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重症监护专科住院医师的压力与职业倦怠:一项教育干预措施的初步评估

Stress and burnout among critical care fellows: preliminary evaluation of an educational intervention.

作者信息

Kashani Kianoush, Carrera Perliveh, De Moraes Alice Gallo, Sood Amit, Onigkeit James A, Ramar Kannan

机构信息

Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, USA.

Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA;

出版信息

Med Educ Online. 2015 Jul 23;20:27840. doi: 10.3402/meo.v20.27840. eCollection 2015.

Abstract

BACKGROUND

Despite a demanding work environment, information on stress and burnout of critical care fellows is limited.

OBJECTIVES

To assess 1) levels of burnout, perceived stress, and quality of life in critical care fellows, and 2) the impact of a brief stress management training on these outcomes.

METHODS

In a tertiary care academic medical center, 58 critical care fellows of varying subspecialties and training levels were surveyed to assess baseline levels of stress and burnout. Twenty-one of the 58 critical care fellows who were in the first year of training at the time of this initial survey participated in a pre-test and 1-year post-test to determine the effects of a brief, 90-min stress management intervention.

RESULTS

Based on responses (n=58) to the abbreviated Maslach Burnout Inventory, reported burnout was significantly lower in Asian fellows (p=0.04) and substantially higher among graduating fellows (versus new and transitioning fellows) (p=0.02). Among the intervention cohort, burnout did not significantly improve--though two-thirds of fellows reported using the interventional techniques to deal with stressful situations. Fellows who participated in the intervention rated the effectiveness of the course as 4 (IQR=3.75-5) using the 5-point Likert scale.

CONCLUSIONS

In comparison with the new and transitioning trainees, burnout was highest among graduating critical care fellows. Although no significant improvements were found in first-year fellows' burnout scores following the single, 90-min training intervention, participants felt the training did provide them with tools to apply during stressful situations.

摘要

背景

尽管工作环境要求苛刻,但关于重症监护专科住院医师压力和职业倦怠的信息有限。

目的

1)评估重症监护专科住院医师的职业倦怠水平、感知压力和生活质量;2)评估简短的压力管理培训对这些结果的影响。

方法

在一家三级医疗学术医学中心,对58名不同亚专业和培训水平的重症监护专科住院医师进行了调查,以评估压力和职业倦怠的基线水平。在初次调查时处于培训第一年的58名重症监护专科住院医师中的21人参加了预测试和1年后的测试,以确定为期90分钟的简短压力管理干预的效果。

结果

根据对简化版马氏职业倦怠量表的回答(n = 58),报告的职业倦怠在亚洲住院医师中显著较低(p = 0.04),而在即将毕业的住院医师中(与新入职和过渡阶段的住院医师相比)则显著较高(p = 0.02)。在干预队列中,职业倦怠没有显著改善——尽管三分之二的住院医师报告使用干预技术来应对压力情况。使用5点李克特量表,参加干预的住院医师对课程效果的评分是4(四分位距 = 3.75 - 5)。

结论

与新入职和过渡阶段的受训人员相比,即将毕业的重症监护专科住院医师职业倦怠程度最高。尽管在单次90分钟的培训干预后,一年级住院医师的职业倦怠得分没有显著改善,但参与者认为培训确实为他们提供了在压力情况下可以应用的工具。

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