Dyrbye Liselotte N, Johnson Pamela O, Johnson LeAnn M, Halasy Michael P, Gossard Andrea A, Satele Daniel, Shanafelt Tait
Professor of Medicine and Medical Education, Co-Director of Mayo Clinic Program on Physician Well-Being, Mayo Clinic, Rochester, Minnesota.
Chief Nursing Officer, Mayo Clinic, Rochester, Minnesota.
J Am Assoc Nurse Pract. 2019 Jul;31(7):403-412. doi: 10.1097/JXX.0000000000000179.
To evaluate the ability of the Well-Being Index (WBI) to stratify distress and well-being (high quality of life [QOL]) in nurse practitioners and physician assistants (NPs and PAs) and identify those whose degree of distress place them at an increased risk for medical error or turnover.
A national sample of NPs and PAs completed a survey that included the WBI and instruments to measure QOL, fatigue, burnout, recent suicidal ideation, medical error, and intent to leave the current job.
Overall, 1,576 of 4,106 (38.4%) NPs and PAs completed the survey. Those NPs and PAs with low mental QOL, extreme fatigue, recent suicidal ideation, or burnout had less favorable WBI scores (all p < .0001). Using a prevalence of low overall QOL among APPs of 14.4% as the pretest probability, the WBI score can reduce the posttest probability of low QOL to 2% or increase it to 64.7%. As the WBI score worsened, the posttest probability of high overall QOL decreased from 73% to 8.2%. Also, WBI score stratified the NPs and PAs likelihood of reporting recent medical errors and intent to leave his or her current job.
The WBI is a useful screening tool to stratify distress and well-being in APPs across a variety of domains and identify those NPs and PAs whose degree of distress may increase the risk of medical error or turnover.
评估幸福感指数（WBI）对执业护士和医师助理（NPs和PAs）的痛苦程度及幸福感（高质量生活[QOL]）进行分层的能力，并识别出那些痛苦程度使其面临医疗差错或离职风险增加的人员。
对NPs和PAs的全国样本进行了一项调查，该调查包括WBI以及用于测量QOL、疲劳、职业倦怠、近期自杀意念、医疗差错和离职意愿的工具。
总体而言，4106名NPs和PAs中有1576名（38.4%）完成了调查。那些心理QOL较低、极度疲劳、近期有自杀意念或职业倦怠的NPs和PAs的WBI得分较低（所有p <.0001）。以APPs中总体QOL较低的患病率14.4%作为预测试概率，WBI得分可将QOL较低的后测试概率降低至2%或提高至64.7%。随着WBI得分变差，总体QOL较高的后测试概率从73%降至8.2%。此外，WBI得分对NPs和PAs报告近期医疗差错及离职意愿的可能性进行了分层。
WBI是一种有用的筛查工具，可在多个领域对APPs的痛苦程度和幸福感进行分层，并识别出那些痛苦程度可能增加医疗差错或离职风险的NPs和PAs。
