UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy
Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
BMJ Open. 2021 Jan 17;11(1):e045127. doi: 10.1136/bmjopen-2020-045127.
OBJECTIVE: To determine burn-out levels and associated factors among healthcare personnel working in a tertiary hospital of a highly burdened area of north-east Italy during the COVID-19 pandemic. DESIGN: Observational study conducted from 21 April to 6 May 2020 using a web-based questionnaire. SETTING: Research conducted in the Verona University Hospital (Veneto, Italy). PARTICIPANTS: Out of 2195 eligible participants, 1961 healthcare workers with the full range of professional profiles (89.3%) completed the survey. PRIMARY OUTCOME MEASURE: Levels of burn-out, assessed by the Maslach Burnout Inventory-General Survey (MBI-GS). Multivariable logistic regression analysis was performed to identify factors associated with burn-out in each MBI-GS dimension (emotional exhaustion, EX; professional efficacy, EF; cynicism, CY). RESULTS: Overall, 38.3% displayed high EX, 46.5% low EF and 26.5% high CY. Burn-out was frequent among staff working in intensive care units (EX 57.0%; EF 47.8%; CY 40.1%), and among residents (EX 34.9%; EF 63.9%; CY 33.4%) and nurses (EX 49.2%; EF 46.9%; CY 29.7%). Being a resident increased the risk of burn-out (by nearly 2.5 times) in all the three MBI subscales and being a nurse increased the risk of burn-out in the EX dimension in comparison to physicians. Healthcare staff directly engaged with patients with COVID-19 showed more EX and CY than those working in non-COVID wards. Finally, the risk of burn-out was higher in staff showing pre-existing psychological problems, in those having experienced a COVID-related traumatic event and in those having experienced interpersonal avoidance in the workplace and personal life. CONCLUSIONS: Burn-out represents a great concern for healthcare staff working in a large tertiary hospital during the COVID-19 pandemic and its impact is more burdensome for front-line junior physicians. This study underlines the need to carefully address psychological well-being of healthcare workers to prevent the increase of burn-out in the event of a new COVID-19 healthcare emergency.
目的：在意大利东北部一个负担过重的地区的一家三级医院工作的医护人员中，确定倦怠水平及其相关因素。
设计：2020 年 4 月 21 日至 5 月 6 日期间使用网络问卷调查进行观察性研究。
地点：在维罗纳大学医院（意大利威尼托地区）进行研究。
参与者：在 2195 名符合条件的参与者中，有 1961 名具有各种专业背景的医护人员（89.3%）完成了调查。
主要结果衡量标准：使用 Maslach 倦怠量表-一般调查（MBI-GS）评估倦怠水平。进行多变量逻辑回归分析，以确定每个 MBI-GS 维度（情感耗竭、EX；专业效能、EF；玩世不恭、CY）与倦怠相关的因素。
结果：总体而言，38.3%的人表现出高度的 EX，46.5%的人表现出低度的 EF，26.5%的人表现出高度的 CY。在重症监护病房工作的医护人员（EX 57.0%；EF 47.8%；CY 40.1%）以及住院医师（EX 34.9%；EF 63.9%；CY 33.4%）和护士（EX 49.2%；EF 46.9%；CY 29.7%）中，倦怠更为常见。与医师相比，住院医师在所有三个 MBI 子量表中都增加了倦怠的风险（近 2.5 倍），而护士则增加了在 EX 维度中倦怠的风险。直接与 COVID-19 患者接触的医护人员比在非 COVID 病房工作的医护人员表现出更多的 EX 和 CY。最后，与 COVID-19 相关的创伤事件、在工作场所和个人生活中经历人际回避的医护人员发生倦怠的风险更高。
结论：在 COVID-19 大流行期间，在一家大型三级医院工作的医护人员中，倦怠是一个令人关注的问题，对一线初级医生的影响更为沉重。这项研究强调需要认真关注医护人员的心理健康，以防止在发生新的 COVID-19 医疗紧急情况时倦怠情绪的增加。
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