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医护人员倦怠与解决社会需求的能力感知。

Health Care Worker Burnout and Perceived Capacity to Address Social Needs.

机构信息

Department of Family and Social Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.

Office of Community and Population Health, Montefiore Health System, Bronx, New York, USA.

出版信息

Popul Health Manag. 2022 Jun;25(3):352-361. doi: 10.1089/pop.2021.0175. Epub 2021 Oct 8.

Abstract

Health care organizations are increasingly incorporating social care programs into medical care delivery models. Recent studies have identified burnout as a potential unintended consequence of this expansion. Successful implementation of these programs requires investment in the health care team, although understanding the impact of this expansion on nonphysician team members remains limited. Utilizing a theory-informed model for organizational behavior change, the authors aim to characterize the perceived elements of capacity to address patients' social needs within a heterogenous group of health care workers, and to examine the association of these behavioral conditions with burnout. A cross-sectional analysis was conducted of a survey of ∼1900 health care staff from 46 organizations in a large delivery system. Exploratory factor analysis identified factors contributing to the "Perceived Capacity to Address Social Needs" domain; Motivation, Organizational Reinforcement, and 3 task-specific capacities (Identification of social needs, Providing care for patients with social needs, and Linkage to social needs resources). Logistic regression found both a lower sense of motivation (OR 0.71, 95% CI 0.59-0.86), and organizational reinforcement (OR 0.51, 95% CI 0.42-0.62) associated with a higher rate of burnout. These associations with burnout differed by organizational role, suggesting role-specific relationships between these behavioral conditions. As health care has evolved into team-based interventions, staff across the care spectrum are now tasked with addressing larger social issues that affect their patients. A systems approach, aligning organizational priorities and staff motivations, in addition to task-specific skill sets is likely necessary to prevent burnout in this setting.

摘要

医疗机构越来越多地将社会护理项目纳入医疗保健服务模式。最近的研究发现,倦怠是这种扩张的潜在意外后果。这些项目的成功实施需要对医疗保健团队进行投资,尽管对这种扩张对非医师团队成员的影响的理解仍然有限。作者利用一个理论指导的组织行为改变模型,旨在描述在一个异质的医疗保健工作者群体中,感知到的满足患者社会需求的能力要素,并研究这些行为条件与倦怠之间的关联。对来自一个大型交付系统的 46 个组织的约 1900 名医疗保健人员的调查进行了横断面分析。探索性因素分析确定了对“感知满足社会需求的能力”领域有贡献的因素;动机、组织强化以及 3 项特定任务能力(识别社会需求、为有社会需求的患者提供护理以及与社会需求资源建立联系)。逻辑回归发现,较低的动机感(OR 0.71,95%CI 0.59-0.86)和组织强化(OR 0.51,95%CI 0.42-0.62)与更高的倦怠率相关。这些与倦怠的关联因组织角色而异,表明这些行为条件之间存在特定于角色的关系。随着医疗保健向团队为基础的干预措施发展,护理范围内的工作人员现在负责解决影响他们患者的更大的社会问题。在这种情况下,可能需要系统的方法来调整组织的优先事项和员工的动机,以及特定任务的技能集,以防止倦怠。

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Health Care Worker Burnout and Perceived Capacity to Address Social Needs.医护人员倦怠与解决社会需求的能力感知。
Popul Health Manag. 2022 Jun;25(3):352-361. doi: 10.1089/pop.2021.0175. Epub 2021 Oct 8.

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