Chambers Charlotte N L, Frampton Christopher M A, Barclay Murray, McKee Martin
Association of Salaried Medical Specialists, Wellington, New Zealand.
University of Otago, Christchurch, New Zealand.
BMJ Open. 2016 Nov 23;6(11):e013947. doi: 10.1136/bmjopen-2016-013947.
To explore the prevalence of, and associated factors contributing to burnout among senior doctors and dentists working in the New Zealand's public health system.
Cross-sectional, mixed methods study.
New Zealand's 20 district health boards (DHBs).
A total of 1487 of 3740 senior doctors and dentists who are members of the Association of Salaried Medical Specialists working in DHBs were recruited (response rate 40%).
Gender, age, self-rated health status, vocation and hours of work per week were obtained from an electronic questionnaire. Burnout was measured using the Copenhagen Burnout Inventory. Qualitative data taken from an open-ended comments section was coded using grounded theory and used for contextual data.
The overall prevalence of high personal burnout was 50%. Women aged <40 years had 71% prevalence of high personal burnout. Prevalence of high work-related burnout and patient-related burnout was 42% and 16%, respectively. Those working in emergency medicine and psychiatry had significantly higher mean work-related burnout than other specialties (p<0.001). On multivariate analysis, having fair or poor health status (OR 10.8, 95% CI 6.8 to 17.1), working more than 14 consecutive hours (OR 1.43, 95% CI 1.12 to 1.82) and being a woman (OR 2.14, 95% CI 1.68 to 2.73) were independently associated with high personal and work-related burnout. Personal burnout rates decreased with age (age 30-39 OR 2.86, 95% CI 1.78 to 4.59, age 40-49 OR 2.45, 95% CI 1.70 to 3.55, age 50-59 OR 1.70, 95% CI 1.17 to 2.46, compared with age>60). Qualitative data emphasised intense and unrelenting workloads, under-staffing, onerous on-call duties and frustrations with management as factors contributing to burnout.
High burnout appears prevalent in New Zealand's senior doctors and dentists. Many attribute their feelings of burnout to work conditions. These findings may assist with understanding contributors to burnout and with developing strategies to ameliorate the high burnout found across this cohort.
探讨在新西兰公共卫生系统工作的资深医生和牙医职业倦怠的患病率及相关影响因素。
横断面混合方法研究。
新西兰的20个地区卫生委员会(DHBs)。
在地区卫生委员会工作的3740名受雇医学专家协会资深医生和牙医中,共招募了1487人(回复率40%)。
通过电子问卷获取性别、年龄、自评健康状况、职业和每周工作时长。使用哥本哈根职业倦怠量表测量职业倦怠。从开放式评论部分获取的定性数据采用扎根理论进行编码,并用作背景数据。
高度个人职业倦怠的总体患病率为50%。年龄<40岁的女性高度个人职业倦怠患病率为71%。高度工作相关职业倦怠和患者相关职业倦怠的患病率分别为42%和16%。从事急诊医学和精神病学工作的人员,其工作相关职业倦怠的平均水平显著高于其他专业(p<0.001)。多因素分析显示,健康状况一般或较差(比值比10.8,95%置信区间6.8至17.1)、连续工作超过14小时(比值比1.43,95%置信区间1.12至1.82)以及女性(比值比2.14,95%置信区间1.68至2.73)与高度个人职业倦怠和工作相关职业倦怠独立相关。个人职业倦怠率随年龄增长而降低(30 - 39岁比值比2.86,95%置信区间1.78至4.59;40 - 49岁比值比2.45,95%置信区间1.70至3.55;50 - 59岁比值比1.70,95%置信区间1.17至2.46,与>60岁相比)。定性数据强调高强度且持续的工作量、人员不足、繁重的值班职责以及对管理的不满是导致职业倦怠的因素。
职业倦怠在新西兰资深医生和牙医中似乎普遍存在。许多人将职业倦怠感归因于工作条件。这些发现可能有助于理解职业倦怠的影响因素,并制定策略来改善该群体中普遍存在的高度职业倦怠状况。