Crowe Liz, Young Jeanine, Turner M Jane
School of Medicine, The University of Queensland, Brisbane, Australia.
School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.
Transl Pediatr. 2021 Oct;10(10):2825-2835. doi: 10.21037/tp-20-400.
Staff in the paediatric intensive care unit work with children and their families in an area of high acuity, mortality, and morbidity. There is complexity due to technological advancements and confronting psychosocial situations. With increasing reports of the threat of burnout to healthcare professionals it is imperative to understand the prevalence of burnout and the determinants of risk factors for staff to work in the paediatric intensive care unit (PICU) in order to inform interventions that reduce risk and support growth and wellbeing of this specialised workforce. We conducted electronic searches of PUBMED, Medline, CINAHL and PsychINFO. Studies meeting eligibility inclusion criteria comprised English text, publication dates 1995 to 2019, use of standardized measures to assess prevalence and risk factors for burnout where the PICU staff data was reported separately and contained sample sizes ≥10 PICU staff. Two reviewers independently identified and extracted citations and assessed the quality of papers using two standardised reporting tools. Twenty studies were included in the final review. Due to the heterogeneity of the included studies a descriptive account of the studies was developed. Outcomes reported included prevalence and levels of burnout reported across professional disciplines, reported scoring criteria for burnout, risk and protective factors for burnout, comparative populations, systems and social context associated with burnout and study strengths and limitations. Most studies were cross-sectional, used a single measure of burnout and focussed on either physicians or nurses. Of the 20 studies reported 62% reported high burnout, 19% moderate burnout, and 19% reported low levels of burnout. Inconsistency was identified in adherence to recommended cut-off scores or reporting for the categorisation of burnout, which contributed to a lack of clarity in the interpretation of prevalence and severity. Reports of factors associated with increased risk and likely protective factors for burnout were often contradictory suggesting that burnout may be situational; dependent upon personal, environmental, leadership, cultural and patient factors within the PICU. This review revealed that determining levels and risk of burnout in PICU staff remains problematic. Further research which examines the experiences of all members of the multidisciplinary team and identification of factors that affect the development of burnout, including those which are protective, is required.
儿科重症监护病房的工作人员在一个高敏锐度、高死亡率和高发病率的领域中与儿童及其家庭打交道。由于技术进步和面临的社会心理状况，工作存在复杂性。随着医护人员职业倦怠威胁的报道日益增多，了解职业倦怠的患病率以及儿科重症监护病房（PICU）工作人员风险因素的决定因素至关重要，以便为降低风险、支持这支专业队伍的成长和福祉的干预措施提供依据。我们对PUBMED、Medline、CINAHL和PsychINFO进行了电子检索。符合纳入标准的研究包括英文文本、1995年至2019年的出版日期、使用标准化措施评估职业倦怠的患病率和风险因素，其中PICU工作人员数据单独报告且样本量≥10名PICU工作人员。两名评审员独立识别和提取引文，并使用两种标准化报告工具评估论文质量。最终评审纳入了20项研究。由于纳入研究的异质性，对这些研究进行了描述性说明。报告的结果包括各专业学科职业倦怠的患病率和水平、职业倦怠的报告评分标准、职业倦怠的风险和保护因素、比较人群、与职业倦怠相关的系统和社会背景以及研究的优势和局限性。大多数研究是横断面研究，使用单一的职业倦怠测量方法，且侧重于医生或护士。在报告的20项研究中，62%报告职业倦怠程度高，19%报告中度职业倦怠，19%报告职业倦怠程度低。在遵守推荐的临界值分数或职业倦怠分类报告方面存在不一致，这导致在患病率和严重程度的解释上缺乏清晰度。与职业倦怠风险增加相关的因素和可能的保护因素的报告往往相互矛盾，这表明职业倦怠可能是情境性的；取决于PICU内的个人、环境、领导、文化和患者因素。本综述表明，确定PICU工作人员职业倦怠的水平和风险仍然存在问题。需要进一步研究多学科团队所有成员的经历，并确定影响职业倦怠发展的因素，包括那些具有保护作用的因素。
