Ifediora Chris
School of Medicine, Griffith University, Gold Coast Campus, QLD, Australia.
Australas Med J. 2015 Nov 30;8(11):345-56. doi: 10.4066/AMJ.2015.2523. eCollection 2015.
The after-hours house call (AHHC) service in Australia is growing, but studies have never explored the doctor variables associated with burnout and stress within the service. This study fills this knowledge gap.
To determine the doctor variables associated with burnout and stress among doctors involved in AHHC.
A quantitative, questionnaire-based survey of all 300 doctors engaged in AHHC through the National Home Doctor Service (NHDS), Australia's largest home visiting doctor-service provider. The Maslach Burnout Inventory (MBI) was used to assess burnout over a 12-month period from October 2013 to September 2014. Ordinal logistics regression was used to identify significant associations.
There were 168 valid responses received, giving a 56 per cent response rate. The most significant factor associated with reduced stress and burnout is the adoption of self-protection measures while on the job. Such measures include the use of chaperones, the use of panic alarms or buttons, adopting de-escalation techniques, and reliance on relevant surgery policies. Other associations with reduced stress include the attainment of postgraduate fellowships (vocational registration), working less than 24 hours per week, being in legally recognised partnerships, and being male. Conversely, having general practice as a career, being under 40 years of age, and obtaining primary medical degrees from Australia (as opposed to overseas) are all associated with increased burnout for doctors involved in AHHC.
A number of doctor variables have been found to significantly reduce burnout in AHHC Among these, the adoption of self-protective measures and the attainment postgraduate fellowships, where possible, should be encouraged among practitioners involved in the service.
澳大利亚的非工作时间上门出诊(AHHC)服务正在增加,但此前的研究从未探讨过该服务中与职业倦怠和压力相关的医生变量。本研究填补了这一知识空白。
确定参与AHHC的医生中与职业倦怠和压力相关的医生变量。
对通过澳大利亚最大的上门出诊医生服务提供商国家家庭医生服务(NHDS)参与AHHC的所有300名医生进行了一项基于问卷的定量调查。使用马氏职业倦怠量表(MBI)评估2013年10月至2014年9月这12个月期间的职业倦怠情况。采用有序逻辑回归来确定显著关联。
共收到168份有效回复,回复率为56%。与压力和职业倦怠减轻最显著相关的因素是在工作时采取自我保护措施。这些措施包括使用陪护人员、使用紧急报警装置或按钮、采用降级技术以及依靠相关的手术政策。与压力减轻相关的其他因素包括获得研究生奖学金(职业注册)、每周工作少于24小时、处于法律认可的伴侣关系以及为男性。相反,以全科医学为职业、年龄在40岁以下以及从澳大利亚(而非海外)获得初级医学学位,这些都与参与AHHC的医生职业倦怠增加有关。
已发现一些医生变量能显著降低AHHC中的职业倦怠。其中,应鼓励参与该服务的从业者在可能的情况下采取自我保护措施并获得研究生奖学金。