Chuang Chien-Huai, Tseng Pei-Chi, Lin Chun-Yu, Lin Kuan-Han, Chen Yen-Yuan
Department of Medical Education, National Taiwan University Hospital National Taiwan University College of Medicine Graduate Institute of Medical Education & Bioethics, National Taiwan University College of Medicine, Taipei, Taiwan.
Medicine (Baltimore). 2016 Dec;95(50):e5629. doi: 10.1097/MD.0000000000005629.
Burnout has been described as a prolonged response to chronic emotional and interpersonal stress on the job that is often the result of a period of expending excessive effort at work while having too little recovery time. Healthcare workers who work in a stressful medical environment, especially in an intensive care unit (ICU), may be particularly susceptible to burnout. In healthcare workers, burnout may affect their well-being and the quality of professional care they provide and can, therefore, be detrimental to patient safety. The objectives of this study were: to determine the prevalence of burnout in the ICU setting; and to identify factors associated with burnout in ICU professionals.
The original articles for observational studies were retrieved from PubMed, MEDLINE, and Web of Science in June 2016 using the following MeSH terms: "burnout" and "intensive care unit". Articles that were published in English between January 1996 and June 2016 were eligible for inclusion. Two reviewers evaluated the abstracts identified using our search criteria prior to full text review. To be included in the final analysis, studies were required to have employed an observational study design and examined the associations between any risk factors and burnout in the ICU setting.
Overall, 203 full text articles were identified in the electronic databases after the exclusion of duplicate articles. After the initial review, 25 studies fulfilled the inclusion criteria. The prevalence of burnout in ICU professionals in the included studies ranged from 6% to 47%. The following factors were reported to be associated with burnout: age, sex, marital status, personality traits, work experience in an ICU, work environment, workload and shift work, ethical issues, and end-of-life decision-making.
The impact of the identified factors on burnout remains poorly understood. Nevertheless, this review presents important information, suggesting that ICU professionals may suffer from a high level of burnout, potentially threatening patient care. Future work should address the effective management of the factors negatively affecting ICU professionals.
职业倦怠被描述为对工作中慢性情绪和人际压力的长期反应,这通常是在工作中过度投入精力而恢复时间过少的一段时间后的结果。在压力大的医疗环境中工作的医护人员,尤其是在重症监护病房(ICU)工作的人员,可能特别容易出现职业倦怠。在医护人员中,职业倦怠可能会影响他们的幸福感以及他们提供的专业护理质量,因此可能对患者安全有害。本研究的目的是:确定重症监护病房环境中职业倦怠的患病率;并确定与重症监护病房专业人员职业倦怠相关的因素。
2016年6月,使用以下医学主题词从PubMed、MEDLINE和科学网检索观察性研究的原始文章:“职业倦怠”和“重症监护病房”。1996年1月至2016年6月期间以英文发表的文章符合纳入条件。两名评审员在进行全文评审之前,先评估根据我们的搜索标准确定的摘要。要纳入最终分析,研究必须采用观察性研究设计,并研究重症监护病房环境中任何风险因素与职业倦怠之间的关联。
总体而言,排除重复文章后,在电子数据库中识别出203篇全文文章。初步评审后,25项研究符合纳入标准。纳入研究中重症监护病房专业人员的职业倦怠患病率在6%至47%之间。据报道,以下因素与职业倦怠相关:年龄、性别、婚姻状况、性格特征、在重症监护病房的工作经验、工作环境、工作量和轮班工作、伦理问题以及临终决策。
已确定的因素对职业倦怠的影响仍知之甚少。然而,本综述提供了重要信息,表明重症监护病房专业人员可能遭受高水平的职业倦怠,这可能威胁到患者护理。未来的工作应解决对重症监护病房专业人员产生负面影响的因素的有效管理问题。