Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
J Surg Educ. 2019 Sep-Oct;76(5):1211-1222. doi: 10.1016/j.jsurg.2019.03.012. Epub 2019 Apr 9.
Compassion fatigue (CF) is the profound sense of emotional exhaustion that care providers can experience as the result of helping others in distress. CF can contribute to burnout (BO), depression, and stress-related illness. While surgeons and surgical trainees may be at high risk for developing CF, it has not been adequately characterized or explored in this population. The objective of this study was to examine the prevalence and impact of CF in surgical trainees with a view to inform a management strategy.
A mixed method study was conducted using survey and interview methods. An email survey including the Professional Quality of Life Scale Version 5, an instrument to assess CF, was sent to all trainees in the Department of Surgery at the University of Toronto. Survey data were analyzed descriptively and using one-sample t tests. Semistructured interviews were conducted with volunteered trainees. Data collection and analysis occurred iteratively and inductively using the constant comparison method.
One hundred fifteen trainees completed the survey representing a 47% response rate. Ninety-nine respondents (40.7%) completed the Professional Quality of Life Scale tool. The mean score on the compassion satisfaction subscale was 36.9 (SD 6.7), on the BO subscale was 26.2 (SD 5.6), and on the secondary traumatic stress (STS) subscale was 21.2 (SD 6.3). The mean on the compassion satisfaction subscale was not statistically different from the population mean (p = 0.22). The means for the BO and STS scales were statistically higher in our study sample compared to the normative data (p < 0.0001 for each). Thematic qualitative findings indicated trainees experienced CF symptoms. Participants described systemic barriers to mitigating CF including workload and a cultural expectation to be unemotional at work.
Surgical trainees report high levels of BO and STS and currently use informal coping strategies outside of their academic and hospital environments. Trainees are likely to welcome and benefit from an organized response to support their emotional health when facing difficult patient encounters.
同情疲劳（CF）是指护理人员在帮助处于困境中的他人时可能经历的深刻的情感疲惫感。CF 可导致倦怠（BO）、抑郁和与压力相关的疾病。虽然外科医生和外科受训者可能面临发生 CF 的高风险，但在这一人群中尚未对其进行充分的描述和探索。本研究的目的是检查外科受训者 CF 的患病率和影响，以期为管理策略提供信息。
采用问卷调查和访谈相结合的混合方法研究。向多伦多大学外科系的所有受训者发送了一份电子邮件调查，其中包括职业生活质量量表第 5 版，这是一种评估 CF 的工具。使用描述性统计和单样本 t 检验对调查数据进行分析。对自愿参加的受训者进行半结构化访谈。数据收集和分析采用迭代和归纳的恒定比较法进行。
共有 115 名受训者完成了调查，回应率为 47%。99 名应答者（40.7%）完成了职业生活质量量表工具。同情满足分量表的平均得分为 36.9（SD 6.7），倦怠分量表为 26.2（SD 5.6），二次创伤压力分量表为 21.2（SD 6.3）。同情满足分量表的平均值与总体平均值无统计学差异（p=0.22）。我们的研究样本中倦怠和二次创伤压力量表的平均值明显高于规范数据（p<0.0001）。主题定性结果表明受训者出现了 CF 症状。参与者描述了减轻 CF 的系统性障碍，包括工作量大和在工作中保持冷静的文化期望。
外科受训者报告倦怠和二次创伤压力水平较高，目前在学术和医院环境之外使用非正式的应对策略。当面对困难的患者时，受训者可能会欢迎并受益于有组织的应对措施来支持他们的情绪健康。
