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医生,怎么了?爱尔兰医院医生心理健康状况的全国性横断面研究。

What's up doc? A national cross-sectional study of psychological wellbeing of hospital doctors in Ireland.

作者信息

Hayes Blánaid, Prihodova Lucia, Walsh Gillian, Doyle Frank, Doherty Sally

机构信息

Occupational Health Department, Beaumont Hospital, Dublin, Ireland.

Research Department, Royal College of Physicians of Ireland, Dublin, Ireland.

出版信息

BMJ Open. 2017 Oct 16;7(10):e018023. doi: 10.1136/bmjopen-2017-018023.

Abstract

OBJECTIVES

To measure levels of psychological distress, psychological wellbeing and self-stigma in hospital doctors in Ireland.

DESIGN

National cross-sectional study of randomised sample of hospital doctors. Participants provided sociodemographic data (age, sex, marital status), work grade (consultant, higher/basic specialist trainee), specialty and work hours and completed well-being questionnaires (the Depression Anxiety Stress Scale, WHO Well-being Index, General Health Questionnaire) and single-item scales on self-rated health and self-stigma.

SETTING

Irish publicly funded hospitals and residential institutions.

PARTICIPANTS

1749 doctors (response rate of 55%). All hospital specialties were represented except radiology.

RESULTS

Half of participants were men (50.5%). Mean hours worked per week were 57 hours. Over half (52%) rated their health as very good/excellent, while 50.5% reported positive subjective well-being (WHO-5). Over a third (35%) experienced psychological distress (General Health Questionnaire 12). Severe/extremely severe symptoms of depression, anxiety and stress were evident in 7.2%, 6.1% and 9.5% of participants (Depression, Anxiety, Stress Scale 21). Symptoms of distress, depression, anxiety and stress were significantly higher and levels of well-being were significantly lower in trainees compared with consultants, and this was not accounted for by differences in sociodemographic variables. Self-stigma was present in 68.4%.

CONCLUSIONS

The work hours of doctors working in Irish hospitals were in excess of European Working Time Directive's requirements. Just over half of hospital doctors in Ireland had positive well-being. Compared with international evidence, they had higher levels of psychological distress but slightly lower symptoms of depression and anxiety. Two-thirds of respondents reported self-stigma, which is likely to be a barrier to accessing care. These findings have implications for the design of support services for doctors, for discussions on quality of patient care and for future research.

摘要

目的

测量爱尔兰医院医生的心理困扰、心理健康和自我污名化水平。

设计

对医院医生随机样本进行的全国横断面研究。参与者提供社会人口学数据(年龄、性别、婚姻状况)、工作级别(顾问、高级/基础专科培训医生)、专业和工作时长,并完成幸福感问卷(抑郁焦虑压力量表、世界卫生组织幸福感指数、一般健康问卷)以及关于自评健康和自我污名化的单项量表。

背景

爱尔兰的公立资助医院和寄宿机构。

参与者

1749名医生(回复率为55%)。除放射科外,涵盖了所有医院专科。

结果

一半参与者为男性(50.5%)。每周平均工作时长为57小时。超过一半(52%)的人将自己的健康评为非常好/优秀,而50.5%的人报告主观幸福感良好(世界卫生组织幸福感指数-5)。超过三分之一(35%)的人经历过心理困扰(一般健康问卷-12)。7.2%、6.1%和9.5%的参与者有严重/极其严重的抑郁、焦虑和压力症状(抑郁、焦虑、压力量表-21)。与顾问相比,培训医生的困扰、抑郁、焦虑和压力症状明显更高,幸福感水平明显更低,且社会人口学变量差异无法解释这一现象。68.4%的人存在自我污名化。

结论

在爱尔兰医院工作的医生工作时长超过了欧洲工作时间指令的要求。爱尔兰略超半数的医院医生有积极的幸福感。与国际证据相比,他们的心理困扰水平更高,但抑郁和焦虑症状略低。三分之二的受访者报告有自我污名化,这可能是获得护理的障碍。这些发现对医生支持服务的设计、患者护理质量的讨论以及未来研究具有启示意义。

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