Crowe Remle P, Fernandez Antonio R, Pepe Paul E, Cash Rebecca E, Rivard Madison K, Wronski Robert, Anderson Sarah E, Hogan Tory H, Andridge Rebecca R, Panchal Ashish R, Ferketich Amy K
ESO Inc Austin Texas USA.
Department of Emergency Medicine School of Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA.
J Am Coll Emerg Physicians Open. 2020 Jan 27;1(1):6-16. doi: 10.1002/emp2.12014. eCollection 2020 Feb.
Although burnout has been linked to negative workplace-level effects, prior studies have primarily focused on individuals rather than job-related characteristics. This study sought to evaluate variation in burnout between agencies and to quantify the relationship between burnout and job-related demands/resources among emergency medical services (EMS) professionals.
An electronic questionnaire was sent to all licensed, practicing EMS professionals in South Carolina. Work-related burnout was measured using the Copenhagen Burnout Inventory. Multivariable generalized estimating equations were used to estimate odds ratios (ORs) for specific job demands and resources while adjusting for confounding variables. Composite scores were used to simultaneously assess the relationship between burnout and job-related demands and resources.
Among 1271 EMS professionals working at 248 EMS agencies, the median agency-level burnout was 35% (interquartile range [IQR]: 13% to 50%). Job-related demands, including time pressure, were associated with increased burnout. Traditional job-related resources, including pay and benefits, were associated with reduced burnout. Less tangible job resources, including autonomy, clinical performance feedback, social support, and adequate training demonstrated strong associations with reduced burnout. EMS professionals facing high job demands and low job resources demonstrated nearly a 10-fold increase in odds of burnout compared with those exposed to low demands and high resources (adjusted OR [aOR]: 9.50, 95% confidence interval [CI]: 6.39-14.10). High job resources attenuated the impact of high job demands.
The proportion of EMS professionals experiencing burnout varied substantially across EMS agencies. Job resources, including those reflective of organizational culture, were associated with reduced burnout. Collectively, these findings suggest an opportunity to address burnout at the EMS agency level.
尽管职业倦怠与工作场所层面的负面效应有关,但先前的研究主要集中在个体而非与工作相关的特征上。本研究旨在评估各机构之间职业倦怠的差异,并量化紧急医疗服务(EMS)专业人员的职业倦怠与工作相关需求/资源之间的关系。
向南卡罗来纳州所有持牌执业的EMS专业人员发送了一份电子问卷。使用哥本哈根职业倦怠量表测量与工作相关的职业倦怠。多变量广义估计方程用于估计特定工作需求和资源的比值比(OR),同时对混杂变量进行调整。综合评分用于同时评估职业倦怠与工作相关需求和资源之间的关系。
在248个EMS机构工作的1271名EMS专业人员中,机构层面职业倦怠的中位数为35%(四分位间距[IQR]:13%至50%)。与工作相关的需求,包括时间压力,与职业倦怠增加有关。传统的与工作相关的资源,包括薪酬和福利,与职业倦怠降低有关。不太具体的工作资源,包括自主权、临床绩效反馈、社会支持和充分的培训,与职业倦怠降低有很强的关联。与那些面临低需求和高资源的人相比,面临高工作需求和低工作资源的EMS专业人员出现职业倦怠的几率增加了近10倍(调整后的OR[aOR]:9.50,95%置信区间[CI]:6.39 - 14.10)。高工作资源减弱了高工作需求的影响。
各EMS机构中经历职业倦怠的EMS专业人员比例差异很大。工作资源,包括那些反映组织文化的资源,与职业倦怠降低有关。总体而言,这些发现表明在EMS机构层面解决职业倦怠问题存在机会。