Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, Imperial College London, London, UK
Department of Development & Regeneration, KU Leuven, Leuven, Belgium.
BMJ Open. 2019 Nov 25;9(11):e030968. doi: 10.1136/bmjopen-2019-030968.
To determine the prevalence of burnout in doctors practising obstetrics and gynaecology, and assess the association with defensive medical practice and self-reported well-being.
Nationwide online cross-sectional survey study; December 2017-March 2018.
Hospitals in the UK.
5661 practising obstetrics and gynaecology consultants, specialty and associate specialist doctors and trainees registered with the Royal College of Obstetricians and Gynaecologists.
Prevalence of burnout using the Maslach Burnout Inventory and defensive medical practice (avoiding cases or procedures, overprescribing, over-referral) using a 12-item questionnaire. The odds ratios (OR) of burnout with defensive medical practice and self-reported well-being.
3102/5661 doctors (55%) completed the survey. 3073/3102 (99%) met the inclusion criteria (1462 consultants, 1357 trainees and 254 specialty and associate specialist doctors). 1116/3073 (36%) doctors met the burnout criteria, with levels highest amongst trainees (580/1357 (43%)). 258/1116 (23%) doctors with burnout reported increased defensive practice compared with 142/1957 (7%) without (adjusted OR 4.35, 95% CI 3.46 to 5.49). ORs of burnout with well-being items varied between 1.38 and 6.37, and were highest for anxiety (3.59, 95% CI 3.07 to 4.21), depression (4.05, 95% CI 3.26 to 5.04) and suicidal thoughts (6.37, 95% CI 95% CI 3.95 to 10.7). In multivariable logistic regression, being of younger age, white or 'other' ethnicity, and graduating with a medical degree from the UK or Ireland had the strongest associations with burnout.
High levels of burnout were observed in obstetricians and gynaecologists and particularly among trainees. Burnout was associated with both increased defensive medical practice and worse doctor well-being. These findings have implications for the well-being and retention of doctors as well as the quality of patient care, and may help to inform the content of future interventions aimed at preventing burnout and improving patient safety.
确定从事妇产科的医生中倦怠的流行率，并评估其与防御性医疗实践和自我报告的幸福感之间的关联。
全国性在线横断面调查研究；2017 年 12 月至 2018 年 3 月。
英国的医院。
5661 名皇家妇产科医师学院注册的妇产科顾问、专科医生和副专科医生以及受训者。
使用 Maslach 倦怠量表评估倦怠的发生率，使用 12 项问卷评估防御性医疗实践（避免病例或程序、过度处方、过度转诊）。倦怠与防御性医疗实践和自我报告的幸福感的比值比（OR）。
5661 名医生中有 3102 名（55%）完成了调查。3102 名中的 3073 名（99%）符合纳入标准（1462 名顾问、1357 名受训者和 254 名专科医生和副专科医生）。3073 名中的 1116 名（36%）医生符合倦怠标准，其中受训者的水平最高（580/1357（43%））。与 1957 名中无倦怠报告的医生（调整后 OR 4.35，95%CI 3.46 至 5.49）相比，1116 名中有倦怠报告的医生中（23%）有更多的防御性实践。与幸福感项目相关的 OR 从 1.38 到 6.37 不等，焦虑（3.59，95%CI 3.07 至 4.21）、抑郁（4.05，95%CI 3.26 至 5.04）和自杀念头（6.37，95%CI 95%CI 3.95 至 10.7）的 OR 最高。在多变量逻辑回归中，年龄较小、白人或“其他”族裔，以及毕业于英国或爱尔兰的医学学位与倦怠的关联最强。
在妇产科医生中观察到较高水平的倦怠，特别是在受训者中。倦怠与防御性医疗实践的增加和医生幸福感的下降均有关联。这些发现对医生的幸福感和保留率以及患者护理质量有影响，可能有助于为预防倦怠和提高患者安全的未来干预措施提供信息。
