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儿科住院医师工作中的意义感:这种价值是否与更高的专业满意度和减少倦怠感有关?

Pediatric Residents' Sense of Meaning in Their Work: Is This Value Related to Higher Specialty Satisfaction and Reduced Burnout?

机构信息

University of Rochester, Golisano Children's Hospital (ND Bayer, A Fallon, and H Wang), Rochester, NY.

Children's Hospital of Philadelphia (A Taylor, JL Santolaya, TW Bamat, and N Washington), Philadelphia, Pa.

出版信息

Acad Pediatr. 2021 Apr;21(3):557-563. doi: 10.1016/j.acap.2020.10.012. Epub 2020 Oct 28.

Abstract

OBJECTIVE

Physician wellness is frequently measured as the absence of burnout, rather than the perception of meaningful work. This study of pediatric residents aimed to test the hypothesis that their sense of meaning at work is associated positively with specialty satisfaction and negatively with burnout.

METHODS

In June 2018, we surveyed residents at a large urban pediatrics program, using the Work and Meaning Inventory (WAMI), the Global Specialty Satisfaction measure, and a single-item burnout measure. Residents were surveyed at the end of their intern, second or third/fourth year. We compared resident responses to outcome measures by year, gender, race, and type of program (pediatrics and medicine-pediatrics). We assessed the associations between WAMI scores and specialty satisfaction using linear regression and between WAMI scores and burnout using logistic regression, both adjusted for residency year and characteristics.

RESULTS

The survey was completed by 119/154 (77.3%) residents. Mean WAMI score was 40.6 ± 5.6 (standard deviation), mean specialty satisfaction score was 11.9 ± 2.4, and 48.7% (58/119) of residents reported burnout with no significant differences in scores by residency year, gender, race, or type of program (all P > .05). Residents' WAMI scores were positively associated with specialty satisfaction (r = +0.57, P < .001) and negatively associated with burnout (adjusted odds ratio  = 0.80, 95% confidence interval 0.73-0.89).

CONCLUSIONS

Pediatric residents' sense of meaning at work was significantly positively associated with specialty satisfaction and negatively associated with burnout. We recommend that efforts to improve resident wellness focus on interventions to foster meaning in work, such as supporting team cohesion and autonomy in job design.

摘要

目的

医生的健康常被定义为没有倦怠,而不是对有意义工作的感知。本研究旨在检测一个假设,即儿科住院医师对工作的意义感与专业满意度呈正相关,与倦怠呈负相关。

方法

2018 年 6 月,我们对一个大型城市儿科项目的住院医师进行了调查,使用了工作和意义问卷(WAMI)、全球专业满意度量表和一项倦怠单因素测量。住院医师在实习结束、第二年或第三/第四年时接受调查。我们按年份、性别、种族和项目类型(儿科和儿科学)比较了住院医师对结果测量的反应。我们使用线性回归评估了 WAMI 评分与专业满意度之间的关联,使用逻辑回归评估了 WAMI 评分与倦怠之间的关联,这两种关联均调整了住院医师年限和特征。

结果

共有 154 名住院医师中的 119 名(77.3%)完成了调查。WAMI 平均得分为 40.6±5.6(标准差),专业满意度平均得分为 11.9±2.4,48.7%(58/119)的住院医师报告存在倦怠,住院医师年限、性别、种族或项目类型的分数均无显著差异(均 P>.05)。住院医师的 WAMI 评分与专业满意度呈正相关(r=+0.57,P<.001),与倦怠呈负相关(调整后的优势比=0.80,95%置信区间 0.73-0.89)。

结论

儿科住院医师对工作的意义感与专业满意度显著正相关,与倦怠呈负相关。我们建议,改善住院医师健康的努力应侧重于促进工作意义的干预措施,例如支持团队凝聚力和工作设计中的自主性。

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