Raimo John, LaVine Sean, Spielmann Kelly, Akerman Meredith, Friedman Karen A, Katona Kyle, Chaudhry Saima
J Grad Med Educ. 2018 Oct;10(5):524-531. doi: 10.4300/JGME-D-18-00273.1.
Residents and practicing physicians displaying signs of stress is common. It is unclear whether stress during residency persists into professional practice or is associated with future burnout.
We assessed the persistence of stress after residency and its correlation with burnout in professional practice. We hypothesized that stress would linger and be correlated with future burnout.
A prospective cohort study was conducted over 10 years using survey instruments with existing validity evidence. Residents over 3 academic years (2003-2005) were surveyed to measure stress in residency. Ten years later, these residents were sought out for a second survey measuring current stress and burnout in professional practice.
From 2003 to 2005, 143 of 155 residents participated in the initial assessment (92% response rate). Of those, 21 were excluded in 2015 due to lack of contact information; follow-up surveys were distributed to 122 participants, and 81 responses were received (66% response rate and 57% of original participants). Emotional distress in residency correlated with emotional distress in professional practice (correlation coefficient = 0.45, < .0001), emotional exhaustion (correlation coefficient = 0.30, = .007), and depersonalization (correlation coefficient = 0.25, = .029). Multivariate linear regression showed that emotional distress in residency was associated with future emotional distress (β estimate = 0.57, = .005) and depersonalization (β estimate = 2.29, = .028).
We showed emotional distress as a resident persists into individuals' professional practice 10 years later and has an association with burnout in practice.
住院医师和执业医师出现压力迹象很常见。目前尚不清楚住院医师培训期间的压力是否会持续到职业生涯中,或者是否与未来的职业倦怠有关。
我们评估了住院医师培训结束后压力的持续性及其与职业生涯中职业倦怠的相关性。我们假设压力会持续存在并与未来的职业倦怠相关。
使用具有现有效度证据的调查问卷进行了一项为期10年的前瞻性队列研究。对三个学年(2003 - 2005年)的住院医师进行调查,以测量住院医师培训期间的压力。十年后,找到这些住院医师进行第二次调查,测量他们目前在职业生涯中的压力和职业倦怠情况。
2003年至2005年,155名住院医师中有143名参与了初始评估(应答率为92%)。其中,2015年有21名因缺乏联系信息而被排除;后续调查发送给了122名参与者,收到了81份回复(应答率为66%,占原始参与者的57%)。住院医师培训期间的情绪困扰与职业生涯中的情绪困扰相关(相关系数 = 0.45,P <.0001)、情感耗竭(相关系数 = 0.30,P = 0.007)和去人格化(相关系数 = 0.25,P = 0.029)。多元线性回归显示,住院医师培训期间的情绪困扰与未来的情绪困扰(β估计值 = 0.57,P = 0.005)和去人格化(β估计值 = 2.29,P = 0.028)相关。
我们发现住院医师时期的情绪困扰会在十年后持续到个人的职业生涯中,并与工作中的职业倦怠有关。