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肿瘤内科住院医师职业倦怠:巴西机构的一项前瞻性多中心队列研究

"Burnout in Medical Oncology Fellows: a Prospective Multicenter Cohort Study in Brazilian Institutions".

作者信息

Cubero Daniel I G, Fumis Renata Rego Lins, de Sá Thiago Hérick, Dettino Aldo, Costa Felipe Osório, Van Eyll Brigitte M R H Adam, Beato Carlos, Peria Fernanda Maris, Mota Augusto, Altino José, Azevedo Sérgio Jobim, da Rocha Filho Duílio Reis, Moura Melba, Lessa Álvaro Edson Ramos, Del Giglio Auro

机构信息

Department of Oncology and Hematology, ABC Foundation School of Medicine, 821 Av Principe de Gales, Anexo 3, Santo André, SP, 09060-650, Brazil.

Sírio Libanês Hospital, 91 Rua Dona Adma Jafet - Bela, 01308-050, São Paulo, Brazil.

出版信息

J Cancer Educ. 2016 Sep;31(3):582-7. doi: 10.1007/s13187-015-0850-z.

Abstract

Burnout syndrome is a common occurrence among oncologists. Doctors enrolled in residency programs in clinical oncology are exposed to similar risk factors; however, few data are available in this population. This study assessed the occurrence of burnout and associated factors among first-year residents at Brazilian institutions. The present prospective, multicenter, cohort study was conducted with doctors enrolled in residency programs in clinical oncology at Brazilian institutions affiliated with the public health system. The participants answered a sociodemographic questionnaire, the Maslach Burnout Inventory (MBI), Lipp's Stress Inventory, and the Beck Depression Inventory (BDI), upon admission to the program and 6 and 12 months later. Of 37 eligible residency programs in 2009, 11 (30.6 %) agreed to participate in the study. Fifty-four residents, representing 100 % of new admissions to the participating institutions, were included. Most of the participants met the criteria for severe burnout upon admission to the residency programs (emotional exhaustion in 49.0 % and depersonalization in 64.7 %). The scores on MBI domains emotional exhaustion and depersonalization increased significantly (p < 0.01) during the first year of residency, and the prevalence of burnout increased to 88 % at the end of that first year. The present study found a high prevalence of burnout among doctors enrolled in residency programs in clinical oncology at Brazilian institutions. A large fraction of the participants met the criteria for burnout syndrome upon admission to the program, which suggests that the problem began during the course of the previous residency program in internal medicine.

摘要

职业倦怠综合征在肿瘤学家中很常见。参加临床肿瘤学住院医师培训项目的医生也面临类似的风险因素;然而,关于这一人群的数据却很少。本研究评估了巴西各机构一年级住院医师职业倦怠的发生率及相关因素。本前瞻性、多中心队列研究是针对巴西公共卫生系统附属机构中参加临床肿瘤学住院医师培训项目的医生开展的。参与者在项目入学时、6个月后和12个月后分别回答了一份社会人口学问卷、马氏职业倦怠量表(MBI)、利普压力量表和贝克抑郁量表(BDI)。2009年,在37个符合条件的住院医师培训项目中,有11个(30.6%)同意参与研究。纳入了54名住院医师,占参与机构新入院人数的100%。大多数参与者在进入住院医师培训项目时就符合严重职业倦怠的标准(情感耗竭率为49.0%,去人格化率为64.7%)。在住院医师培训的第一年,MBI量表中情感耗竭和去人格化领域的得分显著增加(p<0.01),到第一年结束时,职业倦怠的患病率升至88%。本研究发现,巴西各机构参加临床肿瘤学住院医师培训项目的医生中职业倦怠的患病率很高。很大一部分参与者在进入该项目时就符合职业倦怠综合征的标准,这表明该问题在之前的内科住院医师培训期间就已开始。

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