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亚洲重症监护病房医生和护士的职业倦怠:一项多国家调查。

Professional burnout among physicians and nurses in Asian intensive care units: a multinational survey.

机构信息

Division of Respiratory and Critical Care Medicine, University Medicine Cluster, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore, 119228, Singapore.

Department of Critical Care Medicine, Harbin Medical University 1st Hospital, Harbin, China.

出版信息

Intensive Care Med. 2018 Dec;44(12):2079-2090. doi: 10.1007/s00134-018-5432-1. Epub 2018 Nov 16.

Abstract

PURPOSE

Professional burnout is a multidimensional syndrome comprising emotional exhaustion, depersonalization, and diminished sense of personal accomplishment, and is associated with poor staff health and decreased quality of medical care. We investigated burnout prevalence and its associated risk factors among Asian intensive care unit (ICU) physicians and nurses.

METHODS

We conducted a cross-sectional survey of 159 ICUs in 16 Asian countries and regions. The main outcome measure was burnout as assessed by the Maslach Burnout Inventory-Human Services Survey. Multivariate random effects logistic regression analyses of predictors for physician and nurse burnout were performed.

RESULTS

A total of 992 ICU physicians (response rate 76.5%) and 3100 ICU nurses (response rate 63.3%) were studied. Both physicians and nurses had high levels of burnout (50.3% versus 52.0%, P = 0.362). Among countries or regions, burnout rates ranged from 34.6 to 61.5%. Among physicians, religiosity (i.e. having a religious background or belief), years of working in the current department, shift work (versus no shift work) and number of stay-home night calls had a protective effect (negative association) against burnout, while work days per month had a harmful effect (positive association). Among nurses, religiosity and better work-life balance had a protective effect against burnout, while having a bachelor's degree (compared to having a non-degree qualification) had a harmful effect.

CONCLUSIONS

A large proportion of Asian ICU physicians and nurses experience professional burnout. Our study results suggest that individual-level interventions could include religious/spiritual practice, and organizational-level interventions could include employing shift-based coverage, stay-home night calls, and regulating the number of work days per month.

摘要

目的

职业倦怠是一种多维综合征,包括情绪衰竭、去人格化和成就感降低,与员工健康状况不佳和医疗质量下降有关。我们调查了亚洲重症监护病房(ICU)医生和护士的倦怠流行情况及其相关危险因素。

方法

我们对 16 个亚洲国家和地区的 159 个 ICU 进行了横断面调查。主要结局测量是使用 Maslach 倦怠量表-人类服务调查评估的倦怠。对医生和护士倦怠的预测因素进行了多变量随机效应逻辑回归分析。

结果

共研究了 992 名 ICU 医生(应答率为 76.5%)和 3100 名 ICU 护士(应答率为 63.3%)。医生和护士的倦怠程度都很高(50.3%对 52.0%,P=0.362)。在国家或地区中,倦怠率从 34.6%到 61.5%不等。在医生中,宗教信仰(即有宗教背景或信仰)、在当前科室工作年限、轮班工作(与不轮班工作相比)和留家夜间呼叫次数对倦怠有保护作用(负相关),而每月工作天数则有不利影响(正相关)。在护士中,宗教信仰和更好的工作-生活平衡对倦怠有保护作用,而拥有学士学位(与非学位资格相比)则有不利影响。

结论

亚洲 ICU 医生和护士中有很大一部分人经历职业倦怠。我们的研究结果表明,个体层面的干预措施可以包括宗教/精神实践,而组织层面的干预措施可以包括采用轮班制覆盖、留家夜间呼叫和规定每月工作天数。

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