Doolittle Benjamin R, Windish Donna M
Department of Internal Medicine, Yale University School of Medicine, New Haven, USA ; Department of Pediatrics, Yale University School of Medicine, New Haven, USA.
Department of Internal Medicine, Yale University School of Medicine, New Haven, USA.
J Educ Eval Health Prof. 2015 Aug 1;12:41. doi: 10.3352/jeehp.2015.12.41. eCollection 2015.
This study aimed to determine the correlation of burnout syndrome with specific coping strategies, behaviors, and spiritual attitudes among interns in internal medicine, primary care, and internal medicine/pediatrics residency programs at two institutions.
Intern physicians completed anonymous voluntary surveys prior to starting the internship in June 2009 and in the middle of the internship in February 2010. Three validated survey instruments were used to explore burnout, coping, and spiritual attitudes: the Maslach Burnout Inventory, the COPE Inventory, and the Hatch Spiritual Involvement and Beliefs Scale. The interns were in programs at the Yale University School of Medicine and a Yale-affiliated community hospital, New Haven, Connecticut, USA.
The prevalence of self-identified burnout prior to starting the internship was 1/66 (1.5%) in June 2009, increasing to 10/53 (18.9%) in February 2010 (P<0.0001). From June 2009 to February 2010, the prevalence of high emotional exhaustion increased from 30/66 (45.5%) to 45/53 (84.9%) (P<0.0001), and that of high depersonalization increased from 42/66 (63.6%) to 45/53 (84.9%) (P=0.01). Interns who employed the strategies of acceptance and active coping were less likely to experience emotional exhaustion and depersonalization (P<0.05). Perceptions of high personal accomplishment was 75.5% and was positively correlated with total scores on the Hatch Spiritual Involvement and Beliefs Scale, as well as the internal/fluid and existential/meditative domains of that instrument. Specific behaviors did not impact burnout.
Burnout increased during the intern year. Acceptance, active coping, and spirituality were correlated with less burnout. Specific behaviors were not correlated with burnout domains.
本研究旨在确定两所机构内科、初级保健以及内科/儿科住院医师培训项目实习生的职业倦怠综合征与特定应对策略、行为及精神态度之间的相关性。
实习医生于2009年6月开始实习前及2010年2月实习中期完成了匿名自愿调查。使用了三种经过验证的调查工具来探究职业倦怠、应对方式及精神态度：马氏职业倦怠量表、应对方式量表以及哈奇精神参与和信念量表。这些实习生来自美国康涅狄格州纽黑文市的耶鲁大学医学院及一家耶鲁附属社区医院的项目。
2009年6月开始实习前自我认定职业倦怠的发生率为1/66（1.5%），到2010年2月增至10/53（18.9%）（P<0.0001）。从2009年6月到2010年2月，高情感耗竭的发生率从30/66（45.5%）增至45/53（84.9%）（P<0.0001），高去个性化的发生率从42/66（63.6%）增至45/53（84.9%）（P=0.01）。采用接受和积极应对策略的实习生经历情感耗竭和去个性化的可能性较小（P<0.05）。高个人成就感的认知为75.5%，且与哈奇精神参与和信念量表的总分以及该量表的内在/流动和存在/冥想领域呈正相关。特定行为并未影响职业倦怠。
实习期间职业倦怠有所增加。接受、积极应对和精神性与较少的职业倦怠相关。特定行为与职业倦怠领域无关。
