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社会支持在医生职业倦怠与职业行为关系中的中介作用。

The mediating role of social support in the relationship between physician burnout and professionalism behaviors.

作者信息

Song Xinzhi, Li Honghe, Jiang Nan, Song Wenwen, Ding Ning, Wen Deliang

机构信息

Institute for International Health Professions Education and Research, China Medical University, Shenyang, PR China.

Office of Development and Planning, China Medical University, Shenyang, PR China.

出版信息

Patient Educ Couns. 2021 Dec;104(12):3059-3065. doi: 10.1016/j.pec.2021.04.025. Epub 2021 Apr 29.


DOI:10.1016/j.pec.2021.04.025
PMID:33985846
Abstract

OBJECTIVE: Burnout poses as an understudied challenge to professionalism, and social support may explain their relationship. We sought to investigate the role of social support (moderating or mediating) in the association between physician burnout and professionalism (with four behavioral domains: respect, integrity, excellence, responsibility). METHODS: We invited 4100 physicians from nine tertiary hospitals in Liaoning province, China, during February 2017, to participate in a cross-sectional survey. Professionalism, burnout, and social support were respectively assessed using three standardized tools. Descriptive statistics, multivariable linear regression, and ordinal logistic regression were used to analyze the data. RESULTS: 3506 physicians (85.5%) effectively completed the survey. After controlling for potential confounding factors, burnout was associated with lower professionalism (β = -0.65, SE = 0.07), particularly in respect (OR = 0.51, 95%CI: 0.41-0.64) and responsibility (OR=0.72, 95%CI: 0.57-0.90). However, there was no statistically significant association between burnout and integrity or excellence. Social support was associated with higher professionalism ((β = 0.24, SE = 0.02) and all of its behavioral domains and played a partial mediating effect on the association between burnout and professionalism. CONCLUSION: Social support partially mediates the relationship between physician burnout and behavior-based professionalism. PRACTICE IMPLICATIONS: Addressing burnout and promoting social support could be integral in fostering physician professionalism in the healthcare setting.

摘要

目的:职业倦怠是专业精神面临的一个研究不足的挑战,社会支持可能解释它们之间的关系。我们试图研究社会支持在医生职业倦怠与专业精神(包括四个行为领域:尊重、正直、卓越、责任)之间的关联中所起的作用(调节或中介)。 方法:2017年2月,我们邀请了中国辽宁省9家三级医院的4100名医生参与一项横断面调查。分别使用三种标准化工具评估专业精神、职业倦怠和社会支持。采用描述性统计、多变量线性回归和有序逻辑回归分析数据。 结果:3506名医生(85.5%)有效完成了调查。在控制潜在混杂因素后,职业倦怠与较低的专业精神相关(β = -0.65,标准误 = 0.07),尤其是在尊重方面(比值比 = 0.51,95%置信区间:0.41 - 0.64)和责任方面(比值比 = 0.72,95%置信区间:0.57 - 0.90)。然而,职业倦怠与正直或卓越之间没有统计学上的显著关联。社会支持与较高的专业精神相关(β = 0.24,标准误 = 0.02)及其所有行为领域,并在职业倦怠与专业精神之间的关联中起部分中介作用。 结论:社会支持部分中介了医生职业倦怠与基于行为的专业精神之间的关系。 实践意义:解决职业倦怠和促进社会支持可能是在医疗环境中培养医生专业精神的不可或缺的部分。

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