Kratzke Ian M, Woods Lindsay C, Adapa Karthik, Kapadia Muneera R, Mazur Lukasz
Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
J Surg Educ. 2022 May-Jun;79(3):614-623. doi: 10.1016/j.jsurg.2021.11.006. Epub 2021 Nov 24.
The consequences of burnout remain prevalent within general surgery training programs, yet there is no comprehensive description of the factors associated with burnout. Using sociotechnical systems theory, this review aims to qualitatively evaluate the factors associated with burnout in surgical residents.
A systematic review of the literature was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review was conducted using PubMed, Web of Science, Scopus, and Embase. Two reviewers independently selected studies, extracted data, and assessed quality, with a third reviewer acting as a moderator to resolve conflicts. The Systems Engineering Initiative for Patient Safety framework was utilized to categorize factors as either contributing to or mitigating burnout. The study was registered with PROSPERO (CRD42021237448).
Included studies were conducted within the United States and published prior to November 11, 2020.
Included studies were peer-reviewed primary data, that were written in English and evaluated the sociotechnical factors associated with burnout in surgical residents.
A total of 4387 articles were identified and after review, 15 studies were included for analysis. Reported burnout rates ranged from 17 to 94%, with a total mean rate of 57%. Factors found to contribute to burnout include financial stress, work-life imbalance, excessive charting, insufficient job resources, poor social support, and mistreatment. Mitigating factors include having time away from work, increased didactics, supportive faculty, attending social events, and the presence of program-based wellness initiatives. Consequences of burnout include depression, substance abuse, and decreased job satisfaction.
Reported burnout rates among surgical residents are high. A complex number of sociotechnical factors were found to contribute to burnout, yet many factors are also shown to mitigate burnout. Surgical residencies may address burnout by making changes based on the presence or absence of these factors within their program.
职业倦怠的后果在普通外科培训项目中仍然普遍存在，但目前尚无对与职业倦怠相关因素的全面描述。本综述运用社会技术系统理论，旨在定性评估外科住院医师职业倦怠的相关因素。
根据系统评价和Meta分析的首选报告项目指南对文献进行系统综述。通过PubMed、科学网、Scopus和Embase进行检索。两名评审员独立选择研究、提取数据并评估质量，第三名评审员作为仲裁者解决冲突。利用患者安全系统工程倡议框架将因素分类为导致职业倦怠或减轻职业倦怠的因素。该研究已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42021237448）登记。
纳入的研究在美国进行，且于2020年11月11日前发表。
纳入的研究为经过同行评审的原始数据，以英文撰写，评估了与外科住院医师职业倦怠相关的社会技术因素。
共识别出4387篇文章，经筛选后，纳入15项研究进行分析。报告的职业倦怠率在17%至94%之间，总体平均率为57%。发现导致职业倦怠的因素包括经济压力、工作与生活失衡、过多的病历书写、工作资源不足、社会支持差以及虐待。减轻职业倦怠的因素包括有时间离开工作岗位、增加教学活动、有支持性的教员、参加社交活动以及存在基于项目的健康促进措施。职业倦怠的后果包括抑郁、药物滥用和工作满意度下降。
报告显示外科住院医师的职业倦怠率很高。发现有许多复杂的社会技术因素导致职业倦怠，但也有许多因素可减轻职业倦怠。外科住院医师培训项目可根据项目中这些因素的有无进行调整，以解决职业倦怠问题。
