National Institute for Health and Welfare, Department of Health and Social Care Systems, Helsinki, Finland.
University of Helsinki, Department of Psychology and Logopedics, Helsinki, Finland.
Eur J Public Health. 2018 Oct 1;28(5):798-804. doi: 10.1093/eurpub/ckx232.
Increasing wellbeing problems among physicians may lead to serious consequences in health care and means to prevent such development are called for. This study examined longitudinal associations between workload and changes in distress, sleep quality and workability in physicians and whether positive social relations at work would protect from such problems.
A baseline survey was conducted in 2006 for a random sample of 5000 physicians (n = 2841, response rate 57%). In 2015, the follow-up survey was sent to those 2 206 physicians who gave their consent (n = 1462, response rate 68.3%). The survey included scales for distress, sleeping problems, workability, workload, team climate, collegial support and questions for background information.
Increased workload was associated with increased psychological distress, sleeping problems and decreased workability during the 9-year follow-up. Good team climate and collegial support were related to decreased distress and sleep quality and enhanced workability. Good collegial support buffered the associations of workload changes on distress and sleep quality changes. Team climate was more strongly associated with changes in sleep quality and workability among younger and middle aged physicians than older physicians. Also collegial support had a stronger association with sleep quality change among younger or middle aged physicians than older physicians. These associations were robust to adjustments for age, gender, specialization, leadership position, marital status and baseline wellbeing.
Health care organizations should take measures to decrease workload and to increase availability of social support for physicians in order to protect physicians from declining wellbeing.
越来越多的医生出现幸福感问题,这可能会对医疗保健产生严重影响,因此需要采取措施加以预防。本研究旨在探讨医生的工作量与苦恼、睡眠质量和工作能力变化之间的纵向关联,以及工作中的积极社会关系是否能保护他们免受这些问题的影响。
本研究采用随机抽样的方法,对 5000 名医生(n=2841,应答率为 57%)进行基线调查。2015 年,对同意参与的 2066 名医生(n=1462,应答率为 68.3%)进行了随访调查。调查问卷包括苦恼、睡眠问题、工作能力、工作量、团队氛围、同事支持以及背景信息问题等量表。
在 9 年的随访中,工作量的增加与心理苦恼、睡眠问题和工作能力下降有关。良好的团队氛围和同事支持与苦恼和睡眠质量的降低以及工作能力的提高有关。良好的同事支持缓冲了工作量变化与苦恼和睡眠质量变化之间的关联。团队氛围与年轻和中年医生的睡眠质量和工作能力变化的相关性比老年医生更强。同事支持与年轻或中年医生的睡眠质量变化的相关性也比老年医生更强。这些关联在调整了年龄、性别、专业、领导职位、婚姻状况和基线幸福感等因素后仍然存在。
医疗保健组织应采取措施降低工作量,并增加医生获得社会支持的机会,以保护医生的幸福感不下降。