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西班牙基层医疗中心工作人员在 SARS-CoV-2 大流行期间的 burnout 管理。

Management of burnout among the staff of primary care centres in Spain during the pandemic caused by the SARS-CoV-2.

机构信息

Department of Economic Analysis and Finances, Faculty of Social Sciences, Avda. Real Fábrica de Seda S/N, University of Castilla-La Mancha, 45600, Talavera de la Reina, Spain.

Nursing Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain.

出版信息

Hum Resour Health. 2021 Nov 1;19(1):133. doi: 10.1186/s12960-021-00679-9.

Abstract

BACKGROUND

The provision of healthcare during the pandemic caused by the SARS-CoV-2 virus represented a challenge for the management of the resources in the primary care centres. We proposed assessing burnout among the staff of those centres and identifying factors that contributed to its appearance and those that limited it.

METHODS

An observational study which, by means of anonymous questionnaires, collected information about: (i) demographic variables; (ii) the characteristics of each position; (iii) the measures implemented by the medical decision-makers in order to provide care during the pandemic; and (iv) the Burnout Clinical Subtype Questionnaire (BCSQ-36). We performed a descriptive analysis of the burnout mentioned by the staff, and, by means of a multivariate analysis, we identified the factors which influenced it. Using logit models, we analysed whether receiving specific training in COVID-19, feeling involved in decision-making processes, and/or working within different healthcare systems had effects on the development of burnout.

RESULTS

We analysed the replies of 252 employees of primary care centres in Spain with an average age of 45 (SD = 15.7) and 22 (SD = 11.4) years of experience. 68% of the participants (n = 173) indicated burnout of the frenetic subtype. 79% (n = 200) of the employees had high scores in at least one burnout subtype, and 62% (n = 156) in at least two. Women older than 45 had a lower probability of suffering burnout. Receiving specific training (OR = 0.28; CI95%: 0.11-0.73) and feeling involved in decision-making (OR = 0.32; CI95%:0.15-0.70) each reduced the probability of developing burnout. Working in a different department increased the likelihood of developing burnout of at least one clinical subtype (OR = 2.85; CI95%: 1.38-5.86).

CONCLUSIONS

The staff in primary care centres have developed high levels of burnout. Participation in decision-making and receiving specific training are revealed as factors that protect against the development of burnout. The measures taken to contain the adverse effects of a heavy workload appear to be insufficient. Certain factors that were not observed, but which are related to decisions taken by the healthcare management, appear to have had an effect on the development of some burnout subtypes.

摘要

背景

由 SARS-CoV-2 病毒引起的大流行期间的医疗保健提供对基层医疗中心资源管理构成了挑战。我们提出评估这些中心工作人员的倦怠情况,并确定导致倦怠出现和限制其出现的因素。

方法

本观察性研究通过匿名问卷收集以下信息:(i)人口统计学变量;(ii)每个职位的特点;(iii)医疗决策者为在大流行期间提供护理而实施的措施;以及(iv)倦怠临床亚型问卷(BCSQ-36)。我们对工作人员的倦怠情况进行了描述性分析,并通过多变量分析确定了影响倦怠的因素。我们使用对数模型分析了在 COVID-19 方面接受特定培训、参与决策过程以及/或在不同医疗保健系统中工作是否对倦怠的发展产生影响。

结果

我们分析了西班牙 252 名基层医疗中心员工的回复,平均年龄为 45 岁(标准差=15.7),工作经验为 22 年(标准差=11.4)。68%的参与者(n=173)表示患有狂热型倦怠。79%(n=200)的员工至少有一种倦怠亚类型的高分,62%(n=156)的员工至少有两种。年龄大于 45 岁的女性患倦怠的可能性较低。接受特定培训(OR=0.28;95%CI:0.11-0.73)和参与决策(OR=0.32;95%CI:0.15-0.70)都降低了倦怠的可能性。在不同部门工作增加了至少一种临床亚型倦怠的可能性(OR=2.85;95%CI:1.38-5.86)。

结论

基层医疗中心的工作人员倦怠程度较高。参与决策和接受特定培训被证明是预防倦怠发展的因素。为遏制工作量增加的不利影响而采取的措施似乎还不够。一些没有观察到但与医疗保健管理决策相关的因素似乎对某些倦怠亚型的发展产生了影响。

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