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基于性别的角色错位与住院医师职业倦怠:一项观察性研究。

Sex-Based Role Misidentification and Burnout of Resident Physicians: An Observational Study.

机构信息

Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Harvard Medical School, Boston, Massachusetts.

出版信息

Ann Surg. 2022 Aug 1;276(2):404-408. doi: 10.1097/SLA.0000000000004599. Epub 2020 Nov 13.

Abstract

OBJECTIVE

This cross-sectional study characterized associations between sex, role misidentification, and burnout among surgical and nonsurgical residents.

SUMMARY BACKGROUND DATA

Limited evidence suggests that female resident physicians are more likely to be misidentified as nonphysician team members, with potential negative implications for wellbeing. The prevalence and impact of role misidentification on the trainee experience in surgical as compared to nonsurgical specialties is unknown.

METHODS

An anonymous electronic survey was distributed to fourteen different residency programs at 2 academic medical centers in August 2018. The survey included questions about demographics, symptoms of burnout, the frequency of misidentification as another member of the care team, and the effect of misidentification on respondents' well-being. Results: Two-hundred sixty out of 419 (62.1% response rate) resident physicians completed the survey, of whom 184 (77.3%) reported being misidentified as a nonphysician at least weekly. Female sex was associated with a significantly increased odds of being misidentified at least weekly (adjusted OR 23.7, 95% CI 10.9-51.5; P < 0.001), as was training in a surgical program (adjusted OR 3.7, 95% CI 1.7-8.0; P = 0.001). Frequent role misidentification was associated with burnout (OR 2.6, 95% CI 1.2-5.5; P = 0.01). In free-text responses, residents reported that being misidentified invoked a sense of not belonging, caused emotional exhaustion, and interfered with patient communication.

CONCLUSIONS

Role misidentification is more prevalent among female residents and surgical residents, compared to male residents and nonsurgical residents, respectively. Physician role misidentification is associated with burnout and has negative implications for resident wellbeing; interventions to reduce role misidentification are needed.

摘要

目的

本横断面研究旨在描述外科和非外科住院医师中性别、角色认同错位和倦怠之间的关联。

背景资料概要

有限的证据表明,女性住院医师更有可能被误认为是非医疗团队成员,这可能对幸福感产生负面影响。在外科和非外科专业中,角色认同错位对学员体验的普遍性和影响尚不清楚。

方法

2018 年 8 月,我们向 2 家学术医疗中心的 14 个不同住院医师项目发放了匿名电子调查问卷。该调查问卷包括关于人口统计学、倦怠症状、被误认为是医疗团队其他成员的频率以及角色认同错位对受访者幸福感的影响等问题。结果:在 419 名住院医师中有 260 名(62.1%的回复率)完成了调查,其中 184 名(77.3%)报告称每周至少被误认为是非医师一次。女性性别与每周至少被错误识别一次的几率显著增加相关(调整后的 OR 23.7,95%CI 10.9-51.5;P < 0.001),外科项目培训也是如此(调整后的 OR 3.7,95%CI 1.7-8.0;P = 0.001)。频繁的角色认同错位与倦怠有关(OR 2.6,95%CI 1.2-5.5;P = 0.01)。在自由文本回复中,住院医师报告说,被错误识别会让人感觉自己不属于这个团队,导致情绪疲惫,并干扰与患者的沟通。

结论

与男性住院医师和非外科住院医师相比,女性住院医师和外科住院医师中角色认同错位更为普遍。医生角色认同错位与倦怠有关,对住院医师的幸福感有负面影响;需要采取干预措施减少角色认同错位。

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