Jackson Theresa, Zhou Cici, Khorgami Zhamak, Jackson Diane, Agrawal Vaidehi, Taubman Kevin, Nelson Peter, Truitt Michael S
University of Oklahoma Tulsa, Department of Surgery, Tulsa, Oklahoma.
University of Oklahoma College of Medicine, Department of Graduate Medical Education, Oklahoma City, Oklahoma.
J Surg Educ. 2019 Nov-Dec;76(6):e30-e40. doi: 10.1016/j.jsurg.2019.08.002. Epub 2019 Aug 31.
Post-traumatic stress disorder (PTSD) has been shown to be more common in surgical residents than the general population. This may be due to the rigors of a surgical residency. This study aims to compare the prevalence of screening positive for PTSD (PTSD+) among 7 medical specialties. Further, we intend to identify independent risk factors for the development of PTSD.
A cross-sectional national survey of residents (n = 1904) was conducted from September 2016 to May 2017. Residents were screened for PTSD. Traumatic stressors were identified in those who reported symptoms of PTSD. Potential risk factors for PTSD were assessed using multivariate regression analysis with stepwise backward elimination against 30 demographic, occupational, psychological, work-life balance, and work-environment variables.
Residents from anesthesiology (n = 180), emergency medicine (n = 222), internal medicine (n = 473), general surgery (n = 464), obstetrics and gynecology (n = 226), psychiatry (n = 208), and surgical subspecialties (n = 131) were surveyed. No statistical difference was found in the prevalence of PTSD between specialties. Prevalence ranged from 14% to 23%. Eight independent risk factors for the development of PTSD+ were identified: higher postgraduate year, female gender, public embarrassment, emotional exhaustion, feeling unhealthy, job dissatisfaction, hostile hospital culture, and unsafe patient load.
The prevalence of PTSD in surgery residents was not statistically different when compared to those in other medical specialties. However, the overall prevalence of PTSD (20%) remains more than 3 times that of the general population. Overall, 8 risk factors for PTSD were identified. These risk factors varied by specialty. This may highlight the unique challenges of training in each discipline. Specialty specific interventions to improve resident wellness should be emphasized in the development of our young physicians.
创伤后应激障碍（PTSD）在外科住院医师中比普通人群更为常见。这可能是由于外科住院医师培训的严苛性。本研究旨在比较7个医学专业中PTSD筛查呈阳性（PTSD+）的患病率。此外，我们打算确定PTSD发生的独立危险因素。
2016年9月至2017年5月对住院医师（n = 1904）进行了一项全国性横断面调查。对住院医师进行PTSD筛查。在报告有PTSD症状的人中确定创伤性应激源。使用多元回归分析和逐步向后排除法，针对30个人口统计学、职业、心理、工作与生活平衡以及工作环境变量，评估PTSD的潜在危险因素。
对麻醉科（n = 180）、急诊科（n = 222）、内科（n = 473）、普通外科（n = 464）、妇产科（n = 226）、精神科（n = 208）和外科亚专业（n = 131）的住院医师进行了调查。各专业之间PTSD的患病率未发现统计学差异。患病率在14%至23%之间。确定了8个PTSD+发生的独立危险因素：更高的研究生年级、女性、当众尴尬、情绪耗竭、感觉不健康、工作不满意、敌对的医院文化和不安全的患者负荷。
与其他医学专业的住院医师相比，外科住院医师中PTSD的患病率在统计学上没有差异。然而，PTSD的总体患病率（20%）仍比普通人群高出3倍多。总体而言，确定了8个PTSD的危险因素。这些危险因素因专业而异。这可能突出了各学科培训的独特挑战。在培养年轻医生的过程中，应强调针对各专业的干预措施以改善住院医师的健康状况。
