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台湾地区医疗职场与倦怠水准相关的可修正风险因子:横断性研究。

Modifiable risk factors related to burnout levels in the medical workplace in Taiwan: cross-sectional study.

机构信息

Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.

Department of Nursing and Occupational Safety and Health Office, Taichung Veterans General Hospital, Taichung, Taiwan.

出版信息

BMJ Open. 2019 Nov 18;9(11):e032779. doi: 10.1136/bmjopen-2019-032779.

Abstract

OBJECTIVES

To detect the combined effects of lifestyle factors on work-related burnout (WB) and to analyse the impact of the number of weekend catch-up sleep hours on burnout risk in a medical workplace.

DESIGN

Cross-sectional study.

SETTING

Hospital-based survey in Taiwan.

PARTICIPANTS

In total, 2746 participants completed the hospital's Overload Health Control System questionnaire for the period from the first day of January 2016 to the end of December 2016, with a response rate of 70.5%. The voluntary participants included 358 physicians, 1406 nurses, 367 medical technicians and 615 administrative staff.

PRIMARY AND SECONDARY OUTCOME MEASURES

All factors that correlated significantly with WB were entered into a multinomial logistic regression after adjustment for other factors. The dose-response relationship of combined lifestyle factors and catch-up sleep hours associated with WB was explored by logistic regression.

RESULTS

Abnormal meal time (adjusted OR 2.41, 95% CI 1.85 to 3.15), frequently eating out (adjusted OR 1.49, 95% CI 1.12 to 1.97), lack of sleep (adjusted OR 5.13, 95% CI 3.94 to 6.69), no exercise (adjusted OR 1.41, 95% CI 1.10 to 1.81) and >40 work hours (adjusted OR 2.72, 95% CI 2.08-3.57) were independently associated with WB (for high level compared with low level). As the number of risk factors increased (1-5), so did the proportion of high severity of WB (adjusted OR 1.39, 95% CI 0.45 to 4.27, to adjusted OR 32.98, 95% CI 10.78 to 100.87). For those with more than 7 hours' sleep on workdays, weekend catch-up sleep (≤0/>0 and ≤2/>2 hours) was found to be related to an increase of burnout risk (adjusted OR 4.91, 95% CI 2.24 to 10.75/adjusted OR 4.94, 95% CI 2.54 to 9.63/adjusted OR 6.74, 95% CI 2.94 to 15.46).

CONCLUSION

WB in the medical workplace was affected by five unhealthy lifestyle factors, and combinations of these factors were associated with greater severity of WB. Weekend catch-up sleep was correlated with lower burnout risk in those with a short workday sleep duration (less than 7 hours). Clinicians should pay particular attention to medical staff with short sleep duration without weekend catch-up sleep.

摘要

目的

检测生活方式因素对工作相关倦怠(WB)的综合影响,并分析在医疗工作场所中周末补觉时间对倦怠风险的影响。

设计

横断面研究。

地点

中国台湾的医院调查。

参与者

共有 2746 名参与者完成了 2016 年 1 月 1 日至 12 月 31 日期间医院的超负荷健康控制系统问卷,应答率为 70.5%。自愿参加的人员包括 358 名医生、1406 名护士、367 名医疗技术人员和 615 名行政人员。

主要和次要结果

在调整其他因素后,将与 WB 显著相关的所有因素纳入多项逻辑回归。通过逻辑回归探讨了与 WB 相关的生活方式因素和补觉时间的联合剂量反应关系。

结果

异常用餐时间(调整后的 OR 2.41,95%CI 1.85 至 3.15)、经常外出就餐(调整后的 OR 1.49,95%CI 1.12 至 1.97)、睡眠不足(调整后的 OR 5.13,95%CI 3.94 至 6.69)、缺乏运动(调整后的 OR 1.41,95%CI 1.10 至 1.81)和>40 小时的工作时间(调整后的 OR 2.72,95%CI 2.08-3.57)与 WB 独立相关(与低水平相比,高水平)。随着危险因素数量的增加(1-5),WB 严重程度较高的比例也随之增加(调整后的 OR 1.39,95%CI 0.45 至 4.27,调整后的 OR 32.98,95%CI 10.78 至 100.87)。对于工作日睡眠时间超过 7 小时的人,发现周末补觉(≤0/>0 和≤2/>2 小时)与倦怠风险增加有关(调整后的 OR 4.91,95%CI 2.24 至 10.75/调整后的 OR 4.94,95%CI 2.54 至 9.63/调整后的 OR 6.74,95%CI 2.94 至 15.46)。

结论

医疗工作场所的 WB 受到五种不健康的生活方式因素的影响,这些因素的组合与 WB 严重程度的增加有关。周末补觉与工作日睡眠时间较短(少于 7 小时)的人倦怠风险降低有关。临床医生应特别注意睡眠不足且没有周末补觉的医务人员。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d623/6887028/4726af840db4/bmjopen-2019-032779f01.jpg

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