Zhang Qin, Mu Ming-Chun, He Yan, Cai Zhao-Lun, Li Zheng-Chi
Department of Postgraduate Students.
Department of Gastrointestinal Surgery.
Medicine (Baltimore). 2020 Aug 7;99(32):e21462. doi: 10.1097/MD.0000000000021462.
Physician burnout has been a global problem that affects severely the mental status among doctors, especially in emergency medicine (EM). However, few studies have focused on emergency medicine physicians, and the published data are inconsistent. Thus, this meta-analysis is performed to systematically evaluate the prevalence of burnout among emergency medicine physicians.
We systematically searched databases including PubMed, Embase, PsychINFO and the Cochrane Library from inception to September, 2019 for English-language articles. We selected all the original articles those used Maslach Burnout Inventory to assess the prevalence of burnout and its 3 dimensions emotional exhaustion (EE), depersonalization, and personal accomplishment (PA) in emergency medicine physicians. After literature screening, quality evaluation was performed for eligible studies by using the Joanna Briggs Institute (JBI) critical appraisal checklist for studies reporting prevalence data; then, Begg test and Egger test was used to assess publication bias. Pooled prevalence rates were assessed by conducting a meta-analysis using random effects models. Then sensitivity analysis followed to test the stability of the result and detected the source of heterogeneity.
A total of 1943 EM physicians provided burnout data. The pooled prevalence rates of high levels of emotional exhaustion, high levels of depersonalization and low levels of PA were 40% (95% CI: 26%-55%; I = 97.4%), 41% (95% CI: 30%-52%; I = 94.5%) and 35% (95% CI: 19%-52%; I = 99.0%), respectively. The mean burnout scores were 23.95 (SD = 11.88) for emotional exhaustion, 11.63 (SD = 6.85) for depersonalization, and 34.69 (SD = 7.71) for PA.
This meta-analysis demonstrate a high level of burnout prevalent in EM physicians that approximately 40% experience high levels of EE and depersonalization. Our findings also suggest that EM physicians are more susceptible to burnout compared with physicians in other departments and other medical staffs in EM. More attention should be payed to mental status of EM physicians and further investigation concerning how to reduce burnout would be beneficial for EM physicians.Registration: INPLASY202060060 in inplasy.com (doi.org/10.37766/inplasy2020.6.0060).
医生职业倦怠一直是一个全球性问题，严重影响医生的心理状态，尤其是在急诊医学领域。然而，很少有研究关注急诊医学医生，且已发表的数据并不一致。因此，进行这项荟萃分析以系统评估急诊医学医生职业倦怠的患病率。
我们系统检索了从数据库建立至2019年9月的PubMed、Embase、PsychINFO和Cochrane图书馆等数据库，以查找英文文章。我们选择了所有使用马氏职业倦怠量表评估急诊医学医生职业倦怠患病率及其三个维度（情感耗竭、去个性化和个人成就感）的原始文章。经过文献筛选，使用乔安娜·布里格斯研究所（JBI）针对报告患病率数据的研究的批判性评价清单对符合条件的研究进行质量评估；然后，使用Begg检验和Egger检验评估发表偏倚。采用随机效应模型进行荟萃分析来评估合并患病率。随后进行敏感性分析以检验结果的稳定性并检测异质性来源。
共有1943名急诊医学医生提供了职业倦怠数据。情感耗竭水平高、去个性化水平高和个人成就感水平低的合并患病率分别为40%（95%CI：26%-55%；I=97.4%）、41%（95%CI：30%-52%；I=94.5%）和35%（95%CI：19%-52%；I=99.0%）。情感耗竭的平均职业倦怠得分为23.95（标准差=11.88），去个性化得分为11.63（标准差=6.85），个人成就感得分为34.69（标准差=7.71）。
这项荟萃分析表明急诊医学医生中普遍存在高水平的职业倦怠，约40%的人经历高水平的情感耗竭和去个性化。我们的研究结果还表明，与其他科室的医生以及急诊医学领域的其他医务人员相比，急诊医学医生更容易出现职业倦怠。应更加关注急诊医学医生的心理状态，进一步研究如何减少职业倦怠将对急诊医学医生有益。注册信息：inplasy.com上的INPLASY202060060（doi.org/10.37766/inplasy2020.6.0060）
