Section of Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN.
American Academy of Pediatrics, Research, Itasca, IL.
J Pediatr. 2022 Oct;249:84-91. doi: 10.1016/j.jpeds.2022.05.046. Epub 2022 Jun 1.
Compare pediatrician burnout when measured and categorized in different ways to better understand burnout and the association with satisfaction.
We analyzed national survey data from a cohort study of early to midcareer pediatricians. In 2017, participants randomly received 1 of 3 question sets measuring burnout components (emotional exhaustion, depersonalization, and personal accomplishment): group A received the Maslach Burnout Inventory, group B received a previously used measure, and group C received a new severe measure. Repeated measures ANOVA tested differences across burnout categorizations: high emotional exhaustion and high depersonalization and low personal accomplishment; high emotional exhaustion and high depersonalization; and high emotional exhaustion or high depersonalization. Logistic regression tested relationships between burnout profiles (engaged, intermediate, and burnout) and satisfaction. Seventy-one percent of participants completed the survey (1279/1800).
Burnout varied depending on measurement (groups A, B, and C) and categorization. For example, for group A, when categorized as high emotional exhaustion, high depersonalization, and low personal accomplishment, burnout was lower (4.8%) than categorized as high emotional exhaustion and depersonalization (15.2%) (P < .001) or categorized as high emotional exhaustion or depersonalization (44.6%) (P < .001). Most participants were satisfied with their career (83.6%). Using burnout profiles, 38.4%-85.1% fell in the engaged profile. For each group, burnout profiles were associated with satisfaction. For example, group A participants in the burnout or intermediate profile were less likely than those engaged to be satisfied with their careers (aOR, 0.08 [95% CI, 0.03-0.24]; and aOR, 0.23 [95% CI, 0.10-0.56], respectively).
The way burnout is measured and categorized affects burnout prevalence and its association with satisfaction. Transparency in methodology used is critical to interpreting results.
以不同方式衡量和分类儿科医生的倦怠情况，以更好地理解倦怠及其与满意度的关系。
我们分析了一项针对早期至中期儿科医生的队列研究的全国性调查数据。2017 年，参与者随机收到了 3 组衡量倦怠成分（情绪衰竭、去人性化和个人成就感）的问卷中的 1 组：A 组收到了马斯拉赫倦怠量表，B 组收到了之前使用的量表，C 组收到了新的严重量表。重复测量方差分析测试了倦怠分类之间的差异：高情绪衰竭和高去人性化且低个人成就感；高情绪衰竭和高去人性化；高情绪衰竭或高去人性化。逻辑回归测试了倦怠模式（参与型、中间型和倦怠型）与满意度之间的关系。71%的参与者完成了调查（1279/1800）。
倦怠情况因测量（A、B 和 C 组）和分类而异。例如，对于 A 组，当分类为高情绪衰竭、高去人性化和低个人成就感时，倦怠程度（4.8%）低于分类为高情绪衰竭和去人性化（15.2%）（P<0.001）或分类为高情绪衰竭或去人性化（44.6%）（P<0.001）。大多数参与者对自己的职业感到满意（83.6%）。使用倦怠模式，38.4%-85.1%的人属于参与模式。对于每个组，倦怠模式都与满意度相关。例如，A 组中处于倦怠或中间状态的参与者比处于参与状态的参与者更不可能对自己的职业感到满意（比值比，0.08[95%置信区间，0.03-0.24]；比值比，0.23[95%置信区间，0.10-0.56]）。
倦怠的衡量和分类方式会影响倦怠的流行程度及其与满意度的关系。解释结果时，方法的透明度至关重要。
