Department of Infectious Diseases, St. Luke's International Hospital, Japan.
Department of General Internal Medicine, St. Luke's International Hospital, Japan.
Intern Med. 2021 May 1;60(9):1369-1376. doi: 10.2169/internalmedicine.5872-20. Epub 2020 Dec 7.
Objective We examined the prevalence of burnout among resident doctors and its relationship with specific stressors. Method We conducted a nationwide, online, cross-sectional survey in Japan with 604 resident doctors in 2018-2019. Materials Participants completed the Maslach Burnout Inventory-General Survey to evaluate burnout and provided details of their individual factors and working environmental factors. Chi-square tests and t-tests were conducted for categorical and continuous variables, respectively. The association between burnout and resident-reported causes of stress, ways of coping with stress, number of times patient-safety incidents were likely to occur, and individuals who provide support when in trouble was analyzed using logistic regression analyses after controlling for confounding variables. Results A total of 28% met the burnout criteria, 12.2% were exhausted, 2.8% were depressed, and 56.9% were healthy. After adjusting for sex, postgraduate years, type of residency program, marital status, number of inpatients under residents' care, number of working hours, number of night shifts, number of days off, and resident-reported causes of stress - excessive paperwork [odds ratio (OR): 2.24, 95% confidence interval (CI): 1.32-3.80], excessive working hours (OR: 2.75, 95% CI: 1.24-6.04), low autonomy (OR: 3.92, 95% CI: 2.01-7.65), communication problems at the workplace (OR: 2.24, 95% CI: 1.05-4.76), complaints from patients (OR: 6.62, 95% CI: 1.21-36.1), peer competition (OR: 2.22, 95% CI: 1.25-3.93), and anxiety about the future (OR: 2.13, 95% CI: 1.28-3.56) - were independently associated with burnout. The burnout group had more reported patient-safety incidents that were likely to occur per year (>10) (OR: 2.65, 95% CI: 1.01-6.95) and a lack of individuals who could provide support when in trouble (OR: 1.83, 95% CI: 1.01-3.34) than the non-burnout group. Conclusion This study described the prevalence of burnout among residents who responded to our survey. We detected an association between burnout and resident-reported causes of stress, patient-safety incidents, and a lack of individuals who provide support when in trouble. Further interventional studies targeting ways to reduce these concerns are warranted.
调查日本住院医师职业倦怠的流行情况及其与特定压力源的关系。
2018-2019 年,我们采用全国性在线横断面调查的方式,对日本的 604 名住院医师进行了调查。
参与者完成了职业倦怠量表一般调查(Maslach Burnout Inventory-General Survey),以评估倦怠情况,并提供个人因素和工作环境因素的详细信息。使用卡方检验和 t 检验分别对分类变量和连续变量进行分析。在控制混杂变量后,使用逻辑回归分析,分析住院医师报告的压力源、应对压力的方式、发生患者安全事件的可能性次数、遇到困难时提供支持的个体与倦怠之间的关系。
共有 28%的住院医师符合倦怠标准,12.2%的住院医师感到筋疲力尽,2.8%的住院医师感到沮丧,56.9%的住院医师健康。在校正性别、研究生年限、住院医师项目类型、婚姻状况、住院医师负责的住院患者人数、工作时间、夜班次数、休息日天数以及住院医师报告的压力源(过多的文书工作[比值比(OR):2.24,95%置信区间(CI):1.32-3.80]、工作时间过长(OR:2.75,95% CI:1.24-6.04]、自主权低(OR:3.92,95% CI:2.01-7.65])、工作场所沟通问题(OR:2.24,95% CI:1.05-4.76])、患者投诉(OR:6.62,95% CI:1.21-36.1])、同行竞争(OR:2.22,95% CI:1.25-3.93])和对未来的焦虑(OR:2.13,95% CI:1.28-3.56])后,倦怠与这些因素独立相关。与非倦怠组相比,倦怠组报告的每年更有可能发生的患者安全事件(>10 次)(OR:2.65,95% CI:1.01-6.95)和缺乏在遇到困难时提供支持的个体(OR:1.83,95% CI:1.01-3.34)更多。
本研究描述了对我们调查做出回应的住院医师职业倦怠的流行情况。我们发现,倦怠与住院医师报告的压力源、患者安全事件以及缺乏提供支持的个体之间存在关联。需要进一步开展针对减轻这些问题的干预性研究。