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美国家庭医学住院医师培训项目主任职业倦怠的横断面研究:对缓解努力和未来研究的启示。

A cross-sectional study of United States family medicine residency programme director burnout: implications for mitigation efforts and future research.

机构信息

Department of Family Medicine, Medical University of South Carolina, Charleston, SC, USA.

Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA.

出版信息

Fam Pract. 2020 Nov 28;37(6):772-778. doi: 10.1093/fampra/cmaa075.

Abstract

BACKGROUND

Academic physician burnout is concerning. Too little is known about factors associated with residency programme director burnout. Continued uncertainty risks adverse outcomes including graduate medical education leadership turnover and negative impact on recruiting and retaining under-represented minority residency programme directors.

OBJECTIVE

This study assessed symptoms of burnout (emotional exhaustion, depersonalization) and depression along with evidence-based individual and environmental risk factors in a U.S. sample of family medicine residency programme directors.

METHODS

The omnibus 2018 Council of Academic Family Medicine Education Research Alliance survey was used to contact programme directors at all Accreditation Council for Graduate Medical Education accredited U.S. family medicine residency programmes via email. Descriptive data included programme director and programme characteristics, Areas of Worklife (workload, values and control), loneliness (lack companionship, feel left out and feel isolated), burnout (emotional exhaustion, depersonalization) and depressive symptoms. Chi-square tests contrasted descriptive variables with burnout and depressive symptoms. Logistic regression (LR) modelled associations between significant descriptive variables and burnout and depressive symptoms.

RESULTS

The survey response rate was 45.2% (268/590). Programme directors reported: emotional exhaustion (25.0%), depersonalization (10.3%) and depressive symptoms (25.3%). LR models found significant associations with emotional exhaustion (Workload: lacking time and other work-related resources); lack of companionship, depersonalization (North West Central residency region; Workload and lack of companionship) and depressive symptoms (Black/African American ethnicity).

CONCLUSIONS

One-quarter of U.S. programme directors report burnout or depressive symptoms. Future research should consider associated variables as possible intervention targets to reduce programme director distress and turnover.

摘要

背景

学术型医生倦怠令人担忧。对于与住院医师项目主任倦怠相关的因素,我们知之甚少。持续的不确定性带来了不良后果,包括研究生医学教育领导层更替,以及对招聘和留住代表性不足的少数族裔住院医师项目主任的负面影响。

目的

本研究评估了美国家庭医学住院医师项目主任样本中倦怠(情绪疲惫、去人性化)和抑郁的症状,以及基于证据的个体和环境风险因素。

方法

使用 2018 年学术家庭医学教育研究联盟理事会综合调查,通过电子邮件联系所有经研究生医学教育认证委员会认证的美国家庭医学住院医师项目的项目主任。描述性数据包括项目主任和项目特征、工作生活领域(工作量、价值观和控制)、孤独感(缺乏陪伴、被冷落和孤立感)、倦怠(情绪疲惫、去人性化)和抑郁症状。卡方检验对比了描述性变量与倦怠和抑郁症状。逻辑回归(LR)模型分析了显著的描述性变量与倦怠和抑郁症状之间的关联。

结果

调查的回复率为 45.2%(268/590)。项目主任报告了:情绪疲惫(25.0%)、去人性化(10.3%)和抑郁症状(25.3%)。LR 模型发现与情绪疲惫(工作量:缺乏时间和其他与工作相关的资源)、缺乏陪伴、去人性化(西北中部住院医师项目地区;工作量和缺乏陪伴)和抑郁症状(非裔美国人种族)显著相关。

结论

四分之一的美国项目主任报告有倦怠或抑郁症状。未来的研究应考虑相关变量,作为减轻项目主任压力和离职的可能干预目标。

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