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住院医师新生的健康与幸福感:一项多领域调查。

Health and wellness among incoming resident physicians: A multi-domain survey.

作者信息

Tabibian James H, Bertram Amanda K, Yeh Hsin-Chieh, Cofrancesco Joseph, Codori Nancy, Block Lauren, Miller Edgar R, Ranasinghe Padmini D, Marinopoulos Spyridon S

机构信息

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.

出版信息

J Community Med (Reno). 2018;1. doi: 10.33582/2637-4900/1003. Epub 2018 Feb 20.

Abstract

INTRODUCTION

Burnout and depression are well-described in medical students and physicians and can lead to adverse personal and patient outcomes; however, their time course and risk factors remain understudied. Here, we measured multiple domains of mental and physical health and wellness and assessed gender differences among incoming physician trainees beginning residency at an academic medical center.

METHODS

Using a cross-sectional study design, all incoming trainees (i.e. housestaff) at Johns Hopkins Hospital received a questionnaire assessing depression, burnout, sleep, exercise, and alcohol consumption, among other domains. Standardized instruments were utilized for questionnaire development. Tests of significance were two-tailed.

RESULTS

196 of 229 incoming housestaff (86%) completed the survey, and 49% were female. A history of depression was reported in 8%, and 5.4% met criteria for at least moderate depression by Patient Health Questionnaire (PHQ-9). Females were more likely to report a history of depression than males (13% vs. 3%, p=0.02) but had similar PHQ-9 scores. Four percent of participants reported feeling they were in the wrong profession. Goal and mean sleep were 7 and 6.7 hours/night, respectively. Forty-seven percent reported exercising once/week or not at all. While mean reported weekly alcohol consumption was three drinks, participants reported consuming ≥5 drinks in one sitting on average 1.6 times in the prior 6 months, and 4% used alcohol to sleep.

CONCLUSIONS

Incoming housestaff reported generally favorable mental and physical health at the beginning of residency training. However, exercise rates were low, and ill-suited alcohol consumption was noted, though infrequent. The few areas of possible improvement were largely similar between males and females. Wellness interventions might capitalize on the relatively high morale and health at the completion of medical school by helping to promote healthy habits, including regular exercise and avoidance of excess alcohol consumption, throughout future training and practice.

摘要

引言

医学生和医生中职业倦怠和抑郁现象已广为人知,且可能导致不良的个人和患者结局;然而,它们的时间进程和风险因素仍未得到充分研究。在此,我们对即将在一所学术医疗中心开始住院医师培训的医师学员的多个身心健康领域进行了测量,并评估了性别差异。

方法

采用横断面研究设计,约翰霍普金斯医院所有即将入学的学员(即住院医师)均收到一份问卷,评估抑郁、职业倦怠、睡眠、运动和饮酒等领域。问卷开发使用了标准化工具。显著性检验采用双侧检验。

结果

229名即将入学的住院医师中有196名(86%)完成了调查,其中49%为女性。8%的人报告有抑郁病史,5.4%的人根据患者健康问卷(PHQ - 9)符合至少中度抑郁的标准。女性比男性更有可能报告有抑郁病史(13%对3%,p = 0.02),但PHQ - 9得分相似。4%的参与者表示觉得自己入错了行。目标睡眠时间和平均睡眠时间分别为每晚7小时和6.7小时。47%的人报告每周锻炼一次或根本不锻炼。虽然报告的平均每周饮酒量为三杯,但参与者报告在过去6个月中平均有1.6次一次饮用≥5杯酒,4%的人用酒精助眠。

结论

即将入学的住院医师在住院医师培训开始时报告的身心健康状况总体良好。然而,运动率较低,且存在不适当的饮酒情况,尽管不常见。男性和女性在可能需要改进的几个方面大致相似。健康干预措施可以利用医学院校毕业时相对较高的士气和健康状况优势,在未来的培训和实践中帮助促进健康习惯,包括定期锻炼和避免过量饮酒。

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