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部署到阿富汗的美国军事医务人员的职业压力与职业倦怠

Professional Stress and Burnout in U.S. Military Medical Personnel Deployed to Afghanistan.

作者信息

Adler Amy B, Adrian Amanda L, Hemphill Marla, Scaro Nicole H, Sipos Maurice L, Thomas Jeffrey L

机构信息

Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.

Department of Behavioral Health, Womack Army Medical Center, 2817 Reilly Street, Fort Bragg, NC 28310.

出版信息

Mil Med. 2017 Mar;182(3):e1669-e1676. doi: 10.7205/MILMED-D-16-00154.

Abstract

BACKGROUND

Studies of medical staff members have consistently documented high levels of burnout compared to those in other professions. Although there are studies of burnout in military medical staff, there are gaps in understanding the experience of medical staff while they are deployed and few occupationally-related factors associated with decreased burnout have been identified in this population.

PURPOSE

To assess work-related variables accounting for burnout over and above rank, post-traumatic stress disorder (PTSD) symptoms, and professional stressors in the deployed environment.

METHODS

U.S. military medical staff members were surveyed in Afghanistan. The survey assessed burnout (emotional exhaustion and depersonalization), PTSD symptoms, perception of professional stressors, self-care behaviors, taking care of team members (team care), general leadership, and health-promoting leadership. Participants provided informed consent under a protocol approved by the institutional review board at Walter Reed Army Institute of Research, and coordinated through the Washington Headquarters Service and the Joint Casualty Care Research Team located in Afghanistan. A total of 344 individuals provided their consent (83.3%) and completed the survey.

RESULTS

Correlations found significant positive relationships between perception of professional stressors and levels of burnout. Significant negative correlations were found between burnout and self-care, team care, general leadership, and health-promoting leadership. Regression analyses found self-care and team care accounted for less burnout even after controlling for rank, PTSD symptoms, and professional stressors. Health-promoting leadership accounted for less burnout even after controlling for these same covariates and general leadership as well.

CONCLUSION

Although a cross-sectional survey, results provide three specific directions for reducing burnout in deployed medical staff. By emphasizing self-care, team care, and health-promoting leadership, policy makers, researchers, and leaders can address factors that influence burnout in this, and other occupational contexts. In addition, the constructs of team care and leadership offer novel contributions to the study of burnout in medical personnel.

摘要

背景

与其他职业相比,针对医务人员的研究一直表明其职业倦怠程度较高。尽管有关于军队医务人员职业倦怠的研究,但在理解医务人员部署期间的经历方面仍存在差距,且在这一群体中,很少发现与职业倦怠减轻相关的职业因素。

目的

评估在部署环境中,除军衔、创伤后应激障碍(PTSD)症状和职业压力源之外,与职业倦怠相关的工作变量。

方法

对驻阿富汗的美国军队医务人员进行了调查。该调查评估了职业倦怠(情感耗竭和去人格化)、PTSD症状、职业压力源感知、自我护理行为、照顾团队成员(团队护理)、一般领导能力和促进健康的领导能力。参与者在获得沃尔特·里德陆军研究所机构审查委员会批准的方案下提供了知情同意书,并通过华盛顿总部服务局以及位于阿富汗的联合伤亡护理研究团队进行协调。共有344人提供了同意书(83.3%)并完成了调查。

结果

相关性分析发现,职业压力源感知与职业倦怠水平之间存在显著正相关。职业倦怠与自我护理、团队护理、一般领导能力和促进健康的领导能力之间存在显著负相关。回归分析发现,即使在控制了军衔、PTSD症状和职业压力源之后,自我护理和团队护理仍能减少职业倦怠。即使在控制了这些相同的协变量以及一般领导能力之后,促进健康的领导能力也能减少职业倦怠。

结论

尽管这是一项横断面调查,但研究结果为减少部署医务人员的职业倦怠提供了三个具体方向。通过强调自我护理、团队护理和促进健康的领导能力,政策制定者、研究人员和领导者可以解决影响这一群体以及其他职业环境中职业倦怠的因素。此外,团队护理和领导能力的结构为医务人员职业倦怠的研究提供了新的贡献。

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