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住院医师 burnout 的一年制机构观察

A One-Year Institutional View of Resident Physician Burnout.

机构信息

University of Arkansas for Medical Sciences, Little Rock, AR, USA.

University of Massachusetts Medical School, Worcester, MA, USA.

出版信息

Acad Psychiatry. 2019 Aug;43(4):361-368. doi: 10.1007/s40596-019-01043-9. Epub 2019 Feb 28.

Abstract

OBJECTIVES

This prospective study explores the prevalence, associated characteristics, and trajectory of burnout over one academic year in a multidisciplinary sample of resident physicians using a relatively new burnout survey instrument.

METHODS

All residents from a U.S. academic health center (n = 633) were invited to complete the Copenhagen Burnout Inventory (CBI) three times, with 4-month time lags between invitations. A total of 281 (44%) provided complete CBI survey responses at least once, and 43 (7%) did at all three times. Descriptive statistics, cross-sectional analyses, correlations, and multivariable linear regression analyses were computed, as well as repeated measures ANOVAs and paired t tests, as appropriate, for each CBI domain (personal, work, patient-related burnout).

RESULTS

About half had CBI scores indicating moderate-to-high levels of personal burnout (49-52%) and work-related burnout (45-49%), whereas patient-related burnout was less common (14-24%). However, patient-related burnout increased significantly from the beginning to the end of the year. Regression analyses indicated patient-related burnout was significantly higher for postgraduate year 1-2 residents compared to PGY 4+ residents, but was not significantly different by gender. Personal and work burnout scores were significantly higher for females. Persistently high burnout was observed in only 6% of respondents.

CONCLUSIONS

In this study of resident physicians using the CBI, burnout was prevalent and higher levels of burnout were observed for females on the personal and work burnout domains, while junior residents had higher patient-related burnout. Persistently, high burnout was rare. The CBI demonstrated high reliability, was practical to administer, and produced similar results with existing burnout research.

摘要

目的

本前瞻性研究使用一种相对较新的 burnout 调查工具,在多学科住院医师样本中探讨 burnout 在一个学年内的流行率、相关特征和轨迹。

方法

邀请美国学术医疗中心的所有住院医师(n=633)三次填写哥本哈根倦怠量表(CBI),每次邀请之间间隔 4 个月。共有 281 人(44%)至少一次提供了完整的 CBI 调查回复,而 43 人(7%)在所有三次都提供了回复。计算了描述性统计、横断面分析、相关性和多变量线性回归分析,以及适当的重复测量方差分析和配对 t 检验,用于每个 CBI 领域(个人、工作、与患者相关的倦怠)。

结果

大约一半的人 CBI 得分表明存在中高度的个人倦怠(49-52%)和与工作相关的倦怠(45-49%),而与患者相关的倦怠则较少见(14-24%)。然而,与患者相关的倦怠从学年开始到结束显著增加。回归分析表明,与 PGY4+ 住院医师相比,PGY1-2 住院医师的与患者相关的倦怠显著更高,但性别差异不显著。女性的个人和工作倦怠得分显著更高。只有 6%的受访者持续存在高倦怠。

结论

在这项使用 CBI 的住院医师研究中,倦怠很普遍,女性在个人和工作倦怠领域的倦怠水平更高,而初级住院医师的与患者相关的倦怠更高。持续存在的高倦怠很少见。CBI 表现出高可靠性,管理实用,并且与现有倦怠研究产生了相似的结果。

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