Departments of Internal Medicine and Pediatrics, Yale University School of Medicine, 333 Cedar Street - 1074LMP, PO BOX 8033, New Haven, CT, 06520, USA.
J Clin Psychol Med Settings. 2021 Jun;28(2):361-367. doi: 10.1007/s10880-020-09724-6.
Physician burnout influences physician mental health, staff stress, safety events, and patient outcomes. The association of burnout with compassion satisfaction, secondary stress, emotional coping strategies and many psychosocial variables, such as institutional support, friendship, and spirituality, have not been well studied. A convenience sample of internal medicine physicians was emailed a survey using validated instruments to explore these associations. The response rate was 337/1021 (33%), with a burnout prevalence of 175/337 (52%). Grit, acceptance, active coping, positive reframing, and strategy planning were associated with lower burnout domains and greater compassion satisfaction. Certain emotional coping strategies such as denial, disengagement, self-blame, substance abuse, and venting were associated with greater burnout and lower compassion satisfaction. Greater institutional support was associated with lower burnout (r = - .35, p < .001), secondary stress (r = - .14, p < .05), and compassion satisfaction (r = .28, p < .0001). Friendship was associated with lower burnout (r = - .25, p < .0001) and greater compassion satisfaction (r = .28, p < .0001). This study suggests that amelioration of burnout requires both intrinsic strategies that emphasize physician coping skills as well as extrinsic strategies that address institutional support.
医生职业倦怠会影响医生的心理健康、员工压力、安全事件和患者预后。职业倦怠与同情满足感、二级压力、情绪应对策略以及许多心理社会变量（如机构支持、友谊和精神信仰）之间的关系尚未得到充分研究。本研究采用便利抽样方法，向内科医生发送了一份使用验证工具进行的调查，以探讨这些关联。回复率为 337/1021（33%），其中职业倦怠患病率为 175/337（52%）。坚韧、接纳、积极应对、积极重新规划和策略计划与较低的倦怠领域和更高的同情满足感相关。某些情绪应对策略，如否认、脱离、自责、滥用物质和发泄，与更高的倦怠和更低的同情满足感相关。更多的机构支持与较低的倦怠（r= −.35，p< .001）、二级压力（r= −.14，p< .05）和同情满足感（r= .28，p< .0001）相关。友谊与较低的倦怠（r= −.25，p< .0001）和更高的同情满足感（r= −.28，p< .0001）相关。这项研究表明，缓解职业倦怠需要内在策略，强调医生应对技能，也需要外在策略，解决机构支持问题。
