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中国麻醉医师职业倦怠严重,工作满意度低:一项横断面调查。

Chinese Anesthesiologists Have High Burnout and Low Job Satisfaction: A Cross-Sectional Survey.

机构信息

From the Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China.

Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, Beijing, China.

出版信息

Anesth Analg. 2018 Mar;126(3):1004-1012. doi: 10.1213/ANE.0000000000002776.

Abstract

BACKGROUND

The Chinese health care system must meet the needs of 19% of the world's population. Despite recent economic growth, health care resources are unevenly distributed. This creates the potential for job stress and burnout. We therefore conducted a survey among anesthesiologists in the Beijing-Tianjin-Hebei region focusing on job satisfaction and burnout to determine the incidence and associated factors.

METHODS

A large cross-sectional study was performed in the Beijing-Tianjin-Hebei region of China. The anonymous questionnaire was designed to collect and analyze the following information: (1) demographic characteristics and employer information; (2) job satisfaction assessed by Minnesota Satisfaction Questionnaire; (3) burnout assessed by Maslach Burnout Inventory-Human Service Survey; and (4) sleep pattern and physician-patient communication.

RESULTS

Surveys were completed and returned from 211 hospitals (response rate 74%) and 2873 anesthesiologists (response rate 70%) during the period of June to August 2015. The overall job satisfaction score of Minnesota Satisfaction Questionnaire was 65.3 ± 11.5. Among the participants, 69% (95% confidence interval [CI], 67%-71%) met the criteria for burnout. The prevalence of high emotional exhaustion, high depersonalization, and low personal accomplishment was 57% (95% CI, 55%-59%), 49% (95% CI, 47%-51%), and 57% (95% CI, 55%-58%), respectively. Using multivariable logistic regression analysis, we found that age, hospital category, working hours per week, caseload per day, frequency of perceived challenging cases, income, and sleep quality were independent variables associated with burnout. Anesthesiologists with a high level of depersonalization tended to engage in shorter preoperative conversations with patients, provide less information about pain or the procedure, and to have less empathy with them.

CONCLUSIONS

The anesthesiologists in the Beijing-Tianjin-Hebei region of China expressed a below-average level of job satisfaction, and suffered a significant degree of burnout. Improvement in job satisfaction and burnout might create a positive work climate that could benefit both the quality of patient care and the profession of anesthesiology in China.

摘要

背景

中国的医疗体系必须满足世界 19%人口的需求。尽管最近经济有所增长,但医疗资源的分布仍不均衡。这可能导致工作压力和倦怠。因此,我们在北京-天津-河北地区对麻醉师进行了一项调查,重点关注工作满意度和倦怠感,以确定发病率和相关因素。

方法

在中国北京-天津-河北地区进行了一项大型横断面研究。匿名问卷旨在收集和分析以下信息:(1)人口统计学特征和雇主信息;(2)明尼苏达满意度问卷评估的工作满意度;(3)Maslach 倦怠量表-人类服务调查评估的倦怠感;(4)睡眠模式和医患沟通。

结果

2015 年 6 月至 8 月期间,211 家医院(应答率为 74%)和 2873 名麻醉师(应答率为 70%)完成并返回了调查。明尼苏达满意度问卷的总体工作满意度评分为 65.3±11.5。在参与者中,69%(95%置信区间[CI],67%-71%)符合倦怠标准。高情绪衰竭、高去人性化和低个人成就感的患病率分别为 57%(95%CI,55%-59%)、49%(95%CI,47%-51%)和 57%(95%CI,55%-58%)。使用多变量逻辑回归分析,我们发现年龄、医院类别、每周工作时间、每天工作量、感知挑战性病例的频率、收入和睡眠质量是与倦怠相关的独立变量。具有高度去人性化的麻醉师往往与患者进行较短的术前交谈,提供较少的关于疼痛或手术的信息,并且对他们的同理心较少。

结论

北京-天津-河北地区的麻醉师表示工作满意度较低,且倦怠感明显。提高工作满意度和倦怠感可能会营造积极的工作氛围,这将有益于中国患者护理质量和麻醉专业的发展。

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