Bath Spa University, Bath, UK.
University of Bath, Bath, UK.
Anaesthesia. 2019 Oct;74(10):1240-1251. doi: 10.1111/anae.14694. Epub 2019 May 15.
Anaesthetists experience unique stressors, and recent evidence suggests a high prevalence of stress and burnout in trainee anaesthetists. There has been no in-depth qualitative analysis to explore this further. We conducted semi-structured interviews to explore contributory and potentially protective factors in the development of perceived stress, burnout, depression and low work satisfaction. We sampled purposively among participants in the Satisfaction and Wellbeing in Anaesthetic Training study, reaching data saturation at 12 interviews. Thematic analysis identified three overarching themes: factors enabling work satisfaction; stressors of being an anaesthetic trainee; and suggestions for improving working conditions. Factors enabling work satisfaction were patient contact; the privilege of enabling good patient outcomes; and strong support at home and work. Stressors were demanding non-clinical work-loads; exhaustion from multiple commitments; a 'love/hate' relationship, as trainees value clinical work but find the training burden immense; feeling 'on edge', even unsafe at work; and the changing way society sees doctors. Nearly all trainees discussed feeling some levels of burnout (which were high and distressing for some) and also high levels of perceived stress. However, trainees also experienced distinct elements of work satisfaction and support. Suggested recommendations for improvement included: allowing contracted hours for non-clinical work; individuals taking responsibility for self-care in and out of work; cultural acceptance that doctors can struggle; and embedding wellbeing support more deeply in organisations and the specialty. Our study provides a foundation for further work to inform organisational and cultural changes, to help translate anaesthetic trainees' passion for their work into a manageable and satisfactory career.
麻醉师面临着独特的压力源，最近的证据表明，受训麻醉师中存在较高的压力和倦怠发生率。但目前还没有深入的定性分析来进一步探讨这个问题。我们进行了半结构化访谈，以探讨在感知压力、倦怠、抑郁和低工作满意度的发展中起作用的和潜在的保护因素。我们在满足和幸福感在麻醉培训研究中的参与者中进行了有目的的抽样，在 12 次访谈后达到了数据饱和。主题分析确定了三个总体主题：实现工作满意度的因素；成为麻醉师受训者的压力源；改善工作条件的建议。实现工作满意度的因素包括与患者的接触；为良好的患者结局提供支持的特权；以及家庭和工作中的有力支持。压力源包括繁重的非临床工作量；来自多个承诺的疲惫；一种“爱恨交加”的关系，因为受训者重视临床工作，但发现培训负担巨大；感到“紧张”，甚至在工作中感到不安全；以及社会对医生看法的变化。几乎所有的受训者都表示感到一定程度的倦怠（对一些人来说，倦怠程度很高且令人痛苦），同时也感到压力很大。然而，受训者也经历了工作满意度和支持的明显因素。建议的改进措施包括：为非临床工作允许签订合同工时；个人负责工作内外的自我保健；接受医生也会遇到困难的文化观念；并在组织和专业领域更深入地嵌入幸福感支持。我们的研究为进一步的工作提供了基础，以告知组织和文化变革，帮助将麻醉师对工作的热情转化为可管理和满意的职业。
