Hyman Steve Alan, Shotwell Matthew S, Michaels Damon R, Han Xue, Card Elizabeth Borg, Morse Jennifer L, Weinger Matthew B
From the Departments of Anesthesiology.
Biostatistics, Vanderbilt University School of Medicine and Vanderbilt University Medical Center, Nashville, Tennessee.
Anesth Analg. 2017 Dec;125(6):2009-2018. doi: 10.1213/ANE.0000000000002298.
Burnout affects all medical specialists, and concern about it has become common in today's health care environment. The gold standard of burnout measurement in health care professionals is the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which measures emotional exhaustion, depersonalization (DP), and personal accomplishment. Besides affecting work quality, burnout is thought to affect health problems, mental health issues, and substance use negatively, although confirmatory data are lacking. This study evaluates some of these effects.
In 2011, the American Society of Anesthesiologists and the journal Anesthesiology cosponsored a webinar on burnout. As part of the webinar experience, we included access to a survey using MBI-HSS, 12-item Short Form Health Survey (SF-12), Social Support and Personal Coping (SSPC-14) survey, and substance use questions. Results were summarized using sample statistics, including mean, standard deviation, count, proportion, and 95% confidence intervals. Adjusted linear regression methods examined associations between burnout and substance use, SF-12, SSPC-14, and respondent demographics.
Two hundred twenty-one respondents began the survey, and 170 (76.9%) completed all questions. There were 266 registrants total (31 registrants for the live webinar and 235 for the archive event), yielding an 83% response rate. Among respondents providing job titles, 206 (98.6%) were physicians and 2 (0.96%) were registered nurses. The frequency of high-risk responses ranged from 26% to 59% across the 3 MBI-HSS categories, but only about 15% had unfavorable scores in all 3. Mean mental composite score of the SF-12 was 1 standard deviation below normative values and was significantly associated with all MBI-HSS components. With SSPC-14, respondents scored better in work satisfaction and professional support than in personal support and workload. Males scored worse on DP and personal accomplishment and, relative to attending physicians, residents scored worse on DP. There was no significant association between MBI-HSS and substance use.
Many anesthesiologists exhibit some high-risk burnout characteristics, and these are associated with lower mental health scores. Personal and professional support were associated with less emotional exhaustion, but overall burnout scores were associated with work satisfaction and professional support. Respondents were generally economically satisfied but also felt less in control at work and that their job kept them from friends and family. The association between burnout and substance use may not be as strong as previously believed. Additional work, perhaps with other survey instruments, is needed to confirm our results.
职业倦怠影响所有医学专科医生，在当今的医疗环境中，对此的关注已很普遍。医疗保健专业人员职业倦怠测量的金标准是马氏职业倦怠量表-人类服务调查（MBI-HSS），该量表测量情感耗竭、去个性化（DP）和个人成就感。尽管缺乏确凿数据，但职业倦怠除了影响工作质量外，还被认为会对健康问题、心理健康问题和物质使用产生负面影响。本研究评估了其中一些影响。
2011年，美国麻醉医师协会和《麻醉学》杂志共同主办了一次关于职业倦怠的网络研讨会。作为网络研讨会体验的一部分，我们纳入了一项使用MBI-HSS、12项简短健康调查（SF-12）、社会支持与个人应对（SSPC-14）调查以及物质使用问题的调查。结果使用样本统计数据进行总结，包括均值、标准差、计数、比例和95%置信区间。采用调整后的线性回归方法研究职业倦怠与物质使用、SF-12、SSPC-14以及受访者人口统计学特征之间的关联。
221名受访者开始了调查，170名（76.9%）完成了所有问题。总共有266名注册者（31名参加现场网络研讨会，235名参加存档活动），回复率为83%。在提供职位的受访者中，206名（98.6%）是医生，2名（0.96%）是注册护士。在MBI-HSS的三个类别中，高风险回答的频率在26%至59%之间，但只有约15%的人在所有三个类别中得分不佳。SF-12的平均心理综合得分比标准值低1个标准差，并且与MBI-HSS的所有组成部分均显著相关。对于SSPC-14，受访者在工作满意度和专业支持方面的得分高于个人支持和工作量方面的得分。男性在DP和个人成就感方面得分较低，相对于主治医师，住院医师在DP方面得分较低。MBI-HSS与物质使用之间无显著关联。
许多麻醉医师表现出一些高风险的职业倦怠特征，并且这些特征与较低的心理健康得分相关。个人和专业支持与较少的情感耗竭相关，但总体职业倦怠得分与工作满意度和专业支持相关。受访者总体上对经济状况满意，但也感觉在工作中控制权较小，并且工作使他们远离朋友和家人。职业倦怠与物质使用之间的关联可能不像以前认为的那么强。需要开展更多工作，或许使用其他调查工具，以证实我们的结果。
