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美国麻醉医师的职业倦怠率及风险因素

Burnout Rate and Risk Factors among Anesthesiologists in the United States.

作者信息

Afonso Anoushka M, Cadwell Joshua B, Staffa Steven J, Zurakowski David, Vinson Amy E

出版信息

Anesthesiology. 2021 May 1;134(5):683-696. doi: 10.1097/ALN.0000000000003722.

Abstract

BACKGROUND

Physician burnout, widespread across medicine, is linked to poorer physician quality of life and reduced quality of care. Data on prevalence of and risk factors for burnout among anesthesiologists are limited. The objective of the current study was to improve understanding of burnout in anesthesiologists, identify workplace and personal factors associated with burnout among anesthesiologists, and quantify their strength of association.

METHODS

During March 2020, the authors surveyed member anesthesiologists of the American Society of Anesthesiologists. Burnout was assessed using the Maslach Burnout Inventory Human Services Survey. Additional survey questions queried workplace and personal factors. The primary research question was to assess rates of high risk for burnout (scores of at least 27 on the emotional exhaustion subscale and/or at least 10 on the depersonalization subscale of the Maslach Burnout Inventory Human Services Survey) and burnout syndrome (demonstrating all three burnout dimensions, consistent with the World Health Organization definition). The secondary research question was to identify associated risk factors.

RESULTS

Of 28,677 anesthesiologists contacted, 13.6% (3,898) completed the survey; 59.2% (2,307 of 3,898) were at high risk of burnout, and 13.8% (539 of 3,898) met criteria for burnout syndrome. On multivariable analysis, perceived lack of support at work (odds ratio, 6.7; 95% CI, 5.3 to 8.5); working greater than or equal to 40 h/week (odds ratio, 2.22; 95% CI, 1.80 to 2.75); lesbian, gay, bisexual, transgender/transsexual, queer/questioning, intersex, and asexual status (odds ratio, 2.21; 95% CI, 1.35 to 3.63); and perceived staffing shortages (odds ratio, 2.06; 95% CI, 1.76 to 2.42) were independently associated with high risk for burnout. Perceived lack of support at work (odds ratio, 10.0; 95% CI, 5.4 to 18.3) and home (odds ratio, 2.13; 95% CI, 1.69 to 2.69) were most strongly associated with burnout syndrome.

CONCLUSIONS

The prevalence of burnout among anesthesiologists is high, with workplace factors weighing heavily. The authors identified risk factors for burnout, especially perceived support in the workplace, where focused interventions may be effective in reducing burnout.

摘要

背景

医生职业倦怠在医学界普遍存在,与医生较差的生活质量和医疗服务质量下降有关。麻醉医生职业倦怠的患病率及风险因素的数据有限。本研究的目的是加深对麻醉医生职业倦怠的理解,识别与麻醉医生职业倦怠相关的工作场所和个人因素,并量化它们的关联强度。

方法

2020年3月,作者对美国麻醉医师协会的会员麻醉医生进行了调查。使用马氏职业倦怠量表-人类服务调查来评估职业倦怠。其他调查问题询问了工作场所和个人因素。主要研究问题是评估职业倦怠高风险率(马氏职业倦怠量表-人类服务调查中情感耗竭子量表得分至少为27分和/或去个性化子量表得分至少为10分)和职业倦怠综合征(表现出所有三个职业倦怠维度,符合世界卫生组织的定义)。次要研究问题是识别相关风险因素。

结果

在联系的28677名麻醉医生中,13.6%(3898名)完成了调查;59.2%(3898名中的2307名)有职业倦怠高风险,13.8%(3898名中的539名)符合职业倦怠综合征标准。在多变量分析中,工作中感觉缺乏支持(比值比,6.7;95%置信区间,5.3至8.5);每周工作大于或等于40小时(比值比,2.22;95%置信区间,1.80至2.75);女同性恋、男同性恋、双性恋、跨性别者/变性者、酷儿/疑问者、双性人及无性恋身份(比值比,2.21;95%置信区间,1.35至3.63);以及感觉人员短缺(比值比,2.06;95%置信区间,1.76至2.42)与职业倦怠高风险独立相关。工作中感觉缺乏支持(比值比,10.0;95%置信区间,5.4至18.3)和家庭中感觉缺乏支持(比值比,2.13;95%置信区间,1.69至2.69)与职业倦怠综合征关联最强。

结论

麻醉医生职业倦怠的患病率很高,工作场所因素影响很大。作者识别出了职业倦怠的风险因素,尤其是工作场所中的感知支持,针对性干预可能有效降低职业倦怠。

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Physician Well-Being in Practice.医生在执业中的幸福感。
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