Pourmand Kamron, Schiano Thomas D, Motwani Yash, Kriss Michael, Keefer Laurie, Patel Arpan
Division of Liver Diseases Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai New York NY Department of Medicine Statistics Core David Geffen School of Medicine at University of California Los Angeles CA Division of Gastroenterology and Hepatology University of Colorado School of Medicine Aurora CO Division of Gastroenterology Icahn School of Medicine at Mount Sinai New York NY Division of Digestive Diseases David Geffen School of Medicine at University of California Los Angeles CA Division of Gastroenterology and Hepatology Veterans Affairs Greater Los Angeles Healthcare System Los Angeles CA.
Liver Transpl. 2022 May;28(5):867-875. doi: 10.1002/lt.26375. Epub 2021 Dec 26.
Burnout among transplant hepatologists has not been well characterized. The goal of this study was to describe the prevalence and predictors of burnout among practicing transplant hepatologists in the United States. We designed a 69-item survey, including the Maslach Burnout Inventory (MBI)-Human Services Survey and questions on provider demographics, practice characteristics, and psychological factors. The survey was administered to practicing US transplant hepatologists between October and December 2019. We described burnout using MBI subscales (emotional exhaustion [EE], depersonalization [DP], and personal accomplishment [PA]) and determined significant predictors of burnout, which we defined as high EE, using univariate and multivariate analyses. A total of 185 transplant hepatologists completed the survey (response rate = 25% of 738 practicing transplant hepatologists in the United States). A total of 40% reported high EE, whereas 17% and 16% reported high DP and low PA, respectively. On multivariate analysis, respondents with more than 5 colleagues (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.23-0.84) reporting adequate time for outpatient visits (OR, 0.42; 95% CI, 0.22-0.80), reporting greater comfort with their clinical caseload (OR, 0.61; 95% CI, 0.39-0.96), and reporting higher confidence in their prior training (OR, 0.49; 95% CI, 0.28-0.87) had a lower likelihood of high EE. Working 6 or more hours from home outside of work per week (OR, 2.04; 95% CI, 1.07-3.89) predicted a higher likelihood of burnout. Compensation, age, gender, career phase, caregiver status, and transplant center volume did not predict burnout. Of the surveyed transplant hepatologists, 40% experienced burnout, predicted mostly by factors related to work-time distribution, peer support, and affect. These findings should prompt development of system-level initiatives.
移植肝病专家职业倦怠的特征尚未得到充分描述。本研究的目的是描述美国执业移植肝病专家职业倦怠的患病率及预测因素。我们设计了一项包含69个条目的调查问卷，其中包括马氏职业倦怠量表（MBI）-人类服务调查以及关于医疗服务提供者人口统计学、执业特征和心理因素的问题。该调查于2019年10月至12月期间对美国执业移植肝病专家进行。我们使用MBI分量表（情感耗竭[EE]、去人格化[DP]和个人成就感[PA]）来描述职业倦怠情况，并通过单因素和多因素分析确定职业倦怠的显著预测因素，我们将职业倦怠定义为高EE。共有185名移植肝病专家完成了调查（回复率为美国738名执业移植肝病专家的25%）。共有40%的人报告有高EE，而分别有17%和16%的人报告有高DP和低PA。多因素分析显示，有超过5名同事报告门诊就诊时间充足（比值比[OR]，0.44；95%置信区间[CI]，0.23 - 0.84）、对临床工作量更满意（OR，0.42；95% CI，0.22 - 0.80）以及对之前的培训更有信心（OR，0.49；95% CI，0.28 - 0.87）的受访者出现高EE的可能性较低。每周在工作之余在家工作6小时或更长时间（OR，2.04；95% CI，1.07 - 3.89）预示着职业倦怠的可能性更高。薪酬、年龄、性别、职业阶段、照顾者身份和移植中心规模并不能预测职业倦怠。在接受调查的移植肝病专家中，40%经历了职业倦怠，主要由与工作时间分配、同行支持和情感相关的因素预测。这些发现应促使开展系统层面的举措。
