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医学第一年和第三年的职业倦怠与抑郁:一所医学院校不同队列的比较

Burnout and Depression in MS1 and MS3 Years: A Comparison of Cohorts at One Medical School.

作者信息

Elkins Cinthia, Plante Kyle P, Germain Lauren J, Morley Christopher P

机构信息

Department of Family Medicine, SUNY Upstate Medical University.

出版信息

Fam Med. 2017 Jun;49(6):456-459.

Abstract

BACKGROUND

Losses of idealism, empathy, and professionalism over the course of medical education have been described previously in the literature. A 2012 national survey of medical students estimated 37%-44% with burnout, 58% screen positive for depression, and 9.4% with suicidal ideation in the past 12 months. Given changes in related traits, we sought to explore whether burnout and symptoms of depression change over time. The objectives of this study were to assess the differences in medical student burnout and symptoms of depression between first year (MS1) and third-year (MS3) medical students at one medical college.

METHODS

Students were administered the modified Maslach Burnout Inventory (MBI) and the Patient Health Questionnaire-2 (PHQ-2) depression screening instrument as an optional part of a mandatory annual survey administered by the medical college near the end of the academic year (March-May, 2015). Anonymous responses from MS1s and MS3s were analyzed to estimate trends in burnout and possible depression over time and to examine the relationship between the two measures.

RESULTS

Possible depression (Total PHQ2 equal or greater than 3) was present in 28.5% of all respondents. MS3s had significantly higher levels of Emotional Exhaustion (EE) and Depersonalization (DP), and lower levels of Personal Accomplishment (PA), than MS1s. When PHQ2, gender, and campus/program effects were controlled via regression, MS3s tended to record EE and DP scores over 2 points higher than MS1s and PA scores over 2 points lower. Regrets about entering medicine were also higher in MS3s in the controlled models. PHQ2 scores were also positively associated with all subscales except for PA.

CONCLUSIONS

Students appear to be at slightly greater risk for burnout as they temporally progress through medical school. These findings are consistent with similar measurements of decreasing empathy and idealism when comparing cohorts of early versus late medical students.

摘要

背景

医学教育过程中理想主义、同理心和专业精神的丧失此前在文献中已有描述。2012年一项针对医学生的全国性调查估计,在过去12个月中,37%-44%的医学生存在职业倦怠,58%的学生抑郁筛查呈阳性,9.4%的学生有自杀念头。鉴于相关特质的变化,我们试图探讨职业倦怠和抑郁症状是否随时间而变化。本研究的目的是评估某医学院一年级(MS1)和三年级(MS3)医学生在职业倦怠和抑郁症状方面的差异。

方法

在学年末(2015年3月至5月),作为医学院强制性年度调查的一个可选部分,学生们接受了改良的马氏职业倦怠量表(MBI)和患者健康问卷-2(PHQ-2)抑郁筛查工具的测试。对MS1和MS3学生的匿名回复进行分析,以估计职业倦怠和可能的抑郁随时间的变化趋势,并检验这两种测量方法之间的关系。

结果

所有受访者中28.5%存在可能的抑郁(PHQ2总分等于或大于3)。与MS1相比,MS3的情感耗竭(EE)和去个性化(DP)水平显著更高,个人成就感(PA)水平更低。当通过回归控制PHQ2、性别和校园/项目影响时,MS3的EE和DP得分往往比MS1高2分以上,PA得分比MS1低2分以上。在控制模型中,MS3对进入医学领域的后悔程度也更高。PHQ2得分与除PA之外的所有子量表也呈正相关。

结论

随着学生在医学院学习时间的推移,他们出现职业倦怠的风险似乎略有增加。这些发现与比较早期和晚期医学生群体时同理心和理想主义下降的类似测量结果一致。

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