Hall Louise H, Johnson Judith, Heyhoe Jane, Watt Ian, Anderson Kevin, O'Connor Daryl B
School of Psychology, University of Leeds, Leeds, UK.
Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.
Fam Pract. 2018 Jul 23;35(4):511-516. doi: 10.1093/fampra/cmx130.
Primary care physicians are particularly prone to high levels of burnout and poor well-being. Despite this, no qualitative studies have specifically investigated the best ways to improve well-being and prevent burnout in primary care physicians. Previous interventions within primary care have been person-oriented and mainly focused on mindfulness, but there has been no prior research on whether general practitioners (GPs) deem this to be the best approach.
To explore strategies that could improve GP well-being and reduce or prevent burnout, based on GP perceptions of the workplace factors that affect their levels of well-being and burnout.
Five focus groups were conducted, with 25 GPs (locums, salaried, trainees, and partners) in the UK, between September 2015 and February 2016. Focus groups took place in GP practices and private meeting rooms. Discussions were centered on the workplace factors that they perceived to influence their well-being, along with strategies that they use either personally, or as a practice, to try and prevent burnout. Furthermore, strategies that could feasibly be implemented by individuals and practices to improve well-being, as well as changes that are needed by groups or organizations that are external to their practice (e.g., the government) to improve the working conditions, were explored. Thematic analysis was conducted on the transcripts.
Based on the contributors to burnout and workplace well-being that the participants identified, the following feasible strategies were suggested: compulsory daily coffee breaks, increasing self- and organizational awareness of the risks of burnout and mentoring or buddy systems. System-level organizational changes were voiced as vital, however, to improve the well-being of all primary care physicians. Increasing resources seemed to be the ideal solution, to allow for more administrative staff and GPs.
These strategies merit further consideration by researchers, physicians, healthcare organizations and policy makers both in the UK and beyond. Failure to do so may result in healthcare staff becoming even more burntout, potentially leading to a loss of doctors from the workforce.
基层医疗医生特别容易出现高度职业倦怠和健康状况不佳的情况。尽管如此，尚无定性研究专门探究改善基层医疗医生健康状况和预防职业倦怠的最佳方法。此前在基层医疗领域开展的干预措施都是以人为本的，主要侧重于正念，但此前尚无关于全科医生（GPs）是否认为这是最佳方法的研究。
基于全科医生对影响其健康状况和职业倦怠水平的工作场所因素的看法，探索可改善全科医生健康状况并减少或预防职业倦怠的策略。
2015年9月至2016年2月期间，在英国对25名全科医生（临时代理医生、受薪医生、实习医生和合伙人）进行了五次焦点小组访谈。焦点小组访谈在全科医生诊所和私人会议室进行。讨论集中在他们认为会影响其健康状况的工作场所因素，以及他们个人或作为一种做法用来尝试预防职业倦怠的策略。此外，还探讨了个人和诊所可以切实实施的改善健康状况的策略，以及其诊所外部的团体或组织（如政府）为改善工作条件所需做出的改变。对访谈记录进行了主题分析。
根据参与者确定的导致职业倦怠和工作场所健康状况的因素，提出了以下可行策略：强制性每日咖啡休息时间、提高个人和组织对职业倦怠风险的认识以及指导或伙伴制度。然而，大家一致认为，系统层面的组织变革对于改善所有基层医疗医生的健康状况至关重要。增加资源似乎是理想的解决方案，以便配备更多行政人员和全科医生。
这些策略值得英国及其他地区的研究人员、医生、医疗保健组织和政策制定者进一步考虑。不这样做可能会导致医护人员职业倦怠加剧，有可能导致劳动力队伍中的医生流失。
