Gogo Albina, Osta Amanda, McClafferty Hilary, Rana Deborah T
Department of Pediatrics, School of Medicine, University of California Davis, Sacramento, California, United States.
Department of Pediatrics, College of Medicine, University of Illinois, Chicago, Illinois, United States.
Curr Probl Pediatr Adolesc Health Care. 2019 Dec;49(12):100663. doi: 10.1016/j.cppeds.2019.100663. Epub 2019 Sep 26.
The practice of medicine is rewarding on many levels, but demands of the work can result in mental and emotional exhaustion, self-isolation, burnout, depression, suicidal ideation and tragically, completed suicide. It is critical to have effective strategies to address the unique stressors of a medical career, mitigate burnout, and buffer the physiologic toll of chronic stress. Using Zwack and Schweitzer's widely published description of approaches to maintaining resilience and approaches to wellness, we have organized these strategies into three broad domains relevant to medical practice: (1) gratification (connection and communication, meaning and purpose); (2) resilience building practices (self-reflection, time for oneself, self-compassion, spirituality); and (3) useful attitudes (acceptance, flexibility, self-awareness). Several techniques are described including mindfulness-based stress reduction, narrative medicine, skillful communication, and practices in self-compassion, gratitude, and spirituality. The focus of the work is to introduce a spectrum of resilience strategies for individual consideration that can be tailored and combined to meet a physician's changing needs over the course of medical training and practice.
医学实践在许多层面上都有回报，但工作要求可能导致精神和情感疲惫、自我孤立、职业倦怠、抑郁、自杀念头，可悲的是还会导致自杀行为。拥有有效的策略来应对医疗职业独特的压力源、减轻职业倦怠并缓冲慢性压力对生理造成的损害至关重要。利用兹瓦克和施韦策广泛发表的关于保持复原力的方法和健康方法的描述，我们将这些策略组织成与医学实践相关的三个广泛领域：(1) 满足感（联系与沟通、意义与目的）；(2) 复原力培养实践（自我反思、给自己留出时间、自我同情、精神层面）；以及(3) 有益的态度（接纳、灵活性、自我意识）。文中描述了几种技巧，包括基于正念的减压法、叙事医学、有效沟通以及自我同情、感恩和精神层面的实践。这项工作的重点是介绍一系列可供个人考虑的复原力策略，这些策略可以根据医生在医学培训和实践过程中不断变化的需求进行调整和组合。
