Roberts Daniel L, Shanafelt Tait D, Dyrbye Liselotte N, West Colin P
Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Phoenix, Arizona.
J Hosp Med. 2014 Mar;9(3):176-81. doi: 10.1002/jhm.2146. Epub 2014 Jan 16.
General internists suffer higher rates of burnout and lower satisfaction with work-life balance than most specialties, but the impact of inpatient vs outpatient practice location is unclear.
Physicians in the American Medical Association Physician Masterfile were previously surveyed about burnout, depression, suicidal ideation, quality of life, fatigue, work-life balance, career plans, and health behaviors. We extracted and compared data for these variables for the 130 internal medicine hospitalists and 448 outpatient general internists who participated. Analyses were adjusted for age, sex, hours worked, and practice setting.
There were 52.3% of the hospitalists and 54.5% of the outpatient internists affected by burnout (P = 0.86). High scores on the emotional exhaustion subscale (43.8% vs 48.1%, P = 0.71) and on the depersonalization subscale (42.3% vs 32.7%, P = 0.17) were common but similar in frequency in the 2 groups. Hospitalists were more likely to score low on the personal accomplishment subscale (20.3% vs 9.6%, P = 0.04). There were no differences in symptoms of depression (40.3% for hospitalists vs 40.0% for outpatient internists, P = 0.73) or recent suicidality (9.2% vs 5.8%, P = 0.15). Rates of reported recent work-home conflict were similar (48.4% vs 41.3%, P = 0.64), but hospitalists were more likely to agree that their work schedule leaves enough time for their personal life and family (50.0% vs 42.0%, P = 0.007).
Burnout was common among both hospitalists and outpatient general internists, although hospitalists were more satisfied with work-life balance. A better understanding of the causes of distress and identification of solutions for all internists is needed.
与大多数专科相比，普通内科医生职业倦怠率更高，对工作与生活平衡的满意度更低，但住院部与门诊部的执业地点对其影响尚不清楚。
此前对美国医学协会医师主文件中的医生进行了关于职业倦怠、抑郁、自杀意念、生活质量、疲劳、工作与生活平衡、职业规划和健康行为的调查。我们提取并比较了参与调查的130名内科住院医师和448名门诊普通内科医生在这些变量上的数据。分析针对年龄、性别、工作时长和执业环境进行了调整。
52.3%的住院医师和54.5%的门诊内科医生受到职业倦怠的影响（P = 0.86）。两组中情感耗竭子量表高分者（43.8%对48.1%，P = 0.71）和去个性化子量表高分者（42.3%对32.7%，P = 0.17）都很常见且频率相似。住院医师在个人成就感子量表上得分较低的可能性更大（20.3%对9.6%，P = 0.04）。抑郁症状（住院医师为40.3%，门诊内科医生为40.0%，P = 0.73）或近期自杀倾向（9.2%对5.8%，P = 0.15）没有差异。报告的近期工作与家庭冲突发生率相似（48.4%对41.3%，P = 0.64），但住院医师更有可能认同他们的工作时间表为个人生活和家庭留出了足够时间（50.0%对42.0%，P = 0.007）。
职业倦怠在住院医师和门诊普通内科医生中都很常见，尽管住院医师对工作与生活平衡更满意。需要更好地了解困扰的原因并为所有内科医生确定解决方案。
