Ey PhD Sydney, Ladd PhD Benjamin, Soller Md Marie, Moffit PhD Mary
Department of Psychiatry, Oregon Health and Science University, Portland, Oregon.
Department of Psychology, Washington State University Vancouver, Vancouver, Washington.
Glob Adv Health Med. 2021 May 22;10:21649561211017471. doi: 10.1177/21649561211017471. eCollection 2021.
In the face of significant distress among physicians, access to counseling is critical.
An on-site wellness program for physicians-in-training and faculty was assessed by examining (a) were participants representative of those eligible for services and (b) demographic and trainee vs. faculty differences in burnout, distress, suicide risk, and presenting concerns of participants who utilized services.
From 2013-2018, 73% (N = 468; 316 residents/fellows, 152 faculty) of individuals seeking services also consented to research. At intake, participants completed a distress measure (ACORN) and two items from the Maslach Burnout Inventory (MBI), and clinicians categorized presenting concerns and suicide risk. Using Chi-square analyses, participants' characteristics were compared to physicians eligible for treatment. The association between demographics, faculty vs. trainee status, specialty, and distress, burnout, suicide risk, and presenting concerns was evaluated with ANOVAs and logistic regressions.
Women, trainees, and primary care physicians were more likely to access services. On the ACORN, 63% were in the clinical range (M =1.7, SD =0.6). On the MBI, 36% scored in the clinical range. Clinicians rated 9% of participants with suicide risk. Neither gender, racial/ethnic minority status, nor specialty were associated with distress, burnout or suicide risk. Trainees reported greater distress than faculty ( (1,447) = 8.42, =.004, = .018). Participants reported multiple presenting concerns (M = 3.0, SD = 1.18) with faculty more commonly endorsing work-related issues. Trainees more commonly reported new or worsening psychological symptoms, performance and family concerns.
Two physician groups which often report higher levels of burnout and distress when surveyed, women physicians and residents/fellows, were the most likely to get professional help in an on-site wellness program. Physician wellness programs need to be prepared to address work and personal stressors and different levels of distress and risk.
面对医生群体中普遍存在的巨大压力，获得咨询服务至关重要。
通过检查（a）参与者是否代表有资格获得服务的人群，以及（b）在倦怠、压力、自杀风险方面，以及使用服务的参与者所呈现出的问题上，培训医生与教员之间的人口统计学差异，对一项针对培训医生和教员的现场健康计划进行评估。
2013年至2018年期间，寻求服务的个体中有73%（N = 468；316名住院医师/研究员，152名教员）也同意参与研究。在初次问诊时，参与者完成了一项压力测量（ACORN）以及马氏倦怠量表（MBI）中的两个项目，临床医生对呈现出的问题和自杀风险进行了分类。使用卡方分析，将参与者的特征与有资格接受治疗的医生进行比较。通过方差分析和逻辑回归评估人口统计学、教员与学员身份、专业与压力、倦怠、自杀风险以及呈现出的问题之间的关联。
女性、培训医生和初级保健医生更有可能获得服务。在ACORN量表上，63%处于临床范围（M = 1.7，SD = 0.6）。在MBI量表上，36%的得分处于临床范围。临床医生将9%的参与者评定为有自杀风险。性别、种族/族裔少数群体身份或专业均与压力、倦怠或自杀风险无关。培训医生报告的压力比教员更大（F(1,447) = 8.42，p =.004，η² =.018）。参与者报告了多个呈现出的问题（M = 3.0，SD = 1.18），教员更常认可与工作相关的问题。培训医生更常报告新出现或恶化的心理症状、工作表现和家庭方面的问题。
在接受调查时经常报告更高倦怠和压力水平的两个医生群体，即女医生和住院医师/研究员，则最有可能在现场健康计划中获得专业帮助。医生健康计划需要准备好应对工作和个人压力源以及不同程度的压力和风险。
