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住院医师职业倦怠干预措施:对其内容、形式及有效性的范围综述

Burnout Interventions for Resident Physicians: A Scoping Review of Their Content, Format, and Effectiveness.

作者信息

Lu Fang-I, Ratnapalan Savithiri

机构信息

From the Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Lu).

From the Departments of Laboratory Medicine and Pathobiology (Lu), University of Toronto, Toronto, Ontario, Canada.

出版信息

Arch Pathol Lab Med. 2023 Feb 1;147(2):227-235. doi: 10.5858/arpa.2021-0115-EP.

Abstract

CONTEXT.—: Physicians face a high rate of burnout, especially during the residency training period when trainees often experience a rapid increase in professional responsibilities and expectations. Effective burnout prevention programs for resident physicians are needed to address this significant issue.

OBJECTIVE.—: To examine the content, format, and effectiveness of resident burnout interventions published in the last 10 years.

DESIGN.—: The literature search was conducted on the MEDLINE database with the following keywords: internship, residency, health promotion, wellness, occupational stress, burnout, program evaluation, and program. Only studies published in English between 2010 and 2020 were included. Exclusion criteria were studies on interventions related to the COVID-19 pandemic, studies on duty hour restrictions, and studies without assessment of resident well-being postintervention.

RESULTS.—: Thirty studies were included, with 2 randomized controlled trials, 3 case-control studies, 20 pretest and posttest studies, and 5 case reports. Of the 23 studies that used a validated well-being assessment tool, 10 reported improvements postintervention. These effective burnout interventions were longitudinal and included wellness training (7 of 10), physical activities (4 of 10), healthy dietary habits (2 of 10), social activities (1 of 10), formal mentorship programs (1 of 10), and health checkups (1 of 10). Combinations of burnout interventions, low numbers of program participants with high dropout rates, lack of a control group, and lack of standardized well-being assessment are the limitations identified.

CONCLUSIONS.—: Longitudinal wellness training and other interventions appear effective in reducing resident burnout. However, the validity and generalizability of the results are limited by the study designs.

摘要

背景

医生面临着较高的职业倦怠率,尤其是在住院医师培训期间,实习生的工作职责和期望往往会迅速增加。需要有效的住院医师职业倦怠预防项目来解决这一重大问题。

目的

研究过去10年发表的住院医师职业倦怠干预措施的内容、形式和效果。

设计

在MEDLINE数据库中进行文献检索,关键词如下:实习、住院医师培训、健康促进、健康、职业压力、职业倦怠、项目评估和项目。仅纳入2010年至2020年期间以英文发表的研究。排除标准为与2019冠状病毒病疫情相关的干预措施研究、值班时间限制研究以及未评估干预后住院医师幸福感的研究。

结果

共纳入30项研究,其中2项随机对照试验、3项病例对照研究、20项前后测试研究和5项病例报告。在23项使用经过验证的幸福感评估工具的研究中,10项报告干预后有改善。这些有效的职业倦怠干预措施是纵向的,包括健康培训(10项中的7项)、体育活动(10项中的4项)、健康饮食习惯(10项中的2项)、社交活动(10项中的1项)、正式的导师计划(10项中的1项)和健康检查(10项中的1项)。职业倦怠干预措施的组合、项目参与者数量少且辍学率高、缺乏对照组以及缺乏标准化的幸福感评估是已确定的局限性。

结论

纵向健康培训和其他干预措施似乎对减少住院医师职业倦怠有效。然而,研究设计限制了结果的有效性和普遍性。

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