Sinsky Christine A, Brown Roger L, Stillman Martin J, Linzer Mark
American Medical Association, Chicago, IL.
University of Wisconsin School of Nursing, Madison.
Mayo Clin Proc Innov Qual Outcomes. 2021 Dec;5(6):1165-1173. doi: 10.1016/j.mayocpiqo.2021.08.007. Epub 2021 Dec 8.
To evaluate relationships between coronavirus disease 2019 (COVID-19)-related stress and work intentions in a sample of US health care workers.
Between July 1 and December 31, 2020, health care workers were surveyed for fear of viral exposure or transmission, COVID-19-related anxiety or depression, work overload, burnout, and intentions to reduce hours or leave their jobs.
Among 20,665 respondents at 124 institutions (median organizational response rate, 34%), intention to reduce hours was highest among nurses (33.7%; n=776), physicians (31.4%; n=2914), and advanced practice providers (APPs; 28.9%; n=608) while lowest among clerical staff (13.6%; n=242) and administrators (6.8%; n=50; all <.001). Burnout (odds ratio [OR], 2.15; 95% CI, 1.93 to 2.38), fear of exposure, COVID-19-related anxiety/depression, and workload were independently related to intent to reduce work hours within 12 months (all <.01). Intention to leave one's practice within 2 years was highest among nurses (40.0%; n=921), APPs (33.0%; n=694), other clinical staff (29.4%; n=718), and physicians (23.8%; n=2204) while lowest among administrators (12.6%; n=93; all <.001). Burnout (OR, 2.57; 95% CI, 2.29 to 2.88), fear of exposure, COVID-19-related anxiety/depression, and workload were predictors of intent to leave. Feeling valued by one's organization was protective of reducing hours (OR, 0.65; 95% CI, 0.59 to 0.72) and intending to leave (OR, 0.40; 95% CI, 0.36 to 0.45; all <.01).
Approximately 1 in 3 physicians, APPs, and nurses surveyed intend to reduce work hours. One in 5 physicians and 2 in 5 nurses intend to leave their practice altogether. Reducing burnout and improving a sense of feeling valued may allow health care organizations to better maintain their workforces postpandemic.
评估美国医护人员样本中2019冠状病毒病(COVID - 19)相关压力与工作意向之间的关系。
在2020年7月1日至12月31日期间,对医护人员进行调查,了解他们对病毒暴露或传播的恐惧、与COVID - 19相关的焦虑或抑郁、工作负荷过重、职业倦怠以及减少工作时长或离职的意向。
在124家机构的20665名受访者中(机构中位回应率为34%),护士(33.7%;n = 776)、医生(31.4%;n = 2914)和高级执业提供者(APPs;28.9%;n = 608)中减少工作时长的意向最高,而文职人员(13.6%;n = 242)和管理人员(6.8%;n = 50;均P <.001)中该意向最低。职业倦怠(优势比[OR],2.15;95%置信区间[CI],1.93至2.38)、对暴露的恐惧、与COVID - 19相关的焦虑/抑郁以及工作负荷与12个月内减少工作时长的意向独立相关(均P <.01)。在护士(40.0%;n = 921)、APPs(33.0%;n = 694)、其他临床工作人员(29.4%;n = 718)和医生(23.8%;n = 2204)中,2年内离职的意向最高,而管理人员中该意向最低(12.6%;n = 93;均P <.001)。职业倦怠(OR,2.57;95% CI,2.29至2.88)、对暴露的恐惧、与COVID - 19相关的焦虑/抑郁以及工作负荷是离职意向的预测因素。感觉受到所在组织重视对减少工作时长(OR,0.65;95% CI,0.59至0.72)和离职意向(OR,0.40;95% CI,0.36至0.45;均P <.01)具有保护作用。
接受调查的医生、APPs和护士中约三分之一打算减少工作时长。五分之一的医生和五分之二的护士打算完全离职。减少职业倦怠并改善受重视感可能使医疗保健机构在疫情后更好地维持其员工队伍。