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农村医疗保健网络中医疗服务人员职业倦怠单项筛查措施的验证

Validation of Single-Item Screening Measures for Provider Burnout in a Rural Health Care Network.

作者信息

Waddimba Anthony C, Scribani Melissa, Nieves Melinda A, Krupa Nicole, May John J, Jenkins Paul

机构信息

Bassett Healthcare Network Research Institute, Cooperstown, NY, USA Columbia University College of Physicians and Surgeons, New York, NY, USA

Bassett Healthcare Network Research Institute, Cooperstown, NY, USA.

出版信息

Eval Health Prof. 2016 Jun;39(2):215-25. doi: 10.1177/0163278715573866. Epub 2015 Feb 24.

Abstract

We validated three single-item measures for emotional exhaustion (EE) and depersonalization (DP) among rural physician/nonphysician practitioners. We linked cross-sectional survey data (on provider demographics, satisfaction, resilience, and burnout) with administrative information from an integrated health care network (1 academic medical center, 6 community hospitals, 31 clinics, and 19 school-based health centers) in an eight-county underserved area of upstate New York. In total, 308 physicians and advanced-practice clinicians completed a self-administered, multi-instrument questionnaire (65.1% response rate). Significant proportions of respondents reported high EE (36.1%) and DP (9.9%). In multivariable linear mixed models, scores on EE/DP subscales of the Maslach Burnout Inventory were regressed on each single-item measure. The Physician Work-Life Study's single-item measure (classifying 32.8% of respondents as burning out/completely burned out) was correlated with EE and DP (Spearman's ρ = .72 and .41, p < .0001; Kruskal-Wallis χ(2) = 149.9 and 56.5, p < .0001, respectively). In multivariable models, it predicted high EE (but neither low EE nor low/high DP). EE/DP single items were correlated with parent subscales (Spearman's ρ = .89 and .81, p < .0001; Kruskal-Wallis χ(2) = 230.98 and 197.84, p < .0001, respectively). In multivariable models, the EE item predicted high/low EE, whereas the DP item predicted only low DP. Therefore, the three single-item measures tested varied in effectiveness as screeners for EE/DP dimensions of burnout.

摘要

我们验证了针对农村医生/非医生从业者的情绪耗竭(EE)和去个性化(DP)的三项单项测量指标。我们将横断面调查数据(关于提供者的人口统计学、满意度、恢复力和职业倦怠情况)与纽约州北部一个八县服务不足地区的综合医疗保健网络(1家学术医疗中心、6家社区医院、31家诊所和19家学校健康中心)的行政信息相联系。共有308名医生和高级执业临床医生完成了一份自行填写的多仪器问卷(回复率为65.1%)。相当比例的受访者报告有较高的EE(36.1%)和DP(9.9%)。在多变量线性混合模型中,用每项单项测量指标对马氏职业倦怠量表的EE/DP子量表得分进行回归分析。医师工作与生活研究的单项测量指标(将32.8%的受访者归类为职业倦怠/完全职业倦怠)与EE和DP相关(斯皮尔曼相关系数ρ分别为0.72和0.41,p < 0.0001;克鲁斯卡尔-沃利斯检验χ(2)分别为149.9和56.5,p < 0.0001)。在多变量模型中,它预测了较高的EE(但不是较低的EE,也不是低/高DP)。EE/DP单项指标与相应的子量表相关(斯皮尔曼相关系数ρ分别为0.89和0.81,p < 0.0001;克鲁斯卡尔-沃利斯检验χ(2)分别为230.98和197.84,p < 0.0001)。在多变量模型中,EE单项指标预测了高/低EE,而DP单项指标仅预测了低DP。因此,所测试的三项单项测量指标作为职业倦怠的EE/DP维度筛查工具,其有效性各不相同。

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