Division of Vascular Surgery (Rubin), Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network; Goldfarb Intelligence Marketing (Goldfarb), Toronto, Ont.; Division of Biomedical Statistics and Informatics (Satele), Mayo Foundation for Medical Education and Research, Rochester, Minn.; Office of Professional Practice & Policy (Graham), Toronto General Hospital, Toronto, Ont.
CMAJ Open. 2021 Jan 11;9(1):E10-E18. doi: 10.9778/cmajo.20200057. Print 2021 Jan-Mar.
Burnout and distress have a negative impact on physicians and the treatment they provide. Our aim was to measure the prevalence of burnout and distress among physicians in a cardiovascular centre of a quaternary hospital network in Canada, and compare these outcomes to those for physicians at academic health science centres (AHSCs) in the United States.
We conducted a survey of physicians practising in a cardiovascular centre at 2 quaternary referral hospitals in Toronto, Ontario, between Nov. 27, 2018, and Jan. 31, 2019. The survey tool included the Well-Being Index (WBI), which measures fatigue, depression, burnout, anxiety or stress, mental and physical quality of life, work-life integration, meaning in work and distress; a score of 3 or higher indicated high distress. We also evaluated physicians' perception of the adequacy of staffing levels and of fair treatment in the workplace, and satisfaction with the electronic health record. We carried out standard univariate statistical comparisons using the χ, Fisher exact or Kruskal-Wallis test as appropriate to perform univariate comparisons in the sample of respondents. We assessed the relation between a WBI score of 3 or higher and demographic characteristics. We compared univariate associations among WBI data for physicians at AHSCs in the US who completed the WBI to responses from our participants.
The response rate to the survey was 84.1% (127/151). Of the 127 respondents, 83 (65.4%) reported burnout in the previous month, and 68 (53.5%) reported emotional problems. Sixty-nine respondents (54.3%) had a WBI score of 3 or higher. Respondents were more likely to have a WBI score of 3 or higher versus a score less than 3 if they perceived insufficient staffing levels (52/69 [75%] v. 26/58 [45%], = 0.02) or unfair treatment (23/69 [33%] v. 8/58 [14%], = 0.03), or were anesthesiologists (26/35 [74%] v. 43/92 [47%] for other specialists, = 0.005). Compared to 21 594 physicians in practice at AHSCs in the US, our respondents had a higher mean WBI score (2.4 v. 1.8, = 0.004) and reported a higher prevalence of burnout (65.4% v. 56.6%, = 0.048).
Physicians in this study had high levels of burnout and distress, driven by the perception of inadequate staffing levels and being treated unfairly in the workplace. Addressing these institutional factors may improve physicians' work experience and patient outcomes.
倦怠和困扰会对医生及其提供的治疗产生负面影响。我们的目的是衡量加拿大一家四级医院网络中心心血管科医生的倦怠和困扰发生率，并将这些结果与美国学术健康科学中心（AHSC）的医生进行比较。
我们对安大略省多伦多的 2 家四级转诊医院的心血管中心的医生进行了一项调查，调查时间为 2018 年 11 月 27 日至 2019 年 1 月 31 日。调查工具包括 Well-Being Index（WBI），用于衡量疲劳、抑郁、倦怠、焦虑或压力、身心生活质量、工作与生活的融合、工作意义和困扰；3 分或以上表示高度困扰。我们还评估了医生对人员配备水平和工作场所公平待遇的看法，以及对电子健康记录的满意度。我们使用适当的 χ2、Fisher 确切检验或 Kruskal-Wallis 检验进行了标准的单变量统计比较，以便对样本中的受访者进行单变量比较。我们评估了 WBI 得分 3 分或以上与人口统计学特征之间的关系。我们比较了完成 WBI 的美国 AHSC 医生的 WBI 数据之间的单变量关联与我们参与者的反应。
调查的回复率为 84.1%（127/151）。在 127 名应答者中，83 名（65.4%）报告上个月存在倦怠，68 名（53.5%）报告存在情绪问题。69 名应答者（54.3%）的 WBI 得分为 3 分或以上。与 WBI 得分低于 3 分的应答者相比，如果他们认为人员配备不足（52/69 [75%] 比 26/58 [45%]， = 0.02）或待遇不公（23/69 [33%] 比 8/58 [14%]， = 0.03），或者是麻醉师（26/35 [74%] 比其他专科医生 92 名中的 43 名 [47%]， = 0.005），他们更有可能获得 WBI 得分 3 分或以上。与美国 AHSC 实践中的 21594 名医生相比，我们的应答者的平均 WBI 得分更高（2.4 比 1.8， = 0.004），倦怠发生率更高（65.4% 比 56.6%， = 0.048）。
这项研究中的医生倦怠和困扰程度很高，这是由于他们认为人员配备不足和在工作场所受到不公平待遇所致。解决这些机构因素可能会改善医生的工作体验和患者的治疗效果。
