Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Professional Satisfaction, American Medical Association, Chicago, Illinois, USA.
Stress Health. 2019 Apr;35(2):157-175. doi: 10.1002/smi.2849. Epub 2019 Jan 21.
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.
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。