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土耳其家庭医生的职业倦怠:两种不同初级保健系统的比较。

Burnout among family physicians in Turkey: A comparison of two different primary care systems.

作者信息

Kosan Z, Aras A, Cayir Y, Calikoglu E O

机构信息

Department of Public Health, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

Department of Family Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

出版信息

Niger J Clin Pract. 2019 Aug;22(8):1063-1069. doi: 10.4103/njcp.njcp_355_17.

Abstract

AIM

The objective of this study was to determine the prevalence of burnout syndrome and associated factors among family physicians before and after family medicine system (FMS).

MATERIALS AND METHOD

The first part of the study was conducted in 2008 (pre-FMS) and the second part in 2012 (post-FMS). Physician's burnout was investigated by using the Maslach Burnout Inventory (MBI). In total, 139 physicians had been participating pre-FMS and 246 physician's post-FMS.

RESULTS

The mean pre-FMS emotional exhaustion score was 15.7 ± 5.8, increasing significantly to 17.14 ± 7.5 post-FMS (P = 0.045). Mean pre-FMS and post-FMS depersonalization and reduced personal accomplishment scores were similar (P > 0.05). Age was negatively correlated with depersonalization in this study (P = 0.012) and positively correlated with personal accomplishment (P = 0.001). The primary care physicians in the post-FMS period were older, female physicians had a greater preference for primary care, and the levels of married doctors were higher. In addition, a higher level of physicians also owned their own home and cars compared to the pre-FMS period. A negative correlation has been reported between physicians' burnout levels and home or car ownership in the present study.

CONCLUSION

Our findings suggest that physicians working under the family medicine system, a new primary care model, are at greater risk of emotional exhaustion, but that no change has occurred in terms of personal accomplishment or depersonalization, despite this new system.

摘要

目的

本研究的目的是确定家庭医学体系(FMS)实施前后家庭医生职业倦怠综合征的患病率及相关因素。

材料与方法

研究的第一部分于2008年(FMS实施前)进行,第二部分于2012年(FMS实施后)进行。使用马氏职业倦怠量表(MBI)对医生的职业倦怠进行调查。FMS实施前共有139名医生参与,FMS实施后有246名医生参与。

结果

FMS实施前情感耗竭平均得分是15.7±5.8,FMS实施后显著增至17.14±7.5(P = 0.045)。FMS实施前和实施后去个性化及个人成就感降低得分均值相似(P>0.05)。本研究中年龄与去个性化呈负相关(P = 0.012),与个人成就感呈正相关(P = 0.001)。FMS实施后的基层医疗医生年龄更大,女性医生对基层医疗的偏好更高,已婚医生比例更高。此外,与FMS实施前相比,医生水平较高者还拥有自己的住房和汽车。本研究报告医生职业倦怠水平与住房或汽车拥有情况之间存在负相关。

结论

我们的研究结果表明,在新的基层医疗模式——家庭医学体系下工作的医生情感耗竭风险更高,但尽管有这个新体系,个人成就感或去个性化方面并未发生变化。

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