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美国急诊医学住院医师中 burnout 现象的高发生率:来自 2017 年全国急诊医学健康调查的结果。

High Prevalence of Burnout Among US Emergency Medicine Residents: Results From the 2017 National Emergency Medicine Wellness Survey.

机构信息

Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA.

Department of Emergency Medicine, University of Kentucky, Lexington, KY.

出版信息

Ann Emerg Med. 2019 Nov;74(5):682-690. doi: 10.1016/j.annemergmed.2019.01.037. Epub 2019 Mar 14.

Abstract

STUDY OBJECTIVE

Previous work shows that emergency medicine attending physicians have higher-than-average rates of burnout. Preliminary data suggest that emergency medicine residents are also at risk for burnout. The objective of this study was to conduct the first national survey assessment of US emergency medicine residents to determine the prevalence of burnout.

METHODS

This prospective 2017 National Emergency Medicine Resident Wellness Survey study was conducted through the Wellness Think Tank, whereby emergency medicine residents from 247 residencies across the United States were invited to participate in a national survey. The primary measure of burnout was the Maslach Burnout Inventory-Human Services Survey. In accordance with others' work, "burnout" was defined as a dichotomous variable represented by high levels of emotional exhaustion or depersonalization. Because of interpretative variability with the survey tool, we also calculated burnout rates by using a more restrictive definition and a more inclusive definition that have been reported in the literature.

RESULTS

Surveys were completed by 1,522 residents (21.1% of all US emergency medicine residents), representing 193 of 247 US emergency medicine residency programs (78.1%). Within this sample, the prevalence of burnout was 76.1% (95% confidence interval 74.0% to 78.3%). With alternative definitions applied, burnout prevalence rates for this same sample were 18.2% (95% confidence interval 16.3% to 20.1%) with the more restrictive definition and 80.9% (95% confidence interval 78.9% to 82.9%) with the more inclusive definition.

CONCLUSION

The majority of US emergency medicine residents responding to this survey reported symptoms consistent with burnout, highlighting that physician burnout in the emergency medicine profession seems to begin as early as residency training. These findings may provide a baseline against which future work can be compared.

摘要

研究目的

既往研究表明,急诊医学主治医生的倦怠发生率高于平均水平。初步数据表明,急诊医学住院医师也存在倦怠风险。本研究的目的是对美国急诊医学住院医师进行首次全国调查评估,以确定倦怠的流行率。

方法

这项前瞻性的 2017 年全国急诊医学住院医师健康调查研究是通过健康思维库进行的,邀请全美 247 个住院医师项目的急诊医学住院医师参加全国性调查。倦怠的主要衡量标准是 Maslach 倦怠量表-人力资源服务调查。根据他人的工作,“倦怠”被定义为两个变量:情绪耗竭或去人性化程度高。由于调查工具的解释性差异,我们还使用文献中报告的更严格和更广泛的定义来计算倦怠率。

结果

共有 1522 名住院医师(占全美急诊医学住院医师的 21.1%)完成了调查,代表了全美 247 个急诊医学住院医师项目中的 193 个(78.1%)。在这个样本中,倦怠的流行率为 76.1%(95%置信区间为 74.0%至 78.3%)。在应用替代定义的情况下,同一样本的倦怠患病率分别为 18.2%(95%置信区间为 16.3%至 20.1%)和更严格的定义和 80.9%(95%置信区间为 78.9%至 82.9%)的更广泛定义。

结论

对这项调查做出回应的大多数美国急诊医学住院医师报告的症状与倦怠一致,这突出表明,急诊医学专业的医生倦怠似乎早在住院医师培训阶段就开始了。这些发现可以作为未来工作的基准进行比较。

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