Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California.
Department of Medicine, Stanford University School of Medicine, Stanford, California.
JAMA Netw Open. 2020 Aug 3;3(8):e2012762. doi: 10.1001/jamanetworkopen.2020.12762.
Previous research suggests that the prevalence of occupational burnout varies by demographic characteristics, such as sex and age, but the association between physician race/ethnicity and occupational burnout is less well understood.
To investigate possible differences in occupational burnout, depressive symptoms, career satisfaction, and work-life integration by race/ethnicity in a sample of US physicians.
DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, data for this secondary analysis of 4424 physicians were originally collected from a cross-sectional survey of US physicians between October 12, 2017, and March 15, 2018. The dates of analysis were March 8, 2019, to May 21, 2020. Multivariable logistic regression, including statistical adjustment for physician demographic and clinical practice characteristics, was performed to examine the association between physician race/ethnicity and occupational burnout, depressive symptoms, career satisfaction, and work-life integration.
Physician demographic and clinical practice characteristics included race/ethnicity, sex, age, clinical specialty, hours worked per week, primary practice setting, and relationship status.
Physicians with a high score on the emotional exhaustion or depersonalization subscale of the Maslach Burnout Inventory were classified as having burnout. Depressive symptoms were measured using the Primary Care Evaluation of Mental Disorders instrument. Physicians who marked "strongly agree" or "agree" in response to the survey items "I would choose to become a physician again" and "My work schedule leaves me enough time for my personal/family life" were considered to be satisfied with their career and work-life integration, respectively.
Data were available for 4424 physicians (mean [SD] age, 52.46 [12.03] years; 61.5% [2722 of 4424] male). Most physicians (78.7% [3480 of 4424]) were non-Hispanic White. Non-Hispanic Asian, Hispanic/Latinx, and non-Hispanic Black physicians comprised 12.3% (542 of 4424), 6.3% (278 of 4424), and 2.8% (124 of 4424) of the sample, respectively. Burnout was observed in 44.7% (1540 of 3447) of non-Hispanic White physicians, 41.7% (225 of 540) of non-Hispanic Asian physicians, 38.5% (47 of 122) of non-Hispanic Black physicians, and 37.4% (104 of 278) of Hispanic/Latinx physicians. The adjusted odds of burnout were lower in non-Hispanic Asian physicians (odds ratio [OR], 0.77; 95% CI, 0.61-0.96), Hispanic/Latinx physicians (OR, 0.63; 95% CI, 0.47-0.86), and non-Hispanic Black physicians (OR, 0.49; 95% CI, 0.30-0.79) compared with non-Hispanic White physicians. Non-Hispanic Black physicians were more likely to report satisfaction with work-life integration compared with non-Hispanic White physicians (OR, 1.69; 95% CI, 1.05-2.73). No differences in depressive symptoms or career satisfaction were observed by race/ethnicity.
Physicians in minority racial/ethnic groups were less likely to report burnout compared with non-Hispanic White physicians. Future research is necessary to confirm these results, investigate factors contributing to increased rates of burnout among non-Hispanic White physicians, and assess factors underlying the observed patterns in measures of physician wellness by race/ethnicity.
先前的研究表明，职业倦怠的流行程度因人口统计学特征（如性别和年龄）而异，但医师种族/民族与职业倦怠之间的关联了解得较少。
在一项美国医生样本中，研究种族/民族对职业倦怠、抑郁症状、职业满意度和工作-生活融合的可能差异。
设计、地点和参与者：在这项横断面研究中，对 4424 名医生的数据进行了二次分析，这些数据最初是从 2017 年 10 月 12 日至 2018 年 3 月 15 日对美国医生进行的横断面调查中收集的。分析日期为 2019 年 3 月 8 日至 2020 年 5 月 21 日。进行了多变量逻辑回归分析，包括对医生人口统计学和临床实践特征的统计调整，以检查医生种族/民族与职业倦怠、抑郁症状、职业满意度和工作-生活融合之间的关联。
医生的人口统计学和临床实践特征包括种族/民族、性别、年龄、临床专业、每周工作时间、主要执业地点和婚姻状况。
在 Maslach 倦怠量表的情绪衰竭或去人格化子量表上得分较高的医生被归类为倦怠。抑郁症状使用初级保健评估精神障碍工具进行测量。选择“强烈同意”或“同意”回答调查项目“我会再次选择成为医生”和“我的工作时间表为我的个人/家庭生活留下了足够的时间”的医生被认为对他们的职业和工作-生活融合感到满意。
可获得 4424 名医生的数据（平均[标准差]年龄，52.46[12.03]岁；61.5%[2722 名/4424 名]为男性）。大多数医生（78.7%[3480 名/4424 名]）是非西班牙裔白人。非西班牙裔亚裔、西班牙裔/拉丁裔和非西班牙裔黑人医生分别占样本的 12.3%（542 名/4424 名）、6.3%（278 名/4424 名）和 2.8%（124 名/4424 名）。职业倦怠在非西班牙裔白种人医生中观察到 44.7%（1540 名/3447 名）、非西班牙裔亚裔医生中观察到 41.7%（225 名/540 名）、非西班牙裔黑人医生中观察到 38.5%（47 名/122 名），西班牙裔/拉丁裔医生中观察到 37.4%（104 名/278 名）。非西班牙裔亚裔医生（优势比[OR]，0.77；95%置信区间[CI]，0.61-0.96）、西班牙裔/拉丁裔医生（OR，0.63；95% CI，0.47-0.86）和非西班牙裔黑人医生（OR，0.49；95% CI，0.30-0.79）的倦怠调整后的可能性较低与非西班牙裔白人医生相比。与非西班牙裔白人医生相比，非西班牙裔黑人医生更有可能报告对工作-生活融合的满意度（OR，1.69；95% CI，1.05-2.73）。种族/民族之间没有观察到抑郁症状或职业满意度的差异。
与非西班牙裔白人医生相比，少数族裔医生的倦怠报告较少。需要进一步研究来证实这些结果，调查导致非西班牙裔白人医生倦怠率增加的因素，并评估种族/民族对医生健康状况衡量标准的观察到的模式的相关因素。
