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burnout 与德国住院医师的工作家庭冲突和满足危机有关。

Burnout is associated with work-family conflict and gratification crisis among German resident physicians.

机构信息

Institute and Polyclinic of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.

Institute of Medical Biometry and Epidemiology, Hamburg, Germany.

出版信息

BMC Med Educ. 2020 May 8;20(1):145. doi: 10.1186/s12909-020-02061-0.

Abstract

BACKGROUND

Studies investigating the longitudinal predictive value of burnout on both effort-reward imbalance (within the working place) and work-family conflict (between work and private life) in residents are lacking. Former cross-sectional studies showed an association of effort-reward imbalance and work family conflict with an elevated burnout risk in physicians.

METHODS

Data acquisition was carried out within the multi-centric, longitudinal, and prospective "KarMed" study in Germany from 2009 until 2016. Yearly surveys including validated scales: the Maslach Burnout Inventory with its three subscales (emotional exhaustion, personal accomplishment, depersonalisation), the Work-Family Conflict Scale, and the Effort-Reward Imbalance Inventory. Further independent variables were gender and parental status.The analyses were based on general linear models and general linear mixed models with repeated measures designs.

RESULTS

Significant time-fixed effects were found for all three subscales of the Maslach Burnout Inventory, with gender effects on the subscales emotional exhaustion and depersonalisation. The parental status had no significant effect on burnout. All estimated means for burnout during 6 years of post-graduate training were higher when work-family conflict and gratification crisis were taken into account. Personal accomplishment increased continuously over time as well showing neither gender differences nor influences by the parental status.

CONCLUSIONS

Personal accomplishments might act as a buffer compensating to some extent for the physicians' stress experience. Given that burnout may be associated with poor patient care, there is a need to reduce burnout rates and their associated factors in resident physicians.

摘要

背景

目前缺乏研究来调查工作倦怠对工作场所内的努力-回报失衡(工作中)和工作-家庭冲突(工作与私人生活之间)的纵向预测价值。以前的横断面研究表明,工作-家庭冲突和努力-回报失衡与医生的倦怠风险升高有关。

方法

数据采集是在德国的多中心、纵向和前瞻性“KarMed”研究中进行的,时间为 2009 年至 2016 年。每年进行调查,包括经过验证的量表:马斯拉赫倦怠量表及其三个子量表(情绪耗竭、个人成就感、去人性化)、工作-家庭冲突量表和努力-回报失衡量表。其他独立变量为性别和父母身份。分析基于一般线性模型和具有重复测量设计的一般线性混合模型。

结果

马斯拉赫倦怠量表的所有三个子量表均存在显著的时间固定效应,性别对子量表情绪耗竭和去人性化有影响。父母身份对倦怠没有显著影响。在考虑工作-家庭冲突和回报危机后,研究生培训 6 年期间的所有倦怠估计平均值均较高。个人成就感也随着时间的推移而持续增加,既没有性别差异,也不受父母身份的影响。

结论

个人成就感可能在一定程度上充当缓冲,补偿医生的压力体验。鉴于倦怠可能与较差的患者护理有关,因此需要降低住院医师的倦怠率及其相关因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c385/7206716/b8e9d94ee042/12909_2020_2061_Fig1_HTML.jpg

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