污名和个人经历对患有职业倦怠的医学生求助行为的影响。
The Impact of Stigma and Personal Experiences on the Help-Seeking Behaviors of Medical Students With Burnout.
作者信息
Dyrbye Liselotte N, Eacker Anne, Durning Steven J, Brazeau Chantal, Moutier Christine, Massie F Stanford, Satele Daniel, Sloan Jeff A, Shanafelt Tait D
机构信息
L.N. Dyrbye is professor of medicine and medical education, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. A. Eacker is associate professor of medicine, University of Washington School of Medicine, Seattle, Washington. S.J. Durning is professor of medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. C. Brazeau is professor of family medicine and psychiatry, Rutgers New Jersey Medical School, Newark, New Jersey. C. Moutier was professor of psychiatry, University of California, San Diego School of Medicine, San Diego, California, at the time of this study. She is now chief medical officer, American Foundation for Suicide Prevention, New York, New York. F.S. Massie is professor of medicine, University of Alabama School of Medicine, Birmingham, Alabama. D. Satele is statistician, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota. J.A. Sloan is professor of biostatistics and oncology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota. T.D. Shanafelt is professor of medicine, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota.
出版信息
Acad Med. 2015 Jul;90(7):961-9. doi: 10.1097/ACM.0000000000000655.
PURPOSE
Because of the high prevalence of burnout among medical students and its association with professional and personal consequences, the authors evaluated the help-seeking behaviors of medical students with burnout and compared their stigma perceptions with those of the general U.S. population and age-matched individuals.
METHOD
The authors surveyed students at six medical schools in 2012. They measured burnout, symptoms of depression, and quality of life using validated instruments and explored help-seeking behaviors, perceived stigma, personal experiences, and attitudes toward seeking mental health treatment.
RESULTS
Of 2,449 invited students, 873 (35.6%) responded. A third of respondents with burnout (154/454; 33.9%) sought help for an emotional/mental health problem in the last 12 months. Respondents with burnout were more likely than those without burnout to agree or strongly agree with 8 of 10 perceived stigma items. Respondents with burnout who sought help in the last 12 months were twice as likely to report having observed supervisors negatively judge students who sought care (odds ratio [OR] 2.06 [95% confidence interval (CI) 1.25-3.39], P < .01). They also were more likely to have observed peers reveal a student's emotional/mental health problem to others (OR 1.63 [95% CI 1.08-2.47], P = .02). A smaller percentage of respondents would definitely seek professional help for a serious emotional problem (235/872; 26.9%) than of the general population (44.3%) and age-matched individuals (38.8%).
CONCLUSIONS
Only a third of medical students with burnout seek help. Perceived stigma, negative personal experiences, and the hidden curriculum may contribute.
目的
鉴于医学生职业倦怠的高发生率及其与职业和个人后果的关联，作者评估了存在职业倦怠的医学生的求助行为，并将他们对污名的认知与美国普通人群以及年龄匹配个体的认知进行了比较。
方法
作者于2012年对六所医学院校的学生进行了调查。他们使用经过验证的工具测量职业倦怠、抑郁症状和生活质量，并探究求助行为、感知到的污名、个人经历以及对寻求心理健康治疗的态度。
结果
在2449名受邀学生中，873名（35.6%）做出了回应。三分之一存在职业倦怠的受访者（154/454；33.9%）在过去12个月中因情绪/心理健康问题寻求过帮助。存在职业倦怠的受访者比没有职业倦怠的受访者更有可能同意或强烈同意10项感知到的污名条目中的8项。在过去12个月中寻求过帮助的存在职业倦怠的受访者报告观察到上级对寻求治疗的学生进行负面评判的可能性是其他人的两倍（优势比[OR]为2.06[95%置信区间（CI）为1.25 - 3.39]，P <.01）。他们也更有可能观察到同龄人向他人透露学生的情绪/心理健康问题（OR为1.63[95%CI为1.08 - 2.47]，P =.02）。与普通人群（44.3%）和年龄匹配个体（38.8%）相比，肯定会为严重情绪问题寻求专业帮助的受访者比例更小（235/872；26.9%）。
结论
只有三分之一存在职业倦怠的医学生寻求帮助。感知到的污名、负面个人经历和隐性课程可能起到了作用。
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