Department of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA.
Teach Learn Med. 2022 Jan-Mar;34(1):69-77. doi: 10.1080/10401334.2021.1891544. Epub 2021 Mar 15.
Burnout is prevalent among medical students and is correlated with negative feelings, behaviors, and outcomes. Empathy is a desired trait for medical students that has been correlated with reduced burnout. The concept of guilt is closely related to concern about the well-being of others; therefore, feelings of guilt may be associated with empathy. Excessive guilt poses an increased risk for internalized distress, symptoms such as anhedonia, and may be related to burnout. The relationship between pathogenic guilt and burnout in medical students is unknown.
We hypothesize that pathogenic guilt is present and related to both burnout and empathy in medical students.
We conducted a cross-sectional survey study of all students in one medical school. Data were collected in February 2020. The Oldenburg Burnout Inventory (OBLI), Toronto Empathy Questionnaire (TEQ), and Interpersonal Guilt Questionaire-67 (IGQ-67) were used. A modified version of IGQ-67 was used to measure four subscales of pathogenic guilt: survival guilt, separation guilt, omnipotence guilt, and self-hate guilt. Data analyses for this study including screening, evaluation of assumptions, descriptive statistics, reliabilities, one-way ANOVA, and correlation coefficients, were conducted using SPSS version 26.
Of 300, 168 (56.0%) students participated in the study. Survival, omnipotence, and self-hate classes of pathogenic guilt were positively correlated with burnout. Empathy was correlated with two classes of pathogenic guilt: survival and omnipotence. Empathy was inversely related to burnout (disengagement).
Pathogenic guilt may be a contributor to burnout in medical students. Guilt should be a target of prevention and treatment in burnout in medical students.
Supplemental data for this article is available online at https://doi.org/10.1080/10401334.2021.1891544.
倦怠在医学生中很普遍，与负面情绪、行为和结果有关。同理心是医学生所期望的特质，与减少倦怠有关。内疚感的概念与对他人福祉的关注密切相关；因此，内疚感可能与同理心有关。过度内疚会增加内在痛苦的风险，表现为快感缺失等症状，并且可能与倦怠有关。医学生的致病内疚感与倦怠之间的关系尚不清楚。
我们假设致病内疚感在医学生中存在，并与倦怠和同理心有关。
我们对一所医学院的所有学生进行了横断面调查研究。数据于 2020 年 2 月收集。使用了奥尔登堡倦怠量表（OBLI）、多伦多同理心问卷（TEQ）和 67 项人际内疚问卷（IGQ-67）。使用 IGQ-67 的修改版本来衡量致病内疚感的四个亚量表：生存内疚感、分离内疚感、全能内疚感和自我仇恨内疚感。本研究的数据分析包括筛选、假设评估、描述性统计、可靠性、单因素方差分析和相关系数，使用 SPSS 版本 26 进行。
在 300 名学生中，有 168 名（56.0%）学生参加了这项研究。生存、全能和自我仇恨类别的致病内疚感与倦怠呈正相关。同理心与两类致病内疚感有关：生存和全能。同理心与倦怠（脱逸）呈负相关。
致病内疚感可能是医学生倦怠的一个原因。在医学生的倦怠中，内疚感应该是预防和治疗的目标。
本文的补充数据可在 https://doi.org/10.1080/10401334.2021.1891544 在线获取。
