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住院医师心理健康与职业倦怠:泌尿外科项目主任的当前做法与观点

Resident Mental Health and Burnout: Current Practices and Perspectives of Urology Program Directors.

作者信息

Glick Hannah, Ganesh Kumar Nishant, Olinger Thomas A, Vercler Christian J, Kraft Kate H

机构信息

Department of Urology, University of Michigan, Ann Arbor, MI.

Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.

出版信息

Urology. 2022 Feb;160:40-45. doi: 10.1016/j.urology.2021.09.043. Epub 2021 Dec 1.

Abstract

OBJECTIVE

To understand perspectives of urology program directors (PDs) regarding the management and screening of resident mental health and burnout.

METHODS

After piloting and survey validation, an IRB-exempt 14 question survey was distributed to PDs of all 145 ACGME accredited urology residency programs. Statistical significance was determined using an alpha value of 0.05 and response plurality was determined by non-overlapping 95% confidence intervals.

RESULTS

A total of 72 PDs completed the survey (response rate = 49.6%). The majority of PDs (59.7%) do not use standardized screening for resident burnout or mental health. A statistically significant proportion of PDs agreed to implementing periodic mental health (75.0%, 95% CI [65.0%-75.0%]) and burnout (87.6%, 95% CI [79.9%-95.1%]) screening. Female PDs were more likely to agree to implementing mental health screening compared to male PDs (female=94.4% vs male=68.5%; P =.03). If mental health screening was implemented and a resident tested positive, PDs were most concerned about harm to a patient (72.2%, 95% CI [61.9-82.6]) and implications of a positive screen on future licensing and practice (55.6%, 95% CI [44.1-67.0]).

CONCLUSION

Although the majority of urology PDs believe residents should be periodically screened for burnout and mental health, most do not currently screen their trainees. If mental health screening was implemented, PDs expressed concern about patient harm and challenges associated with future licensing. Our survey results suggest opportunities for improving management of resident burnout and mental health.

摘要

目的

了解泌尿外科住院医师培训项目主任(PDs)对住院医师心理健康和职业倦怠管理及筛查的看法。

方法

在进行试点和调查验证后,向145个经美国毕业后医学教育认证委员会(ACGME)认可的泌尿外科住院医师培训项目的PDs发放了一份豁免机构审查委员会(IRB)审查的包含14个问题的调查问卷。使用0.05的α值确定统计学显著性,并通过非重叠的95%置信区间确定回答的多数情况。

结果

共有72名PDs完成了调查(回复率 = 49.6%)。大多数PDs(59.7%)未对住院医师的职业倦怠或心理健康进行标准化筛查。有统计学显著比例的PDs同意实施定期心理健康筛查(75.0%,95%置信区间[65.0%-75.0%])和职业倦怠筛查(87.6%,95%置信区间[79.9%-95.1%])。与男性PDs相比,女性PDs更有可能同意实施心理健康筛查(女性 = 94.4%,男性 = 68.5%;P = 0.03)。如果实施心理健康筛查且住院医师检测呈阳性,PDs最担心对患者造成伤害(72.2%,95%置信区间[61.9 - 82.6])以及阳性筛查结果对未来执照和执业的影响(55.6%,95%置信区间[44.1 - 67.0])。

结论

尽管大多数泌尿外科PDs认为应定期对住院医师进行职业倦怠和心理健康筛查,但目前大多数人并未对其学员进行筛查。如果实施心理健康筛查,PDs对患者伤害以及与未来执照相关的挑战表示担忧。我们的调查结果表明在改善住院医师职业倦怠和心理健康管理方面存在机会。

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