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保持热情但避免倦怠:居民幸福感计划的实施和评估。

Maintaining the Fire but Avoiding Burnout: Implementation and Evaluation of a Resident Well-Being Program.

机构信息

Department of Surgery, University of Arizona, Tucson, Arizona.

Department of Surgery, University of Arizona, Tucson, Arizona.

出版信息

J Am Coll Surg. 2018 Apr;226(4):369-379. doi: 10.1016/j.jamcollsurg.2017.12.017. Epub 2017 Dec 28.

Abstract

BACKGROUND

There have been few programs designed to improve surgical resident well-being, and such efforts often lack formal evaluation.

STUDY DESIGN

General surgery residents participated in the Energy Leadership Well-Being and Resiliency Program. They were assessed at baseline and 1 year after implementation using the Energy Leadership Index (measures emotional intelligence), Maslach Burnout Inventory General Survey, Perceived Stress Scale, the Beck Depression Inventory, and the annual required ACGME resident survey. Scores before and after implementation were compared using paired t-tests for continuous variables and chi-square tests for categorical variables.

RESULTS

Forty-nine general surgery residents participate in the program. One year after implementation, resident score on the Energy Leadership Index improved (from 3.16 ± 0.24 to 3.24 ± 0.32; p = 0.03). Resident perceived stress decreased from baseline (Perceived Stress Scale score, from 17.0 ± 7.2 to 15.7 ± 6.2; p = 0.05). Scores on the emotional exhaustion scale of the Maslach Burnout Inventory decreased (from 16.8 ± 8.4 to 14.4 ± 8.5; p = 0.04). Resident-reported satisfaction improved in many areas; satisfaction with leadership skills, work relationships, communication skills, productivity, time management, personal freedom, and work-life balance, increased during the 1-year intervention (p = NS). On the annual ACGME resident survey, residents' evaluation of the program as positive or very positive increased from 80% to 96%.

CONCLUSIONS

This study demonstrates that formal implementation of a program to improve resident well-being positively impacted residents' perceived stress, emotional exhaustion, emotional intelligence, life satisfaction, and their perception of the residency program. Formal evaluation and reporting of such efforts allow for reproducibility and scalability, with the potential for widespread impact on resident well-being.

摘要

背景

目前鲜有旨在提高外科住院医师幸福感的项目,且此类项目往往缺乏正式评估。

研究设计

普通外科住院医师参加了“能量领导力幸福和韧性计划”。他们在实施前和实施后 1 年使用能量领导力指数(衡量情绪智力)、马斯拉赫倦怠量表总调查、感知压力量表、贝克抑郁量表和年度必需的 ACGME 住院医师调查进行评估。使用配对 t 检验比较连续变量和卡方检验比较分类变量的实施前后得分。

结果

49 名普通外科住院医师参加了该计划。实施后 1 年,住院医师的能量领导力指数得分提高(从 3.16 ± 0.24 提高至 3.24 ± 0.32;p = 0.03)。住院医师的感知压力从基线开始下降(感知压力量表得分,从 17.0 ± 7.2 降至 15.7 ± 6.2;p = 0.05)。马斯拉赫倦怠量表的情绪衰竭量表得分降低(从 16.8 ± 8.4 降低至 14.4 ± 8.5;p = 0.04)。住院医师报告在许多方面的满意度提高;在领导力技能、工作关系、沟通技巧、工作效率、时间管理、个人自由和工作生活平衡方面的满意度在 1 年的干预中增加(p = NS)。在年度 ACGME 住院医师调查中,住院医师对该计划的评价从 80%提高到 96%,为积极或非常积极。

结论

本研究表明,正式实施一项提高住院医师幸福感的计划可积极影响住院医师的感知压力、情绪耗竭、情绪智力、生活满意度和对住院医师计划的看法。对这些努力进行正式评估和报告可实现可重复性和可扩展性,有可能对住院医师的幸福感产生广泛影响。

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