Medisauskaite Asta, Kamau Caroline
Department of Organizational Psychology, Birkbeck, University of London, London, UK.
Psychooncology. 2017 Nov;26(11):1732-1740. doi: 10.1002/pon.4382. Epub 2017 Feb 17.
High mortality from cancer and rising patient numbers can trigger distress among oncologists because of a heavy and emotionally demanding workload. This systematic review and meta-analysis assesses the prevalence of high levels of distress among oncologists.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol is registered at the PROSPERO international prospective register (ref. 2015:CRD42015016325). We categorised data items according to the following distress factors: burnout, psychiatric morbidity, stress, depression, disrupted sleep, stress-induced physical symptoms, and substance use. We meta-analysed the prevalence of burnout and psychiatric morbidity using random effects models with MetaXL software.
The meta-analyses showed that 32% of 4876 oncologists had high burnout (±CI 28%-36%) and 27% of 2384 had high psychiatric morbidity (±CI 23%-32%). Studies also showed that 42% to 69% feel stressed at work, >12% of oncologists screen positive for depression, many oncologists suffer from sleep deprivation, up to 30% drink alcohol in a problematic way, and up to 20% of junior oncologists use hypnotic drugs, and some frequently experience stress-induced complaints such as ulcers, gastric problems, headaches, and arrhythmia.
Occupational distress reduces career satisfaction, affects patient care, and increases the chances of oncologists switching to another area of medicine; therefore, future research should explore appropriate interventions.
癌症导致的高死亡率以及患者数量的不断增加,可能会因工作量繁重且情感需求高而引发肿瘤学家的困扰。本系统评价和荟萃分析评估了肿瘤学家中高度困扰的患病率。
系统评价和荟萃分析的首选报告项目协议已在PROSPERO国际前瞻性注册库注册(参考文献2015:CRD42015016325)。我们根据以下困扰因素对数据项进行分类:职业倦怠、精神疾病、压力、抑郁、睡眠中断、压力引起的身体症状和物质使用。我们使用MetaXL软件的随机效应模型对职业倦怠和精神疾病的患病率进行荟萃分析。
荟萃分析表明,4876名肿瘤学家中有32%存在高度职业倦怠(±可信区间28%-36%),2384名中有27%存在高度精神疾病(±可信区间23%-32%)。研究还表明,42%至69%的人在工作中感到有压力,超过12%的肿瘤学家抑郁筛查呈阳性,许多肿瘤学家睡眠不足,高达30%的人饮酒存在问题,高达20%的初级肿瘤学家使用催眠药物,一些人经常出现压力引起的不适,如溃疡、胃部问题、头痛和心律失常。
职业困扰会降低职业满意度,影响患者护理,并增加肿瘤学家转向其他医学领域的可能性;因此,未来的研究应探索适当的干预措施。