Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia.
School of Psychiatry, University of New South Wales, UNSW Sydney, Sydney, New South Wales, Australia.
Intern Med J. 2021 Jul;51(7):1074-1080. doi: 10.1111/imj.15124. Epub 2021 Jun 22.
Doctors-in-training report elevated rates of mental disorders and high levels of stress. Whilst a number of work-related sources of stress have been identified in the medical profession, it remains unclear as to the relative importance of workplace stressors for mental ill-health in junior doctors.
To examine workplace stressors reported by junior doctors and identify variables associated with adverse mental health outcomes.
Cross-sectional analysis of national 2013 survey of Australian doctors focussing on junior medical officers (N = 3053; 24.9% of total sample). Primary outcomes were caseness of common mental disorder (CMD) and suicidal ideation in the past year.
Perceived level of conflict between study/career and family/personal responsibility (OR = 3.76, 95% CI: 2.61-5.43; P < 0.01) and sleep deprivation (OR = 2.19, 95% CI: 1.46-3.28; P < 0.01) were significantly associated with CMD, while perceived level of conflict between study/career and family/personal responsibility (OR = 3.13, 95% CI: 1.78-5.50; P < 0.01) and bullying (OR = 2.92, 95% CI: 1.42-6.03; P < 0.01) were most strongly associated with suicidal ideation in adjusted models.
This study identifies modifiable workplace variables that are influential in junior doctors' mental health, and in doing so, provides meaningful evidence-informed targets for future interventions to prevent suicide and mental disorder in this population.
受训医生报告称其精神障碍和压力水平较高。虽然在医学领域已经确定了一些与工作相关的压力源,但对于初级医生心理健康不良的工作场所压力因素的相对重要性仍不清楚。
检查初级医生报告的工作场所压力源,并确定与不良心理健康结果相关的变量。
对 2013 年澳大利亚医生全国调查进行横断面分析,重点关注初级医疗官(N=3053;总样本的 24.9%)。主要结果是过去一年常见精神障碍(CMD)和自杀意念的发病情况。
研究/职业与家庭/个人责任之间感知到的冲突程度(OR=3.76,95%CI:2.61-5.43;P<0.01)和睡眠剥夺(OR=2.19,95%CI:1.46-3.28;P<0.01)与 CMD 显著相关,而研究/职业与家庭/个人责任之间感知到的冲突程度(OR=3.13,95%CI:1.78-5.50;P<0.01)和欺凌(OR=2.92,95%CI:1.42-6.03;P<0.01)在调整后的模型中与自杀意念的相关性最强。
本研究确定了对初级医生心理健康有影响的可调节工作场所变量,从而为预防该人群的自杀和精神障碍提供了有意义的循证目标。