Department of Business Administration, University of Manitoba, 181 Freedman Crescent, Winnipeg, MB R3T 5V4, Canada.
Hum Resour Health. 2013 Sep 28;11:48. doi: 10.1186/1478-4491-11-48.
Health care organizations globally realize the need to address physician burnout due to its close linkages with quality of care, retention and migration. The many functions of health human resources include identifying and managing burnout risk factors for health professionals, while also promoting effective coping. Our study of physician burnout aims to show: (1) which correlates are most strongly associated with emotional exhaustion (EE) and depersonalization (DP), and (2) whether the associations vary across regions and specialties.
Meta-analysis allowed us to examine a diverse range of correlates. Our search yielded 65 samples of physicians from various regions and specialties.
EE was negatively associated with autonomy, positive work attitudes, and quality and safety culture. It was positively associated with workload, constraining organizational structure, incivility/conflicts/violence, low quality and safety standards, negative work attitudes, work-life conflict, and contributors to poor mental health. We found a similar but weaker pattern of associations for DP.Physicians in the Americas experienced lower EE levels than physicians in Europe when quality and safety culture and career development opportunities were both strong, and when they used problem-focused coping. The former experienced higher EE levels when work-life conflict was strong and they used ineffective coping. Physicians in Europe experienced lower EE levels than physicians in the Americas with positive work attitudes. We found a similar but weaker pattern of associations for DP.Outpatient specialties experienced higher EE levels than inpatient specialties when organization structures were constraining and contributors to poor mental health were present. The former experienced lower EE levels when autonomy was present. Inpatient specialties experienced lower EE levels than outpatient specialties with positive work attitudes. As above, we found a similar but weaker pattern of associations for DP.
Although we could not infer causality, our findings suggest: (1) that EE represents the core burnout dimension; (2) that certain individual and organizational-level correlates are associated with reduced physician burnout; (3) the benefits of directing resources where they are most needed to physicians of different regions and specialties; and (4) a call for research to link physician burnout with performance.
全球医疗保健组织认识到需要解决医生职业倦怠问题，因为它与医疗质量、保留和迁移密切相关。卫生人力资源的许多职能包括识别和管理卫生专业人员的职业倦怠风险因素，同时促进有效应对。我们对医生职业倦怠的研究旨在表明：(1)哪些相关因素与情绪疲惫(EE)和去人格化(DP)最密切相关，(2)这些关联是否因地区和专业而异。
元分析使我们能够检查广泛的相关因素。我们的搜索结果是来自不同地区和专业的 65 名医生样本。
EE 与自主性、积极的工作态度以及质量和安全文化呈负相关。它与工作量、限制组织结构、不文明/冲突/暴力、低质量和安全标准、消极的工作态度、工作-生活冲突以及导致心理健康不佳的因素呈正相关。我们发现 DP 也存在类似但较弱的关联模式。当质量和安全文化以及职业发展机会都很强，并且当他们使用问题焦点应对时，美洲的医生经历的 EE 水平低于欧洲的医生。当工作-生活冲突强烈且他们使用无效应对时，前者经历的 EE 水平更高。欧洲的医生比美洲的医生有更高的 EE 水平，当工作态度积极时，EE 水平更高。我们发现 DP 也存在类似但较弱的关联模式。当组织结构受到限制且存在导致心理健康不佳的因素时，门诊专业人员的 EE 水平高于住院专业人员。当自主性存在时，前者经历的 EE 水平较低。当工作态度积极时，住院专业人员的 EE 水平低于门诊专业人员。与上述情况类似，我们发现 DP 也存在类似但较弱的关联模式。
尽管我们无法推断因果关系，但我们的研究结果表明：(1) EE 代表核心倦怠维度；(2)某些个体和组织层面的相关因素与减少医生倦怠有关；(3)需要将资源分配给不同地区和专业的医生；(4)呼吁研究将医生倦怠与绩效联系起来。
