Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Trends Psychiatry Psychother. 2020 Jun;42(2):185-189. doi: 10.1590/2237-6089-2019-0048. Epub 2020 Mar 20.
Introduction Physician burnout is considered an epidemic. In 2019, 44% of U.S. physicians reported feeling burned out. The work environment is a central risk factor for this. The aim of this study is to develop and test an instrument to evaluate work environment factors in medical training courses. Method After focus groups, an initial pool of 14 items was generated and tested in a pilot study (n = 66). Face validity was verified, and small adjustments were made. The resulting version was administered to a sample of 115 psychiatry residents. Eleven items were selected based on the correlations between them, principal component analysis, and theoretical reasons, and then tested for internal and construct validity. Results The final version had high reliability (Cronbach's alpha = 0.898) and comprised three dimensions: relations with the institution; with colleagues; and with preceptors. Both total scores and dimensions correlated significantly with burnout scores (p < 0.01). Cutoffs defining the environment as healthy (>32 points); risky (23-31 points); or toxic (<22 points) were suggested and related to the risk of burnout. Conclusion Several authors have emphasized the importance of approaching institutional factors as an effective strategy for coping with the increased prevalence of burnout. This instrument should contribute to these efforts.
简介 医生倦怠被认为是一种流行病。2019 年,44%的美国医生报告感到倦怠。工作环境是这种情况的一个核心风险因素。本研究旨在开发和测试一种评估医学培训课程中工作环境因素的工具。
方法 在焦点小组之后,生成了一个包含 14 个项目的初始池,并在一项试点研究(n=66)中进行了测试。验证了表面有效性,并进行了小的调整。然后对 115 名精神病学住院医师进行了该版本的测试。根据它们之间的相关性、主成分分析和理论原因,选择了 11 个项目,然后对其进行内部和结构有效性测试。
结果 最终版本具有很高的可靠性(Cronbach's alpha=0.898),包含三个维度:与机构的关系;与同事的关系;与导师的关系。总分和各维度与倦怠得分显著相关(p<0.01)。建议将环境定义为健康(>32 分);有风险(23-31 分);或有毒(<22 分)的分界点,并与倦怠的风险相关。
结论 一些作者强调了将机构因素作为应对倦怠普遍增加的有效策略的重要性。这个工具应该有助于这些努力。