Department of Medicine, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
Public Health, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia.
Intern Med J. 2022 May;52(5):745-754. doi: 10.1111/imj.15720. Epub 2022 Apr 6.
Junior doctors experience high levels of psychological distress and emotional exhaustion. The current Coronavirus disease 2019 (COVID-19) pandemic has resulted in significant changes to healthcare globally, with quantitative studies demonstrating increased fatigue, depression and burnout in junior doctors. However, there has been limited qualitative research to examine junior doctors' experiences, challenges and beliefs regarding management of future crises.
To investigate the workplace and psychosocial experiences of Australian junior doctors working during the second wave of the COVID-19 pandemic.
Australian healthcare workers were invited to participate in a nationwide, voluntary, anonymous, single time point, online survey between 27 August and 23 October 2020. A qualitative descriptive study of responses to four free-text questions from 621 junior doctors was undertaken, with responses analysed using inductive content analysis.
Participants were predominantly female (73.2%), aged 31-40 years (48.0%) and most frequently reported working in medical specialties (48.4%), emergency medicine (21.7%) or intensive care medicine (11.4%). Most (51.9%) participants had 0-5 years of clinical experience since medical graduation. Junior doctors described experiences related to four key themes: a hierarchical, difficult workplace culture; challenging working conditions; disrupted training and career trajectories; and broader psychosocial impacts. The COVID-19 pandemic exacerbated longstanding, workplace issues and stressors for junior doctors and highlighted the threat that crises pose to medical workforce retention. There is an urgent need for authentic, positive workplace cultural interventions to engage, validate and empower junior doctors.
Challenging workplace cultures and conditions, which have worsened during the COVID-19 pandemic, are associated with poor psychological well-being in junior doctors. There exists a need for long-term, widespread improvements in workplace culture and working conditions to ensure junior doctors' well-being, facilitate workforce retention and enhance the safety and quality of patient care in Australia.
初级医生经历着较高水平的心理困扰和情绪耗竭。当前的 2019 年冠状病毒病（COVID-19）大流行导致全球医疗保健发生重大变化，定量研究表明初级医生的疲劳感、抑郁和职业倦怠感有所增加。然而，对于初级医生在未来危机管理方面的经验、挑战和信念，仅有有限的定性研究进行了探讨。
调查澳大利亚初级医生在 COVID-19 大流行第二波期间的工作场所和心理社会经历。
邀请澳大利亚医护人员于 2020 年 8 月 27 日至 10 月 23 日期间参加一项全国性的、自愿的、匿名的、单次时间点的在线调查。对 621 名初级医生对 4 个自由文本问题的回答进行定性描述性研究，使用归纳内容分析法对回答进行分析。
参与者主要为女性（73.2%），年龄为 31-40 岁（48.0%），大多数报告从事医学专科（48.4%）、急诊医学（21.7%）或重症监护医学（11.4%）工作。大多数（51.9%）参与者在医学毕业以来的临床经验为 0-5 年。初级医生描述了与以下四个关键主题相关的经历：等级分明、困难的工作场所文化；具有挑战性的工作条件；培训和职业轨迹中断；以及更广泛的心理社会影响。COVID-19 大流行使初级医生长期存在的工作场所问题和压力源恶化，并凸显了危机对医疗劳动力保留构成的威胁。迫切需要进行真实、积极的工作场所文化干预，以吸引、验证和增强初级医生的能力。
在 COVID-19 大流行期间恶化的挑战性工作场所文化和条件与初级医生的心理健康状况不佳有关。需要长期、广泛地改善工作场所文化和工作条件，以确保初级医生的福祉、促进劳动力保留，并提高澳大利亚的患者护理安全性和质量。
