑郁症状在第 1 期有 9 名（17%）护理人员，而在第 2 期有 3 名（6%），p < 0.05，风险降低近 60%。
在 ICU 中实施积极的、强化的临终关怀沟通策略与稳定的护理人员群体中 BOS 和抑郁发生率的显著降低相关。
