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美国医疗体系中女性、年轻临床医生和护理人员在 COVID-19 期间的倦怠和健康体验。

Women, Younger Clinicians', and Caregivers' Experiences of Burnout and Well-being During COVID-19 in a US Healthcare System.

机构信息

Center for Health Systems Research, Sutter Health and Palo Alto Medical Foundation Research Institute, 795 El Camino Real, Palo Alto, CA, 94301, USA.

Sutter Medical Group, Sacramento, CA, USA.

出版信息

J Gen Intern Med. 2022 Jan;37(1):145-153. doi: 10.1007/s11606-021-07134-4. Epub 2021 Nov 2.

Abstract

BACKGROUND

The COVID-19 pandemic brought rapid changes to the work and personal lives of clinicians.

OBJECTIVE

To assess clinician burnout and well-being during the COVID-19 pandemic and guide healthcare system improvement efforts.

DESIGN

A survey asking about clinician burnout, well-being, and work experiences.

PARTICIPANTS

Surveys distributed to 8141 clinicians from June to August 2020 in 9 medical groups and 17 hospitals at Sutter Health, a large healthcare system in Northern California.

MAIN MEASURES

Burnout was the primary outcome, and other indicators of well-being and work experience were also measured. Descriptive statistics and multivariate logistic regression analyses were performed. All statistical inferences were based on weighted estimates adjusting for response bias.

KEY RESULTS

A total of 3176 clinicians (39.0%) responded to the survey. Weighted results showed 29.2% reported burnout, and burnout was more common among women than among men (39.0% vs. 22.7%, p<0.01). In multivariate models, being a woman was associated with increased odds of reporting burnout (OR=2.19, 95% CI: 1.51-3.17) and being 55+ years old with lower odds (OR=0.54, 95% CI: 0.34-0.87). More women than men reported that childcare/caregiving was impacting work (32.9% vs. 19.0%, p<0.01). Even after controlling for age and gender, clinicians who reported childcare/caregiving responsibilities impacted their work had substantially higher odds of reporting burnout (OR=2.19, 95% CI: 1.54-3.11). Other factors associated with higher burnout included worrying about safety at work, being given additional work tasks, concern about losing one's job, and working in emergency medicine or radiology. Protective factors included believing one's concerns will be acted upon and feeling highly valued.

CONCLUSIONS

This large survey found the pandemic disproportionally impacted women, younger clinicians, and those whose caregiving responsibilities impacted their work. These results highlight the need for a holistic and targeted strategy for improving clinician well-being that addresses the needs of women, younger clinicians, and those with caregiving responsibilities.

摘要

背景

COVID-19 大流行给临床医生的工作和个人生活带来了迅速变化。

目的

评估 COVID-19 大流行期间临床医生的倦怠和幸福感,并指导医疗系统的改进工作。

设计

一项调查,询问临床医生的倦怠、幸福感和工作经历。

参与者

2020 年 6 月至 8 月,在北加州大型医疗保健系统萨特健康的 9 个医疗集团和 17 家医院向 8141 名临床医生分发了调查。

主要措施

倦怠是主要结果,幸福感和工作经历的其他指标也进行了测量。进行了描述性统计和多变量逻辑回归分析。所有统计推断均基于基于响应偏差调整的加权估计。

主要结果

共有 3176 名临床医生(39.0%)对调查做出了回应。加权结果显示,29.2%的人报告倦怠,女性比男性更常见(39.0%比 22.7%,p<0.01)。在多变量模型中,女性与报告倦怠的几率增加相关(OR=2.19,95%CI:1.51-3.17),55 岁以上的人则几率降低(OR=0.54,95%CI:0.34-0.87)。报告育儿/照顾工作对工作有影响的女性多于男性(32.9%比 19.0%,p<0.01)。即使控制了年龄和性别,报告育儿/照顾责任影响工作的临床医生报告倦怠的几率也大大增加(OR=2.19,95%CI:1.54-3.11)。与倦怠率较高相关的其他因素包括担心工作场所的安全、被分配额外的工作任务、担心失业以及在急诊医学或放射科工作。保护因素包括相信自己的担忧将得到处理并感到非常有价值。

结论

这项大型调查发现,大流行不成比例地影响了女性、年轻的临床医生和那些因照顾责任而影响工作的人。这些结果强调需要制定一项全面和有针对性的策略来改善临床医生的幸福感,以满足女性、年轻临床医生和有照顾责任的人的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbf2/8738787/52b01c5e274a/11606_2021_7134_Fig1_HTML.jpg

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