Raj Kristin S
J Grad Med Educ. 2016 Dec;8(5):674-684. doi: 10.4300/JGME-D-15-00764.1.
Rates of physician burnout have increased in recent years, and high burnout levels are reported by physicians in training.
This review of the research on resident well-being seeks to identify factors associated with well-being, summarize well-being promotion interventions, and provide a framework for future research efforts.
Keywords were used to search PubMed, PsycINFO, and MEDLINE. Studies included were conducted between 1989 and 2014. The search yielded 82 articles, 26 which met inclusion criteria, and were assessed using the Medical Education Research Study Quality Instrument.
Articles measured resident well-being and associated factors, predictors, effects, barriers, as well as interventions to improve well-being. Factors identified in psychological well-being research-autonomy, building of competence, and strong social relatedness-are associated with resident well-being. Sleep and time away from work are associated with greater resident well-being. Perseverance is predictive of well-being, and greater well-being is associated with increased empathy. Interventions focused on health and coping skills appear to improve well-being, although the 3 studies that examined interventions were limited by small samples and single site administration.
An important step in evolving research in this area entails the development of a clear definition of resident well-being and a scale for measuring the construct. The majority (n = 17, 65%) of existing studies are cross-sectional analyses of factors associated with well-being. The literature summarized in this review suggests future research should focus on factors identified in cross-sectional studies, including sleep, coping mechanisms, resident autonomy, building competence, and enhanced social relatedness.
近年来，医生职业倦怠率有所上升，且培训中的医生报告称职业倦怠程度较高。
本综述对住院医师幸福感的研究进行分析，旨在确定与幸福感相关的因素，总结促进幸福感的干预措施，并为未来的研究工作提供框架。
使用关键词检索PubMed、PsycINFO和MEDLINE。纳入的研究时间跨度为1989年至2014年。检索共得到82篇文章，其中26篇符合纳入标准，并使用医学教育研究质量工具进行评估。
文章测量了住院医师的幸福感及其相关因素、预测因素、影响因素、障碍因素以及改善幸福感的干预措施。心理健康研究中确定的因素——自主性、能力培养和强烈的社会关系——与住院医师的幸福感相关。睡眠和工作之余的时间与更高的住院医师幸福感相关。毅力可预测幸福感，更高的幸福感与同理心增强相关。尽管有3项研究对干预措施进行了检验，但这些研究因样本量小和单中心实施而受到限制，不过专注于健康和应对技能的干预措施似乎能改善幸福感。
该领域研究发展的一个重要步骤是明确住院医师幸福感的定义并制定衡量该概念的量表。现有研究中的大多数（n = 17，65%）是对与幸福感相关因素的横断面分析。本综述总结的文献表明，未来的研究应关注横断面研究中确定的因素，包括睡眠、应对机制、住院医师自主性、能力培养和增强社会关系。
