Jt Comm J Qual Patient Saf. 2021 Feb;47(2):76-85. doi: 10.1016/j.jcjq.2020.09.011. Epub 2020 Oct 4.
Cognitive task load can affect providers' ability to perform their job well and may contribute to burnout.
The researchers evaluated whether task load, measured by the National Aeronautics and Space Administration (NASA) Task Load Index (TLX), correlated with burnout scores in a large national study of US physicians between October 2017 and March 2018 with a 17.1% response rate. Burnout was measured using the Emotional Exhaustion and Depersonalization scales of the Maslach Burnout Inventory, and a high score on either score was considered a manifestation of professional burnout. The NASA-TLX was chosen to evaluate physician task load (PTL) due to its robust validation and use across many industries, including health care, over the past 30 years. The domains included in the PTL were mental, physical, and temporal demands, and perception of effort.
Mean score in task load dimension varied by specialty. In aggregate, high emotional exhaustion, depersonalization, and one symptom of burnout was seen in 38.8%, 27.4%, and 44.0% of participants, respectively. The mean PTL score was 260.9/400 (standard deviation = 71.4). The specialties with the highest PTL score were emergency medicine, urology, anesthesiology, general surgery subspecialties, radiology, and internal medicine subspecialties. A dose response relationship between PTL and burnout was observed. For every 40-point (10%) decrease in PTL there was 33% lower odds of experiencing burnout (odds ratio = 0.67, 95% confidence interval = 0.65-0.70, p < 0.0001).
The relationship between PTL and burnout may suggest areas of particular focus to improve the practice environment and reduce physician burnout.
认知任务负荷会影响提供者履行职责的能力，并可能导致倦怠。
研究人员评估了任务负荷（通过美国国家航空航天局（NASA）任务负荷指数（TLX）测量）与 2017 年 10 月至 2018 年 3 月期间对美国医生进行的一项大型全国性研究中的倦怠得分之间的相关性，该研究的回复率为 17.1%。倦怠使用 Maslach 倦怠量表的情绪耗竭和去人格化量表进行衡量，任一分量表的高分都被认为是职业倦怠的表现。由于其在过去 30 年中在许多行业（包括医疗保健）中的广泛验证和使用，因此选择 NASA-TLX 来评估医生的任务负荷（PTL）。PTL 包含的维度包括心理、身体和时间需求以及对努力的感知。
任务负荷维度的平均得分因专业而异。总体而言，分别有 38.8%、27.4%和 44.0%的参与者出现高情绪耗竭、去人格化和一种倦怠症状。PTL 的平均得分为 260.9/400（标准差=71.4）。PTL 得分最高的专业是急诊医学、泌尿科、麻醉学、普通外科亚专业、放射科和内科亚专业。观察到 PTL 与倦怠之间存在剂量反应关系。PTL 每降低 40 分（10%），倦怠的可能性就降低 33%（优势比=0.67，95%置信区间=0.65-0.70，p<0.0001）。
PTL 与倦怠之间的关系可能表明需要特别关注的领域，以改善实践环境并减少医生倦怠。
