Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), Institute of Psychiatry, University of Palermo, Palermo, Sicilia, Italy.
District Health Authority (ASP) of Trapani, National Health System, Trapani, Sicilia, Italy.
Prehosp Disaster Med. 2020 Apr;35(2):133-140. doi: 10.1017/S1049023X20000059. Epub 2020 Jan 27.
Burnout is present at a high rate in emergency medicine. The ambulance driver-rescuers, who furnish first aid to the victims, are the non-medical part of the Italian 118-service staff. There is a lack of research on burnout risk in Italian Emergency Medical Services and, particularly, for this category of workers. The two Italian studies, including a little group of ambulance driver-rescuers, reported inconsistent findings.
This survey investigated for the first time the prevalence and exact profile of burnout in a large sample of Italian driver-rescuers. As a secondary aim, the study described how the items of the Italian version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) cluster in components in this sample.
This cross-sectional census survey was conducted from June 2015 through May 2016 and involved all the driver-rescuers operating in Sicily, the biggest and most southern region of Italy. The subjects received a classification according to different profiles of burnout by using the Italian version of the MBI-HSS (burnout, engagement, disengagement, over-extension, and work-inefficacy). In order to explore the existence of independent factors, a Principal Component Analysis (PCA) was conducted on the survey to obtain eigenvalues >one for each component in the data.
The final sample comprised 2,361 responders (96.6% of the initial sample). Of them, 29.8% were in burnout (95% confidence interval [CI], 27.8% to 31.8%) and 1.7% presented a severe form (95% CI, 1.1% to 2.3%); 30.0% were engaged in their work (95% CI, 21.0% to 34.8%), 24.7% of responders were disengaged (95% CI, 22.9% to 26.5%), 1.2% presented an over-extension profile (95% CI, 0.8% to 1.7%), and 12.6% felt work-inefficacy (95% CI, 11.3% to 14.1%). The factors loaded into a five-factor solution at PCA, explaining 48.1% of the variance and partially replicating the three-factor structure. The Emotional Exhaustion (EE) component was confirmed. New dimensions from Personal Accomplishment (PA) and Depersonalization (DP) sub-scales described empathy and disengagement with patients, respectively, and were responsible for the increased risk of burnout.
These results endorse the importance of screening and psychological interventions for this population of emergency workers, where burnout could manifest itself more insidiously. It is also possible to speculate that sub-optimal empathy skills could be related to the disengagement and work-inefficacy feelings registered.
在急诊医学中，倦怠的发生率很高。救护车驾驶员-救援人员为受害者提供急救，是意大利 118 服务人员的非医疗人员。意大利急救医疗服务机构的倦怠风险研究，特别是针对这一类工作人员的研究还很缺乏。两项包括一小部分救护车驾驶员-救援人员的意大利研究报告了不一致的结果。
本研究首次调查了大量意大利驾驶员-救援人员中倦怠的流行率和确切特征。作为次要目标，本研究描述了意大利版 Maslach 倦怠量表-人力资源服务调查（MBI-HSS）的项目如何在该样本中聚类为组成部分。
这项横断面普查从 2015 年 6 月至 2016 年 5 月进行，涉及意大利最大和最南部的西西里岛的所有驾驶员-救援人员。根据意大利版 MBI-HSS（倦怠、投入、脱离、过度扩展和工作无效），对这些人员进行不同倦怠特征的分类。为了探索独立因素的存在，对调查进行了主成分分析（PCA），以获得数据中每个组成部分的特征值>1。
最终样本包括 2361 名应答者（初始样本的 96.6%）。其中，29.8%处于倦怠状态（95%置信区间[CI]，27.8%至 31.8%），1.7%为严重倦怠（95%CI，1.1%至 2.3%）；30.0%投入工作（95%CI，21.0%至 34.8%），24.7%的应答者脱离工作（95%CI，22.9%至 26.5%），1.2%呈现过度扩展特征（95%CI，0.8%至 1.7%），12.6%感觉工作无效（95%CI，11.3%至 14.1%）。在 PCA 中，因子加载到一个五因子解中，解释了 48.1%的方差，部分复制了三因子结构。情绪耗竭（EE）成分得到了证实。来自个人成就（PA）和去人格化（DP）子量表的新维度分别描述了对患者的同理心和脱离，这增加了倦怠的风险。
这些结果支持对这一急诊工作人员群体进行筛查和心理干预的重要性，因为倦怠可能表现得更加隐匿。也可以推测，次优的同理心技能可能与登记的脱离和工作无效感有关。
