Cheng Michelle Y, Neves Stacey L, Rainwater Julie, Wang Jenny Z, Davari Parastoo, Maverakis Emanual, Rea Margaret, Servis Mark, Nuovo Jim, Fazel Nasim
Department of Dermatology, University of California, Davis School of Medicine, 3301 C Street, Suite 1400, Sacramento, CA 95816 USA.
Schools of Health, University of California, Davis, Sacramento, CA USA.
Med Sci Educ. 2020 Jan 7;30(1):315-321. doi: 10.1007/s40670-019-00905-z. eCollection 2020 Mar.
Resident physician mistreatment and burnout are widespread issues in medical training, but the association between the two remains unclear. This study examines the prevalence and types of mistreatment among resident physicians in core specialties and its association with burnout syndrome as well as feelings of depression/anxiety.
A cross-sectional, survey-based observational study of medical residents was conducted at the University of California, Davis Medical Center in 2014. Current residents (PGY2 or higher) in the internal medicine, family medicine, obstetrics/gynecology, surgery, and pediatrics programs completed anonymous questionnaires addressing topics such as workplace mistreatment, feelings of depression/anxiety, and stress management. Burnout was measured using the Maslach Burnout Inventory.
Forty-four out of 105 residents (41.9%) witnessed mistreatment of their co-residents while 26 residents (24.8%) disclosed personal accounts of mistreatment. Seventy-one percent of residents met the criteria for burnout. Residents who had been personally mistreated were almost eight times more likely to report burnout (OR 7.6, 95% CI = 1.7-34.4) and almost four times more likely to report symptoms of anxiety and depression (OR 3.8, 95% CI = 1.6-9.1). Public belittlement or humiliation was the most common type of mistreatment.
Encountering mistreatment was associated with higher rates of burnout, as well as depression/anxiety. While it is uncertain if mistreatment in the workplace has a causative impact on burnout syndrome, the findings reveal the need to address work-related environmental factors that may contribute to both resident physician mistreatment and burnout.
住院医师遭受虐待和职业倦怠是医学培训中普遍存在的问题，但两者之间的关联尚不清楚。本研究调查了核心专业住院医师遭受虐待的发生率和类型，及其与职业倦怠综合征以及抑郁/焦虑情绪的关联。
2014年在加利福尼亚大学戴维斯分校医学中心对住院医师进行了一项基于调查的横断面观察性研究。内科、家庭医学、妇产科、外科和儿科项目的现任住院医师（PGY2或更高年级）完成了匿名问卷调查，内容涉及工作场所虐待、抑郁/焦虑情绪和压力管理等主题。使用马氏职业倦怠量表测量职业倦怠。
105名住院医师中有44名（41.9%）目睹了同事遭受虐待，26名住院医师（24.8%）披露了自己遭受虐待的经历。71%的住院医师符合职业倦怠的标准。曾遭受个人虐待的住院医师报告职业倦怠的可能性几乎高出八倍（OR 7.6，95%CI = 1.7 - 34.4），报告焦虑和抑郁症状的可能性几乎高出四倍（OR 3.8，95%CI = 1.6 - 9.1）。公开贬低或羞辱是最常见的虐待类型。
遭受虐待与更高的职业倦怠率以及抑郁/焦虑有关。虽然工作场所的虐待是否对职业倦怠综合征有因果影响尚不确定，但研究结果表明需要解决可能导致住院医师遭受虐待和职业倦怠的工作相关环境因素。
