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采用 Mini-Z 和 Maslach 职业倦怠量表测量的与医生职业倦怠相关的工作场所应激源的横断面调查。

Cross-sectional survey of workplace stressors associated with physician burnout measured by the Mini-Z and the Maslach Burnout Inventory.

机构信息

Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.

Professional Satisfaction, American Medical Association, Chicago, Illinois, USA.

出版信息

Stress Health. 2019 Apr;35(2):157-175. doi: 10.1002/smi.2849. Epub 2019 Jan 21.

Abstract

Rising physician burnout has adverse effects on healthcare. This study aimed to identify remediable stressors associated with burnout using the 10-item Mini-Z and the Maslach Burnout Inventory (MBI), and to compare performance of the Mini-Z's single-item burnout metric against the 22-item MBI. Surveys were emailed to 4,118 clinicians affiliated with an academic health system; 1,252 clicked the link, and 557 responded (completion rate 44%). Four hundred seventy-five practicing physicians were included: academic faculty (372), hospital employed (52), and private practitioners (81). Prevalence of burnout via the MBI was 56.6%. Predictors of burnout were poor control over workload [OR = 8.24, 95% CI 4.(81, 14.11)], inefficient teamwork [OR = 7.61, 95% (CI 3.28, 17.67)], insufficient documentation time [OR = 5.83, 95% (CI 3.35, 10.15)], hectic-chaotic work atmosphere [OR = 3.49, 95% (CI 2.12, 5.74)], lack of value-alignment with leadership [OR = 3.27, 95% (CI 2.12, 5.74)], and excessive electronic medical record time at home [OR = 1.99, 95% CI (1.21, 3.27)]. Academic faculty experienced more burnout than private practitioners (59.9% vs. 42.0%, p = 0.013). Odds of burnout associated with stressors were generally concordant via Mini-Z's burnout metric versus the MBI. The Mini-Z is a brief, valid method to identify stressors associated with burnout and guide interventions.

摘要

医生职业倦怠日益严重,对医疗保健产生了不良影响。本研究旨在使用 Mini-Z 和 Maslach 职业倦怠量表(MBI)识别与倦怠相关的可纠正压力源,并比较 Mini-Z 的单一倦怠指标与 22 项 MBI 的表现。向隶属学术医疗系统的 4118 名临床医生发送了电子邮件调查;1252 人点击了链接,557 人回复(完成率为 44%)。475 名执业医生被纳入研究:学术教员(372 人)、医院雇佣人员(52 人)和私人开业医生(81 人)。MBI 倦怠的发生率为 56.6%。倦怠的预测因素包括对工作量控制不佳[比值比(OR)=8.24,95%置信区间(CI)4.81-14.11]、团队合作效率低下[OR=7.61,95%CI(3.28-17.67)]、记录时间不足[OR=5.83,95%CI(3.35-10.15)]、紧张忙碌的工作氛围[OR=3.49,95%CI(2.12-5.74)]、与领导层价值观不一致[OR=3.27,95%CI(2.12-5.74)]以及在家处理电子病历时间过多[OR=1.99,95%CI(1.21-3.27)]。学术教员比私人开业医生经历更多的倦怠(59.9%比 42.0%,p=0.013)。Mini-Z 倦怠指标和 MBI 都一致地显示出与压力源相关的倦怠的可能性。Mini-Z 是一种简短、有效的方法,可以识别与倦怠相关的压力源并指导干预措施。

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