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医生职业倦怠:生活方式医学视角

Physician Burnout: A Lifestyle Medicine Perspective.

作者信息

Merlo Gia, Rippe James

机构信息

Editorial Board: Psychiatry and Mental Health, American Journal of Lifestyle Medicine; New York University Rory Meyers College of Nursing, New York; and New York University Grossman School of Medicine, New York.

University of Massachusetts Medical School, Worcester, MA; Shrewsbury, Massachusetts; and Rippe Lifestyle Institute, Shrewsbury, Massachusetts.

出版信息

Am J Lifestyle Med. 2020 Dec 29;15(2):148-157. doi: 10.1177/1559827620980420. eCollection 2021 Mar-Apr.

Abstract

Physician burnout, as described in North America, is a multidimensional work-related syndrome that includes emotional exhaustion, depersonalization, and a low sense of accomplishment from work. More than 50% of physicians were reporting symptoms of burnout prior to the COVID-19 pandemic. This silent epidemic of burnout is bound to become less silent as the pandemic continues. Lifestyle medicine is an evidence-based discipline that describes how daily habits and health practices can affect overall health and well-being of individuals. Lifestyle Medicine can potentially play a significant role in preventing and ameliorating physician burnout. This article explores the burnout process, including the historical context, international definitions, symptoms, and imprecision of the clinical diagnosis. The systemic etiological issues are discussed, and the psychological underpinnings are explored, including physicians' personal vulnerabilities contributing to burnout. The stress response and lifestyle medicine's role in healthy coping are described. A prevention model for risk factor reduction is proposed, focusing on primordial, primary, secondary, and tertiary prevention. Lifestyle medicine clinicians' role in prevention, treatment, and advocacy to ameliorate the potential for burnout is discussed along with specific recommendations.

摘要

正如在北美所描述的那样,医生职业倦怠是一种多维度的与工作相关的综合征,包括情感耗竭、去个性化以及工作成就感低落。在新冠疫情大流行之前,超过50%的医生报告有职业倦怠症状。随着疫情的持续,这种悄无声息的职业倦怠流行病注定会变得不那么悄无声息。生活方式医学是一门基于证据的学科,它描述了日常习惯和健康行为如何影响个体的整体健康和幸福。生活方式医学在预防和改善医生职业倦怠方面可能发挥重要作用。本文探讨了职业倦怠过程,包括历史背景、国际定义、症状以及临床诊断的不精确性。讨论了系统性病因问题,并探讨了心理基础,包括导致职业倦怠的医生个人易感性。描述了应激反应以及生活方式医学在健康应对中的作用。提出了一个降低风险因素的预防模型,重点关注初级预防、一级预防、二级预防和三级预防。讨论了生活方式医学临床医生在预防、治疗和倡导方面的作用,以改善职业倦怠的可能性,并给出了具体建议。

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