Department of Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland.
Faculty of Health, Department of Human Medicine, University of Witten/Herdecke, Witten, Germany.
World J Surg. 2022 Jul;46(7):1609-1622. doi: 10.1007/s00268-022-06521-0. Epub 2022 Mar 18.
Declining number of applicants and high attrition of residents are a dire reality. Surgeons in training are confronted to various stressors which interfere with their performance and may promote burnout. This study measures stress levels of Swiss surgical residents.
Swiss surgery residents taking the Surgical Basic Exam from 2016 to 2020 completed the Perceived Stress Scale 10 (PSS). The PSS measures how unpredictable, uncontrollable, and overloaded the respondents evaluate their work life. Scores up to 13 are normal, and scores around 20 are highly pathologic. High subscores of helplessness (PH) and lower subscores of self-efficacy (PSE) indicate distress.
A total of 1694 questionnaires were evaluated (return rate 95.7%). Resident median (m) age was 29 years, 43.5% were female, and 72.7% of the residents were in their first 2 years of training. Residents reported a high PSS (m = 15), a high PH (m = 9), and an ordinary PSE (m = 5). Females reported worse PSS (p < 0.001), PH (p < 0.001), and PSE (p = 0.036). In multivariable analysis, male sex (p < 0.001), aiming at orthopedic (p = 0.017) or visceral surgery (p = 0.004), and French as mother tongue (p = 0.037) predicted lower stress levels, while graduating from a country not adjacent to Switzerland led to higher stress (p = 0.047).
Perceived stress levels are high in this prospective and representative cohort study of Swiss surgical residents. Females endured significantly worse stress and helplessness levels than males. These figures are worrisome as they may directly contribute to the declining attractivity of surgical residencies. Detailed sex-specific analysis and correction of stressors are urgently needed to improve residency programs.
申请人数量减少和住院医师流失率高是一个严峻的现实。受训外科医生面临着各种压力源，这些压力源会干扰他们的表现，并可能导致倦怠。本研究测量了瑞士外科住院医师的压力水平。
2016 年至 2020 年参加外科基础考试的瑞士外科住院医师完成了 10 项感知压力量表（PSS）。PSS 衡量受访者如何评估他们的工作生活的不可预测性、不可控性和超负荷。得分在 13 分以下为正常，得分在 20 分左右为高度病理。无助感高分（PH）和自我效能感低分（PSE）表示苦恼。
共评估了 1694 份问卷（回收率为 95.7%）。住院医师的中位数（m）年龄为 29 岁，43.5%为女性，72.7%的住院医师处于培训的头 2 年。住院医师报告的 PSS 较高（m=15），PH 较高（m=9），PSE 中等（m=5）。女性报告的 PSS（p<0.001）、PH（p<0.001）和 PSE（p=0.036）更差。多变量分析显示，男性（p<0.001）、目标为骨科（p=0.017）或内脏手术（p=0.004）以及母语为法语（p=0.037）预测压力水平较低，而毕业于瑞士邻国的国家导致压力较高（p=0.047）。
在这项针对瑞士外科住院医师的前瞻性、代表性队列研究中，感知压力水平较高。女性承受的压力和无助感水平明显高于男性。这些数字令人担忧，因为它们可能直接导致外科住院医师吸引力下降。迫切需要进行详细的性别特异性分析和纠正压力源，以改善住院医师培训计划。
