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与应对 COVID-19 大流行的住院医师倦怠相关的因素:一项为期 2 个月的纵向观察研究。

Factors Associated with Burnout among Resident Physicians Responding to the COVID-19 Pandemic: A 2-Month Longitudinal Observation Study.

机构信息

Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11354, USA.

Department of Psychology, St. John's University, 152-11 Union Turnpike, Jamaica, NY 11367, USA.

出版信息

Int J Environ Res Public Health. 2022 Aug 7;19(15):9714. doi: 10.3390/ijerph19159714.

Abstract

BACKGROUND

Burnout during residency may be a function of intense professional demands and poor work/life balance. With the onset of the COVID-19 pandemic, NYC hospital systems were quickly overwhelmed, and trainees were required to perform beyond the usual clinical duties with less supervision and limited education.

OBJECTIVE

The present longitudinal study examined the effects of COVID-19 caseload over time on burnout experienced by resident physicians and explored the effects of demographic characteristics and organizational and personal factors as predictors of burnout severity.

METHODS

This study employed a prospective design with repeated measurements from April 2020 to June 2020. Participants were surveyed about their well-being every 5 days. Predictors included caseload, sociodemographic variables, self-efficacy, hospital support, perceived professional development, meaning in work, and postgraduate training level.

RESULTS

In total, 54 resident physicians were recruited, of whom 50% reported burnout on initial assessment. Periods of higher caseload were associated with higher burnout. PGY-3 residents reported more burnout initially but appeared to recover faster compared to PGY-1 residents. Examined individually, higher self-efficacy, professional development, meaningful work, and hospital support were associated with lower burnout. When all four predictors were entered simultaneously, only self-efficacy was associated with burnout. However, professional development, meaningful work, and hospital support were associated with self-efficacy.

CONCLUSION

Burnout among residency is prevalent and may have implications for burnout during later stages of a physician's career. Self-efficacy is associated with lower burnout and interventions to increase self-efficacy and the interpersonal factors that promote self-efficacy may improve physician physical and emotional well-being.

摘要

背景

住院医师的职业倦怠可能是高强度职业需求和工作/生活失衡的结果。随着 COVID-19 大流行的爆发,纽约市的医院系统迅速不堪重负,住院医师需要在没有多少监督和有限教育的情况下,承担超出常规临床职责的工作。

目的

本纵向研究考察了 COVID-19 病例数随时间的变化对住院医师职业倦怠的影响,并探讨了人口统计学特征和组织及个人因素作为职业倦怠严重程度预测因子的作用。

方法

本研究采用前瞻性设计,于 2020 年 4 月至 6 月期间进行重复测量。每 5 天对参与者的幸福感进行一次调查。预测因子包括病例数、社会人口统计学变量、自我效能、医院支持、感知职业发展、工作意义和研究生培训水平。

结果

共招募了 54 名住院医师,其中 50%在初次评估时报告有职业倦怠。较高的病例数与较高的职业倦怠相关。PGY-3 住院医师最初报告的倦怠程度更高,但与 PGY-1 住院医师相比,他们的恢复速度更快。单独检查时,较高的自我效能、职业发展、工作意义和医院支持与较低的倦怠相关。当同时纳入所有四个预测因子时,只有自我效能与倦怠相关。然而,职业发展、工作意义和医院支持与自我效能相关。

结论

住院医师的职业倦怠很普遍,可能对医生职业生涯后期的职业倦怠产生影响。自我效能与较低的职业倦怠相关,而增强自我效能和促进自我效能的人际因素的干预措施可能会改善医生的身体和心理健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b406/9367700/783e852729be/ijerph-19-09714-g001.jpg

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