个体因素和住院医师培训项目与医师住院医师抑郁、焦虑和倦怠的关系——巴西调查。
Individual and residency program factors related to depression, anxiety and burnout in physician residents - a Brazilian survey.
机构信息
Division of Neuropsychiatry, Federal University of Pernambuco (UFPE), Recife, Brazil.
Neurology Unit, Hospital da Restauração, Recife, Brazil.
出版信息
BMC Psychiatry. 2022 Apr 19;22(1):272. doi: 10.1186/s12888-022-03916-0.
BACKGROUND
Psychological distress is common among medical trainees. This study aimed to assess the frequency of depression, anxiety and burnout among physician residents and their association with both individual and residency program-related factors.
METHODS
This was a cross-sectional study applying an online survey in a national-wide sample of medical residents from Brazil. Depression, anxiety, burnout and diurnal somnolence were assessed with validated tools (Patient Health Questionnaire-4, 2 items version of Maslach Burnout Inventory, and Epworth Sleepiness Scale). Socio-demographic and residency program-related factors were measured with internally validated instruments. We performed multivariate binary logistic regression analysis for each of the main outcomes.
RESULTS
Screening for depression, anxiety and burnout was positive respectively in 46.9%, 56.6% and 37.0% of our sample (n = 1,419). Depression was independently related to female sex, longer duty hours, absence of day off, poor learning perception, poor feeling about the residency program, overall occurrence of psychological abuse, anxiety, diurnal somnolence and burnout (AUROC = .859 [95%CI = .840-.878], p < .001). Anxiety was independently associated with female sex, higher age and duty hours, work-personal life conflicts, few classroom activities, providing assistance without supervision, depression and diurnal somnolence (837 [.816-.857], p < .001). Burnout was related to lower age and leisure time, male sex, longer duty hours, absence of day off, provision of care without supervision, choice of the wrong specialty, poor learning, psychological abuse, depression and diurnal somnolence (.780 [.753-.806], p < .001).
CONCLUSION
Frequency of psychological distress in residency training is high and related to both individuals and environmental factors, namely high workloads, occurrence of psychological abuse, poor faculty supervision, poor learning experience and work-personal life conflicts.
背景
心理困扰在医学受训者中很常见。本研究旨在评估医生住院医师的抑郁、焦虑和倦怠频率，并评估其与个体和住院医师项目相关因素的关联。
方法
这是一项横断面研究，在巴西全国范围内的医学住院医师中应用在线调查。使用经过验证的工具（患者健康问卷-4、Maslach 倦怠量表的 2 项版本和 Epworth 嗜睡量表）评估抑郁、焦虑、倦怠和日间嗜睡。使用内部验证的工具测量社会人口统计学和住院医师项目相关因素。我们对每个主要结果进行了多变量二元逻辑回归分析。
结果
我们的样本（n=1419）中，抑郁、焦虑和倦怠的筛查阳性率分别为 46.9%、56.6%和 37.0%。女性、更长的值班时间、没有休息日、较差的学习感知、对住院医师项目的较差感觉、整体发生的心理虐待、焦虑、日间嗜睡和倦怠与抑郁独立相关（AUROC=0.859 [95%CI=0.840-.878]，p<.001）。焦虑与女性、较高的年龄和值班时间、工作-个人生活冲突、较少的课堂活动、无监督提供帮助、抑郁和日间嗜睡独立相关（837 [.816-.857]，p<.001）。倦怠与年龄和闲暇时间较低、男性、更长的值班时间、没有休息日、无监督提供护理、选择错误的专业、学习较差、心理虐待、抑郁和日间嗜睡有关（.780 [.753-.806]，p<.001）。
结论
住院医师培训中心理困扰的频率很高，与个体和环境因素有关，即高工作量、发生心理虐待、教师监督不力、学习体验不佳以及工作-个人生活冲突。
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