Chaukos Deanna, Chad-Friedman Emma, Mehta Darshan H, Byerly Laura, Celik Alper, McCoy Thomas H, Denninger John W
Massachusetts General Hospital, Boston, MA, USA.
University of California San Francisco, San Francisco, CA, USA.
Acad Psychiatry. 2017 Apr;41(2):189-194. doi: 10.1007/s40596-016-0628-6. Epub 2016 Dec 27.
We investigated hypothesized risk and resilience factors and their association with burnout in first year medicine and psychiatry residents at an urban teaching hospital in order to help guide the development of interventions targeted at reducing burnout.
We administered the Maslach Burnout Inventory (MBI), Perceived Stress Scale-10, Functional Assessment of Chronic Illness Therapy-Fatigue Scale, Penn State Worry Questionnaire, Patient Health Questionnaire-9 (depression symptoms), Revised Life Orientation Test (optimism), Self-Efficacy Questionnaire, Cognitive and Affective Mindfulness Scale, Interpersonal Reactivity Index Perspective-Taking Scale (empathy), and Measure of Current Status-Part A to first year medicine and psychiatry residents prior to initiation of clinical rotations in June.
The response rate was 91 % (68 of 75 residents). Nineteen respondents (28 %) met criteria for burnout as measured by the MBI. Residents with burnout scored higher on self-report measures assessing perceived stress (Cohen's d = 0.97; p = 0.004), fatigue (d = 0.79; p = 0.018), worry (d = 0.88; p = 0.0009), and depression symptoms (d = 0.84; p = 0.035) and scored lower on questionnaires assessing mindfulness (d = -0.63; p = 0.029) and coping ability (d = -0.79; p = 0.003).
In a cross-sectional assessment using self-report measures, we found that nearly a third of first year residents prior to starting their internships experience burnout. They exhibit lower levels of mindfulness and coping skills and higher levels of depression symptoms, fatigue, worry, and stress. These preliminary findings should encourage programs to initiate and study curricula that combine mindfulness and self-awareness coping strategies to enhance or protect against burnout as well as cognitive behavioral coaching strategies to offset symptoms of burnout when present.
我们调查了一所城市教学医院的医学和精神病学一年级住院医师的假定风险因素和恢复力因素及其与职业倦怠的关联，以帮助指导旨在减少职业倦怠的干预措施的制定。
在6月开始临床轮转之前，我们对医学和精神病学一年级住院医师进行了马氏职业倦怠量表（MBI）、感知压力量表-10、慢性病治疗功能评估-疲劳量表、宾夕法尼亚州立大学忧虑问卷、患者健康问卷-9（抑郁症状）、修订版生活取向测试（乐观）、自我效能量表、认知与情感正念量表、人际反应指数观点采择量表（同理心）以及现状测量-A部分的测试。
回复率为91%（75名住院医师中的68名）。根据MBI测量，19名受访者（28%）符合职业倦怠标准。职业倦怠的住院医师在评估感知压力（科恩d值=0.97；p=0.004）、疲劳（d=0.79；p=0.018）、忧虑（d=0.88；p=0.0009）和抑郁症状（d=0.84；p=0.035）的自我报告测量中得分较高，而在评估正念（d=-0.63；p=0.029）和应对能力（d=-0.79；p=0.003）的问卷中得分较低。
在一项使用自我报告测量的横断面评估中，我们发现近三分之一的一年级住院医师在开始实习前经历职业倦怠。他们表现出较低的正念和应对技能水平，以及较高的抑郁症状、疲劳、忧虑和压力水平。这些初步发现应促使各项目启动并研究结合正念和自我意识应对策略的课程，以增强或预防职业倦怠，以及采用认知行为辅导策略来缓解出现职业倦怠症状时的状况。
