Halbach Susan M, Pillutla Kartik, Seo-Mayer Patricia, Schwartz Alan, Weidemann Darcy, Mahan John D
Division of Nephrology, Seattle Children's Hospital, Seattle, WA, United States.
Department of Pediatrics, University of Washington, Seattle, WA, United States.
Front Pediatr. 2022 May 4;10:849370. doi: 10.3389/fped.2022.849370. eCollection 2022.
Physician well-being is an important contributor to both job satisfaction and patient outcomes. Rates of burnout among physicians vary by specialty, ranging from 35 to 70%. Among pediatric residents, longitudinal data demonstrates consistent rates of burnout around 50-60%, although little is known about burnout among pediatric subspecialty fellows. Specifically, the degree of burnout among pediatric nephrologists remains unknown, as does the impact faculty burnout may have on trainee burnout. We sought to evaluate prevalence and predictors of burnout among US pediatric nephrology fellows and faculty, and assess for interactions between groups. In this multi-center pilot survey of all United States pediatric nephrology training programs from February to April 2020, burnout was assessed through abbreviated Maslach Burnout Inventory and predictors were explored through survey items devoted to demographic, personal characteristics, and job and career satisfaction questions. A total of 30/34 available fellows and 86/102 faculty from 11 institutions completed the survey (overall response rate 85%). The prevalence of burnout was 13% among fellows and 16% among faculty. Demographic (age, gender, year of training, faculty rank, marital status) and program factors (fellowship size, faculty size, current block/rotation, vacation or weekend off timing) were not significantly associated with burnout. Faculty and fellows with burnout reported significantly lower quality of life (5.3 vs. 7.9, < 0.05), higher perceived stress (2.4 vs. 1.4, < 0.05) and lower satisfaction with career choice (66 vs. 22%) and work life balance (28 vs. 0%), compared to those without burnout ( < 0.05 for all). Other important factors positively associated with burnout included lower institutional support for wellness programs and lower satisfaction with both colleague and faculty support. Larger studies are needed to explore if burnout is truly less prevalent among pediatric nephrology fellows and faculty compared to pediatric residents and graduate physicians. A larger sample size is also necessary to determine whether any interactions exist between the faculty and trainee roles in the developments of burnout. Future studies should also explore how to promote well-being through addressing key factors such as overall learning/working environment, stress reduction, and building personal resilience.
医生的职业幸福感是工作满意度和患者治疗效果的重要影响因素。医生的职业倦怠率因专业而异，范围在35%至70%之间。在儿科住院医师中，纵向数据显示职业倦怠率始终在50%至60%左右，不过对于儿科亚专业研究员的职业倦怠情况了解甚少。具体而言，儿科肾病医生的职业倦怠程度尚不清楚，教员的职业倦怠对学员职业倦怠的影响也不明确。我们试图评估美国儿科肾病研究员和教员职业倦怠的患病率及预测因素，并评估不同群体之间的相互作用。在这项于2020年2月至4月对美国所有儿科肾病培训项目进行的多中心试点调查中，通过简化版的马氏职业倦怠量表评估职业倦怠情况，并通过专门针对人口统计学、个人特征以及工作和职业满意度问题的调查项目探究预测因素。来自11个机构的30名/34名在职研究员和86名/102名教员完成了调查（总体回复率85%）。研究员的职业倦怠患病率为13%，教员为16%。人口统计学因素（年龄、性别、培训年份、教员职级、婚姻状况）和项目因素（研究员人数、教员人数、当前阶段/轮转、休假或周末休息时间）与职业倦怠无显著关联。与未出现职业倦怠的人相比，出现职业倦怠的教员和研究员报告的生活质量显著更低（5.3对7.9，<0.05），感知压力更高（2.4对1.4，<0.05），对职业选择的满意度更低（66%对22%），对工作与生活平衡的满意度也更低（28%对0%）（所有比较均<0.05）。与职业倦怠呈正相关的其他重要因素包括机构对健康项目的支持力度较低，以及对同事和教员支持的满意度较低。需要开展更大规模的研究，以探究与儿科住院医师和研究生医生相比，儿科肾病研究员和教员的职业倦怠率是否真的更低。还需要更大的样本量来确定在职业倦怠的发展过程中，教员和学员角色之间是否存在相互作用。未来的研究还应探索如何通过解决诸如整体学习/工作环境、减压以及培养个人适应能力等关键因素来促进职业幸福感。
