Kancherla Binal S, Upender Raghu, Collen Jacob F, Rishi Muhammad Adeel, Sullivan Shannon S, Ahmed Omer, Berneking Michael, Flynn-Evans Erin E, Peters Brandon R, Gurubhagavatula Indira
Department of Pediatrics, Division of Pediatric Pulmonology, Texas Children's Hospital - Baylor College of Medicine, Houston, Texas.
Department of Neurology, Division of Sleep Medicine, Vanderbilt Medical Center, Nashville, Tennessee.
J Clin Sleep Med. 2020 May 15;16(5):807-810. doi: 10.5664/jcsm.8412. Epub 2020 Feb 28.
The occurrence of physician burnout is widespread among clinicians and academic faculty, who report indicators such as low quality of life and poor work-life balance. Chronic insufficient sleep, whether due to extended work hours, circadian misalignment, or unrecognized sleep disorders, is a critically important risk factor for burnout that is overlooked and under-studied, and interventions to promote healthy sleep may reduce burnout susceptibility among attending physicians. While strategies to reduce burnout among resident and attending physicians have been under-evaluated, evidence suggests a need to address burnout at both individual and organizational levels. Solutions have been offered that are applicable to many stakeholders, including employers; payers; licensing and certification boards; state and federal regulatory agencies; and physicians and researchers. As more studies are undertaken to evaluate how these approaches impact burnout, two questions need to be addressed: (1) What is the role of sleep in the crisis of burnout, specifically among attendings, who are particularly under-studied? (2) Is restoration of healthy sleep the fundamental mechanism by which burnout interventions work? It is essential for key stakeholders to consider the role of sleep, sleepiness, and sleep disorders in order to optimize any efforts to mitigate the present crisis in physician burnout, particularly among attending physicians, an understudied group.
医生职业倦怠现象在临床医生和学术教员中普遍存在，他们报告了生活质量低下和工作与生活平衡不佳等指标。慢性睡眠不足，无论是由于工作时间延长、昼夜节律失调还是未被识别的睡眠障碍，都是职业倦怠的一个极其重要的风险因素，但却被忽视且研究不足，而促进健康睡眠的干预措施可能会降低主治医生的职业倦怠易感性。虽然减少住院医生和主治医生职业倦怠的策略尚未得到充分评估，但有证据表明需要在个人和组织层面解决职业倦怠问题。已经提出了适用于许多利益相关者的解决方案，包括雇主、付款方、执照和认证委员会、州和联邦监管机构以及医生和研究人员。随着越来越多的研究致力于评估这些方法如何影响职业倦怠，有两个问题需要解决：（1）睡眠在职业倦怠危机中扮演什么角色，特别是在研究较少的主治医生中？（2）恢复健康睡眠是否是职业倦怠干预措施起作用的基本机制？关键利益相关者必须考虑睡眠、嗜睡和睡眠障碍的作用，以便优化任何减轻当前医生职业倦怠危机的努力，特别是在主治医生这一研究不足的群体中。
