Hooker Stephanie A, Post Robert E, Sherman Michelle D
HealthPartners Institute, 8170 33rd Avenue, Mail Stop 23301A, Minneapolis, MN 55425 952-967-5056. 952-967-5022.
Department of Family Medicine, Virtua Health System, Voorhees, NJ.
Fam Med. 2020 Jan 4;52(1):11-16. doi: 10.22454/FamMed.2019.562297. Epub 2019 Nov 4.
Burnout is considered a public health crisis among physicians and is related to poor quality of life, increased medical errors, and lower patient satisfaction. A recent literature review and conceptual model suggest that awareness of life meaning, or meaning salience, is related to improved stress and coping, and may also reduce experience of burnout. This study examined associations among meaning salience, burnout, fatigue, and quality of life among family medicine residency program directors.
Data were collected via an online survey administered by the Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA; n=268, response rate of 45.4%) in December 2018. Program directors completed measures of meaning salience, burnout, fatigue, and quality of life. Data were analyzed using Spearman correlations and path analysis.
Program directors who reported greater experienced meaning salience also reported significantly less burnout (β=-.40, P<.001) and less fatigue (β=-.38, P<.001), which were then both significantly associated with greater quality of life (Ps<.001). Program directors who reported greater meaning salience also reported greater quality of life (β=.21, P<.001). Additionally, there were significant indirect associations between meaning salience and quality of life through less burnout and fatigue (β=.26, P<.001).
The potential for increasing physicians' awareness of their sense of meaning as a means to prevent or decrease burnout is underresearched and warrants further study. Both preventive measures (eg, wellness curricula) and interventions with already-distressed physicians may encourage regular reflection on meaning in life, especially during busy workdays.
职业倦怠被认为是医生群体面临的公共卫生危机，与生活质量下降、医疗差错增加以及患者满意度降低相关。最近的一项文献综述和概念模型表明，对生活意义的认知，即意义显著性，与压力缓解和应对能力的提升有关，也可能减少职业倦怠的体验。本研究考察了家庭医学住院医师培训项目主任的意义显著性、职业倦怠、疲劳与生活质量之间的关联。
数据通过学术家庭医学理事会（CAFM）教育研究联盟（CERA）于2018年12月进行的在线调查收集（n = 268，回复率为45.4%）。项目主任完成了意义显著性、职业倦怠、疲劳和生活质量的测量。数据采用Spearman相关性分析和路径分析。
报告有更高意义显著性体验的项目主任，其职业倦怠（β = -0.40，P <.001）和疲劳程度（β = -0.38，P <.001）也显著更低，而这两者又都与更高的生活质量显著相关（P <.001）。报告有更高意义显著性的项目主任也报告有更高的生活质量（β = 0.21，P <.001）。此外，通过更少的职业倦怠和疲劳，意义显著性与生活质量之间存在显著的间接关联（β = 0.26，P <.001）。
将提高医生对自身意义感的认知作为预防或减轻职业倦怠的一种手段，这方面的潜力研究不足，值得进一步探讨。预防措施（如健康课程）以及针对已经出现职业倦怠的医生的干预措施，都可能鼓励他们定期思考生活的意义，尤其是在忙碌的工作日。
