Department of Medicine, College of Medicine, Mayo Clinic, Rochester, MN 55906, USA.
Acad Med. 2012 Aug;87(8):1024-31. doi: 10.1097/ACM.0b013e31825cfa35.
Although burnout is associated with erosion of professionalism and serious personal consequences, whether positive mental health can enhance professionalism and how it shapes personal experience remain poorly understood. The study simultaneously explores the relationship between positive mental health and burnout with professionalism and personal experience.
The authors surveyed 4,400 medical students at seven U.S. medical schools in 2009 to assess mental health (categorized as languishing, moderate, and flourishing) and burnout. Additional items explored professional behaviors, beliefs, suicidal ideation, and serious thoughts of dropping out.
A total of 2,682/4,400 (61%) responded. Prevalence of suicidal ideation (55/114 [48.2%], 281/1,128 [24.9%], and 127/1,409 [9.1%]) and serious thoughts of dropping out (15/114 [13.2%], 30/1,128 [2.7%], and 14/1,409 [1.0%]) decreased as mental health improved from languishing, moderate, and flourishing, respectively (all P < .0001); this relationship between personal experience and mental health persisted independent of burnout (all P < .001). As mental health improved, the prevalence of unprofessional behaviors (i.e., cheating and dishonest behaviors) also declined, whereas students' altruistic beliefs regarding physicians' responsibility toward society improved. For example, 33/113 (29.2%), 426/1,120 (38.0%), and 718/1,391 (51.6%) of students with languishing, moderate, and flourishing mental health endorsed all five altruistic professional beliefs (P < .0001). The relationship between professional beliefs and mental health persisted among students with burnout, whereas fewer relationships were found among students without burnout.
Findings suggest that positive mental health attenuates some adverse consequences of burnout. Medical student wellness programs should aspire to prevent burnout and promote mental health.
尽管倦怠与专业精神的侵蚀和严重的个人后果有关，但积极的心理健康是否能增强专业精神以及它如何塑造个人体验仍知之甚少。本研究同时探讨了积极的心理健康与倦怠与专业精神和个人体验的关系。
作者于 2009 年在美国七所医学院的 4400 名医学生中进行了调查，以评估心理健康（分为萎靡、中等和繁荣）和倦怠。其他项目探讨了专业行为、信仰、自杀意念和严重辍学念头。
共有 2682/4400（61%）人作出回应。自杀意念的发生率（55/114 [48.2%]、281/1128 [24.9%]和 127/1409 [9.1%]）和严重辍学念头的发生率（15/114 [13.2%]、30/1128 [2.7%]和 14/1409 [1.0%]）随着心理健康从萎靡、中等和繁荣依次改善而降低（均 P<.0001）；这种个人体验和心理健康之间的关系在独立于倦怠的情况下仍然存在（均 P<.001）。随着心理健康的改善，不专业行为（即欺骗和不诚实行为）的发生率也有所下降，而学生对医生对社会的责任的利他主义信仰也有所改善。例如，33/113（29.2%）、426/1120（38.0%）和 718/1391（51.6%）有萎靡、中等和繁荣心理健康的学生都认可所有五个利他主义专业信仰（P<.0001）。在有倦怠的学生中，专业信仰和心理健康之间的关系仍然存在，而在没有倦怠的学生中，这种关系则较少。
研究结果表明，积极的心理健康可以减轻倦怠的一些不良后果。医学生健康计划应该旨在预防倦怠和促进心理健康。
