使用自我护理和数字健康策略对减少实习医生职业倦怠的新型干预措施进行评估：一项混合方法试点研究。
Evaluation of a novel intervention to reduce burnout in doctors-in-training using self-care and digital wellbeing strategies: a mixed-methods pilot.
作者信息
Rich Antonia, Aly Amira, Cecchinato Marta E, Lascau Laura, Baker Magdalen, Viney Rowena, Cox Anna L
机构信息
Research Department of Medical Education, UCL Medical School, University College London, London, UK.
Computer and Information Sciences Department, Northumbria University, Newcastle Upon Tyne, UK.
出版信息
BMC Med Educ. 2020 Sep 9;20(1):294. doi: 10.1186/s12909-020-02160-y.
BACKGROUND
Burnout for doctors-in-training is increasingly cause for concern. Our objectives were to assess the feasibility, acceptability and impact of a novel intervention to reduce burnout and improve wellbeing. This is the first wellbeing intervention for medical doctors to include strategies for work-life boundary management and digital wellbeing.
METHODS
Twenty-two doctors participated in face-to-face workshops which included group discussion of challenges experienced and strategies to enhance self-care and wellbeing. A pre-post-test mixed-methods evaluation was undertaken. Questionnaire measures were the Oldenburg Burnout Inventory, Warwick-Edinburgh Mental Wellbeing Scale and the boundary control subscale of the Work-Life Indicator (i.e., the degree of perception of control of the boundaries between work and personal life). Paired t-tests examined whether there were statistically significant differences. Eleven doctors also participated in post-intervention semi-structured interviews. Transcripts were analysed using thematic analysis.
RESULTS
The intervention was well-received, with all trainees finding the workshop useful and saying they would recommend it to others. At baseline most participants had scores indicative of burnout on both the disengagement (82%) and exhaustion (82%) subscales of the Oldenburg Burnout Inventory. One month post-intervention, participants had a statistically significant reduction in burnout (both disengagement and exhaustion) and improvement in boundary control. Wellbeing scores also improved, but differences were not statistically significant. Qualitative analysis indicated participants had welcomed a safe space to discuss stressors and many had implemented digital wellbeing strategies to manage their smartphone technology, and increased self-care such as mindfulness practice and walking in green space.
CONCLUSIONS
The intervention reduced burnout and improved boundary control. We suggest that having protected time for doctors to share personal experiences, adopt digital wellbeing and self-care strategies are effective tools to support doctors' wellbeing and should be investigated further.
背景
实习医生的职业倦怠日益引起关注。我们的目标是评估一种新型干预措施在减少职业倦怠和改善幸福感方面的可行性、可接受性及影响。这是首个针对医生的包含工作 - 生活界限管理和数字健康策略的幸福感干预措施。
方法
22名医生参加了面对面的工作坊，其中包括对所经历挑战的小组讨论以及增强自我护理和幸福感的策略。进行了一项前后测混合方法评估。问卷调查指标包括奥尔登堡倦怠量表、沃里克 - 爱丁堡心理健康量表以及工作 - 生活指标的界限控制子量表（即对工作和个人生活之间界限的控制感知程度）。配对t检验用于检验是否存在统计学上的显著差异。11名医生还参加了干预后的半结构化访谈。使用主题分析法对访谈记录进行分析。
结果
该干预措施受到好评，所有学员都认为工作坊有用，并表示会向他人推荐。在基线时，大多数参与者在奥尔登堡倦怠量表的脱离（82%）和疲惫（82%）子量表上的得分都表明存在职业倦怠。干预后一个月，参与者的职业倦怠（脱离和疲惫）有统计学上的显著降低，界限控制得到改善。幸福感得分也有所提高，但差异无统计学意义。定性分析表明，参与者欢迎有一个安全的空间来讨论压力源，许多人实施了数字健康策略来管理他们的智能手机使用，并且增加了自我护理，如正念练习和在绿色空间散步。
结论
该干预措施减少了职业倦怠，改善了界限控制。我们建议为医生留出专门时间来分享个人经历、采用数字健康和自我护理策略，这些是支持医生幸福感的有效工具，应进一步研究。
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