Division of Policy and Law, Institute of Public Health, National Yang-Ming University, No.155, Sec. 2, Linong St., Beitou Dist, Taipei, Taiwan; Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, No.95, Wenchang Rd., Shilin Dist., Taipei City 111, Taiwan.
Institute of Public Health, National Yang-Ming University, No.155, Sec. 2, Linong St., Beitou Dist, Taipei, Taiwan.
J Formos Med Assoc. 2019 Oct;118(10):1438-1449. doi: 10.1016/j.jfma.2018.12.015. Epub 2019 Jan 7.
BACKGROUND/PURPOSE: This study hypothesized that low 'felt trust' from patients may induce resident burnout. The authors developed and validated a scale to measure physician felt trust from patients and surveyed residents in Taiwan to estimate the prevalence of burnout, and to verify the association between felt trust and burnout.
Residents in Taiwan were surveyed between November 2015 and May 2016. The Chinese version occupational burnout inventory and the four-item 'physician-felt-trust-from-patient' (PFTFP) scale were used to measure burnout and physician felt trust. Generalized linear model with generalized estimating equation with burnout as the dependent variable was employed to estimate the association between physician felt trust and burnout while adjusting other potential confounders.
There were 1016 questionnaires returned (response rate 67.8%). The prevalence of personal burnout and client-related burnout were 44.0% and 14.8%. The PFTFP scale demonstrated adequate internal consistency (Chrobach's α 0.68) and favorable construct validity. Residents feeling less trusted from patients had significantly more burnout, especially client-related burnout, which showed a strong dose-response pattern. Residents having longer work hours or consecutive work hours and higher psychological job demands experienced more burnout, especially personal burnout. Residents with self-reported medical errors in recent 3 months had more client-related but not personal burnout.
The prevalence of burnout among residents in Taiwan was high, especially personal burnout. The validity of the PFTFP scale is satisfactory. Strategies in improving wellbeing of residents shall not overlook the importance of positive social capital such as resident's feeling of patient trust.
背景/目的：本研究假设患者的低“信任感受”可能会导致住院医师倦怠。作者开发并验证了一种衡量医生从患者那里获得信任的量表，并对台湾的住院医师进行了调查，以估计倦怠的流行程度，并验证信任感受与倦怠之间的关联。
台湾的住院医师于 2015 年 11 月至 2016 年 5 月接受调查。使用中文版职业倦怠量表和四项“医生从患者处获得的信任感受”（PFTFP）量表来衡量倦怠和医生的信任感受。使用广义线性模型和广义估计方程，以倦怠为因变量，在调整其他潜在混杂因素的同时，估计医生信任感受与倦怠之间的关联。
共收回 1016 份问卷（应答率 67.8%）。个人倦怠和与患者相关的倦怠的患病率分别为 44.0%和 14.8%。PFTFP 量表表现出足够的内部一致性（Chrobach's α 0.68）和良好的结构效度。感觉患者信任度较低的住院医师倦怠程度更高，尤其是与患者相关的倦怠，呈现出强烈的剂量-反应模式。工作时间较长或连续工作时间较长、心理工作要求较高的住院医师倦怠程度更高，尤其是个人倦怠。报告最近 3 个月发生医疗差错的住院医师有更多的与患者相关的倦怠，但没有个人倦怠。
台湾住院医师的倦怠患病率较高，尤其是个人倦怠。PFTFP 量表的效度令人满意。改善住院医师幸福感的策略不应忽视积极社会资本（如住院医师对患者信任的感受）的重要性。
