Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Surg Innov. 2023 Apr;30(2):239-250. doi: 10.1177/15533506221120145. Epub 2022 Aug 16.
COVID-19 has placed demands on General Surgery residents, who are already at high risk of burnout. This study examined the pandemic's impact on burnout and wellness among General Surgery residents at a large training program.
General Surgery residents at our institution completed a survey focused on self-reported burnout, mental health, perceptions of wellness resources, and changes in activities during the pandemic. Burnout was measured using the Maslach Burnout Inventory (MBI). Unsupervised machine learning ( clustering) was used to identify profiles of burnout and comparisons between profiles were made.
Of 82 eligible residents, 51 completed the survey (62% response rate). During COVID-19, 63% of residents had self-described burnout, 43% had depression, 18% acknowledged binge drinking/drug use, and 8% had anxiety. There were no significant differences from pre-pandemic levels ( all >.05). Few residents perceived available wellness resources as effective (6%). Based on MBI scores, the clustering analysis identified three clusters, characterized as "overextended", "engaged", and "ineffective". Engaged residents had the least concerning MBI scores and were significantly more likely to exercise, retain social contact during the pandemic, and had less self-reported anxiety or depression. Research residents were overrepresented in the ineffective cluster (46%), which had high rates of self-reported burnout (77%) and was characterized by the lowest personal accomplishment scores. Rates of self-reported burnout for overextended and engaged residents were 73% and 48%, respectively.
Surgical residents have high rates of self-reported burnout and depression during the COVID-19 pandemic. Clusters of burnout may offer targets for individualized intervention.
COVID-19 给普通外科住院医师带来了压力，他们已经处于倦怠的高风险之中。本研究调查了大培训项目中 COVID-19 对普通外科住院医师倦怠和健康的影响。
我们机构的普通外科住院医师完成了一项专注于自我报告的倦怠、心理健康、对健康资源的看法以及大流行期间活动变化的调查。使用 Maslach 倦怠量表（MBI）衡量倦怠。使用无监督机器学习（聚类）来识别倦怠的概况，并对概况进行比较。
在 82 名符合条件的住院医师中，有 51 名完成了调查（62%的应答率）。在 COVID-19 期间，63%的住院医师有自我描述的倦怠，43%有抑郁，18%承认酗酒/吸毒，8%有焦虑。与大流行前水平相比没有显着差异（均>.05）。很少有住院医师认为现有的健康资源有效（6%）。根据 MBI 得分，聚类分析确定了三个聚类，特征为“过度扩展”、“参与”和“无效”。参与度高的住院医师 MBI 得分最低，更有可能在大流行期间进行锻炼、保持社交联系，且自我报告的焦虑或抑郁程度较低。研究住院医师在无效聚类中所占比例过高（46%），该聚类的自我报告倦怠率高（77%），其特点是个人成就感得分最低。过度扩展和参与的住院医师的自我报告倦怠率分别为 73%和 48%。
在 COVID-19 大流行期间，外科住院医师有很高的自我报告倦怠和抑郁率。倦怠的聚类可能为个性化干预提供目标。
