Gazelle Gail, Liebschutz Jane M, Riess Helen
Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, POB 669, Brookline, MA, 02446, USA,
J Gen Intern Med. 2015 Apr;30(4):508-13. doi: 10.1007/s11606-014-3144-y. Epub 2014 Dec 20.
Twenty-five to sixty percent of physicians report burnout across all specialties. Changes in the healthcare environment have created marked and growing external pressures. In addition, physicians are predisposed to burnout due to internal traits such as compulsiveness, guilt, and self-denial, and a medical culture that emphasizes perfectionism, denial of personal vulnerability, and delayed gratification. Professional coaching, long utilized in the business world, provides a results-oriented and stigma-free method to address burnout, primarily by increasing one's internal locus of control. Coaching enhances self-awareness, drawing on individual strengths, questioning self-defeating thoughts and beliefs, examining new perspectives, and aligning personal values with professional duties. Coaching utilizes established techniques to increase one's sense of accomplishment, purpose, and engagement, all critical in ameliorating burnout. Coaching presumes that the client already possesses strengths and skills to handle life's challenges, but is not accessing them maximally. Although an evidence base is not yet established, the theoretical basis of coaching's efficacy derives from the fields of positive psychology, mindfulness, and self-determination theory. Using a case example, this article demonstrates the potential of professional coaching to address physician burnout.
25%至60%的医生表示,所有专业领域的医生都存在职业倦怠现象。医疗环境的变化带来了显著且不断增加的外部压力。此外,由于诸如强迫性、内疚感和自我否定等内在特质,以及强调完美主义、否认个人脆弱性和延迟满足感的医学文化,医生容易出现职业倦怠。长期以来在商业领域使用的专业辅导,提供了一种以结果为导向且无污名化的方法来应对职业倦怠,主要是通过增强个人的内在掌控感。辅导可提高自我意识,利用个人优势,质疑自我挫败的想法和信念,审视新观点,并使个人价值观与职业职责保持一致。辅导运用既定技巧来增强个人的成就感、目标感和参与感,所有这些对于缓解职业倦怠都至关重要。辅导假定客户已经具备应对生活挑战的优势和技能,但尚未充分发挥这些优势和技能。尽管尚未建立起实证依据,但辅导有效性的理论基础源自积极心理学、正念和自我决定理论等领域。本文通过一个案例展示了专业辅导在解决医生职业倦怠方面的潜力。