From the Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
Can J Surg. 2020 May 1;63(3):E190-E195. doi: 10.1503/cjs.004319.
Physician health is of increasing concern in health care systems. The purpose of this study was to determine the prevalence of distress among orthopedic surgeons and trainees and to identify factors associated with distress.
Voluntary, anonymous online surveys were sent to attending orthopedic surgeons and orthopedic trainees across Canada. The survey for attending surgeons used the Expanded Physician Well-Being Index, and the survey for trainees used the Resident/Fellow Well-Being Index. Demographic information was also collected. To look for predictors of physician distress, we evaluated the relationship between respondents' classification as "distressed" and "not distressed" against demographic factors.
In total, 1138 attending orthopedic surgeons and 493 orthopedic trainees were invited to complete the survey. The survey response rate was 31.2% for attending orthopedic surgeons and 24.3% for orthopedic trainees. Overall, 55.4% of attending surgeons and 40.0% of trainees screened positive for distress. Among both attending surgeons and trainees, having dependents was not a risk factor for distress, nor was gender. Practice location was not a risk factor for distress among attending surgeons. Attending surgeons who were classified as distressed had spent significantly fewer years in practice (median 11 yr) than those who were classified as "not distressed" (median 16 yr) (p = 0.004).
We found a higher rate of distress among orthopedic surgeons than has been previously reported. The distress rate among orthopedic trainees in this population is similar to that reported in other international publications, although self-reported rates of burnout were higher. The findings from this study may indicate a need for continuing research to determine intrinsic and extrinsic risk factors for distress among orthopedic surgeons and trainees and for the evaluation of prescriptive, evidence-based initiatives to address this crisis.
医生的健康状况越来越受到医疗保健系统的关注。本研究的目的是确定骨科医生和受训者的痛苦发生率，并确定与痛苦相关的因素。
向加拿大各地的骨科医生和骨科受训者发送了自愿、匿名的在线调查。给主治医生的调查使用了扩展医师健康指数，给受训者的调查使用了住院医师/研究员健康指数。还收集了人口统计学信息。为了寻找医生痛苦的预测因素，我们评估了受访者被分类为“痛苦”和“不痛苦”与人口统计学因素之间的关系。
共邀请 1138 名骨科医生和 493 名骨科受训者完成调查。参加骨科医生的调查回复率为 31.2%，骨科受训者的回复率为 24.3%。总的来说，55.4%的主治医生和 40.0%的受训者筛查出有痛苦。在主治医生和受训者中，有家属并不是痛苦的风险因素，性别也不是。执业地点并不是主治医生痛苦的风险因素。被归类为痛苦的主治医生的执业年限明显短于被归类为“不痛苦”的医生（中位数 11 年与中位数 16 年）（p = 0.004）。
我们发现骨科医生的痛苦发生率高于之前的报告。在这一人群中，骨科受训者的痛苦率与其他国际出版物报告的相似，尽管自我报告的倦怠率更高。本研究的结果可能表明需要继续研究，以确定骨科医生和受训者痛苦的内在和外在风险因素，并评估解决这一危机的有针对性的、基于证据的举措。
