Groupement Interprofessionnel Médico-Social (GIMS), 11, rue de la République, C.S. 52336, 13213, Marseille Cedex 02, France.
Aix-Marseille Univ, CEReSS, 3279, Marseille, France.
Int Arch Occup Environ Health. 2022 Apr;95(3):559-571. doi: 10.1007/s00420-021-01784-x. Epub 2022 Feb 26.
Estimate the effort-reward imbalance prevalence (ERI) among physicians.
A systematic review was conducted from 2005 to 2019 using PRISMA guidelines on the PubMed and EBSCOhost search engines. Data were classified according to the ERI definition used by the authors. A meta-analysis was performed on effort and reward scores and on ERI prevalence rates.
Out of 3787 results, we selected 41 studies. The physicians' ERI prevalence rate ranged from 3.50 to 96.9%. The standardized pooled effort mean score was 58.5 for effort and 48.9 for a reward out of 100, respectively. The overall combined ERI rate (when the ratio between effort and reward scores was above 1) was 40.2% among 21,939 practitioners (31.7% in the working European population). ERI rate was 70.2% using a four-point Likert scale and 21.1% using a five-point Likert scale. The highest rate (96.9%) was observed among German rural general practitioners and the lowest rate (3.50%) among Swiss hospital practitioners. The low percentage of variability (I = 27%) attributed to effort scores heterogeneity between studies suggested that this dimension is not discriminant in the physician ERI assessment. The high heterogeneity in reward scores (I = 83%) indicated that this dimension is sensible in ERI assessment among physicians. The number of items used did not appear as a significant source of heterogeneity.
Physician job ERI appeared to be higher than in the working population. Studying each dimension and item indicators could help improve psychosocial risk prevention.
评估医生的工作投入-回报失衡（ERI）发生率。
采用 PRISMA 指南，对 2005 年至 2019 年在 PubMed 和 EBSCOhost 搜索引擎上发表的研究进行系统综述。根据作者使用的 ERI 定义对数据进行分类。对工作投入和回报评分以及 ERI 发生率进行荟萃分析。
在 3787 项研究结果中，我们选择了 41 项研究。医生的 ERI 发生率范围为 3.50%至 96.9%。标准化的 pooled effort 平均得分为 58.5，代表 100 分中的工作投入；reward 平均得分为 48.9，代表 100 分中的回报。在 21939 名从业者中（欧洲工作人群中的 31.7%），总体合并 ERI 发生率（当投入与回报得分之比大于 1 时）为 40.2%。使用四点 Likert 量表时，ERI 发生率为 70.2%；使用五点 Likert 量表时，ERI 发生率为 21.1%。在德国农村全科医生中观察到最高的 ERI 发生率（96.9%），而在瑞士医院医生中观察到最低的 ERI 发生率（3.50%）。研究间投入得分异质性的低百分比（I = 27%）表明，这一维度在医生 ERI 评估中不具有区分性。回报得分的高度异质性（I = 83%）表明，这一维度在医生的 ERI 评估中是敏感的。使用的项目数量似乎不是异质性的重要来源。
医生的工作 ERI 似乎高于工作人群。研究每个维度和项目指标有助于改善心理社会风险预防。
