澳大利亚全科住院医师韧性、倦怠和不确定性容忍度调查。
A survey of resilience, burnout, and tolerance of uncertainty in Australian general practice registrars.
机构信息
Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Queensland, Australia.
出版信息
BMC Med Educ. 2013 Jan 7;13:2. doi: 10.1186/1472-6920-13-2.
BACKGROUND
Burnout and intolerance of uncertainty have been linked to low job satisfaction and lower quality patient care. While resilience is related to these concepts, no study has examined these three concepts in a cohort of doctors. The objective of this study was to measure resilience, burnout, compassion satisfaction, personal meaning in patient care and intolerance of uncertainty in Australian general practice (GP) registrars.
METHODS
We conducted a paper-based cross-sectional survey of GP registrars in Australia from June to July 2010, recruited from a newsletter item or registrar education events. Survey measures included the Resilience Scale-14, a single-item scale for burnout, Professional Quality of Life (ProQOL) scale, Personal Meaning in Patient Care scale, Intolerance of Uncertainty-12 scale, and Physician Response to Uncertainty scale.
RESULTS
128 GP registrars responded (response rate 90%). Fourteen percent of registrars were found to be at risk of burnout using the single-item scale for burnout, but none met the criteria for burnout using the ProQOL scale. Secondary traumatic stress, general intolerance of uncertainty, anxiety due to clinical uncertainty and reluctance to disclose uncertainty to patients were associated with being at higher risk of burnout, but sex, age, practice location, training duration, years since graduation, and reluctance to disclose uncertainty to physicians were not.Only ten percent of registrars had high resilience scores. Resilience was positively associated with compassion satisfaction and personal meaning in patient care. Resilience was negatively associated with burnout, secondary traumatic stress, inhibitory anxiety, general intolerance to uncertainty, concern about bad outcomes and reluctance to disclose uncertainty to patients.
CONCLUSIONS
GP registrars in this survey showed a lower level of burnout than in other recent surveys of the broader junior doctor population in both Australia and overseas. Resilience was also lower than might be expected of a satisfied and professionally successful cohort.
背景
倦怠和无法容忍不确定性与低工作满意度和较低质量的患者护理有关。虽然适应力与这些概念有关，但没有研究在医生队列中研究这三个概念。本研究的目的是衡量澳大利亚全科医生（GP）住院医师的适应力、倦怠、同情心满足、患者护理中的个人意义和无法容忍不确定性。
方法
我们于 2010 年 6 月至 7 月对澳大利亚的 GP 住院医师进行了基于纸张的横断面调查，通过时事通讯项目或住院医师教育活动进行招募。调查措施包括 14 项适应力量表、一项倦怠单项目量表、职业生活质量（ProQOL）量表、患者护理中的个人意义量表、无法容忍不确定性-12 量表和医师对不确定性的反应量表。
结果
128 名 GP 住院医师做出了回应（回应率为 90%）。使用倦怠单项目量表发现，有 14%的住院医师有倦怠风险，但使用 ProQOL 量表则没有符合倦怠标准。继发性创伤应激、一般无法容忍不确定性、由于临床不确定性引起的焦虑以及不愿向患者透露不确定性与更高的倦怠风险相关，但性别、年龄、实践地点、培训时间、毕业年限以及不愿向医生透露不确定性则不相关。只有 10%的住院医师有较高的适应力评分。适应力与同情心满足和患者护理中的个人意义呈正相关。适应力与倦怠、继发性创伤应激、抑制性焦虑、一般无法容忍不确定性、对不良结果的关注以及不愿向患者透露不确定性呈负相关。
结论
在这项调查中，与澳大利亚和海外更广泛的初级医生人群的其他近期调查相比，GP 住院医师的倦怠程度较低。适应力也低于预期的满意度和专业成功群体。
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