burnout、wellbeing 及其相关性:全科住院医师中的定性研究。

Burnout, wellbeing and how they relate: A qualitative study in general practice trainees.

机构信息

School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.

GPEx Ltd., Adelaide, South Australia, Australia.

出版信息

Med Educ. 2023 Mar;57(3):243-255. doi: 10.1111/medu.14931. Epub 2022 Aug 31.

Abstract

PURPOSE

Although research has explored burnout risk factors among medical trainees, there has been little exploration of the personal experiences and perceptions of this phenomenon. Similarly, there has been little theoretical consideration of trainee wellbeing and how this relates to burnout. Our study aimed to conceptualise both constructs.

METHOD

We situated this study within a post-positivist epistemology using grounded theory to guide the research process. Participants were recruited from one Australian General Practice training organisation. Fourteen trainees completed interviews, while a further five focus groups explored the views of 33 supervisors, educators and training coordinators. Data collection and analysis occurred concurrently, drawing upon constant comparison and triangulation. Template analysis, using an iterative process of coding, was employed to generate conceptual models of the phenomena of interest.

RESULTS

Participants described burnout as an insidious syndrome lying on a spectrum, with descriptions coalescing under seven themes: altered emotion, compromised performance, disengagement, dissatisfaction, exhaustion, overexertion and feeling overwhelmed. Wellbeing was perceived to comprise personal and professional domains that interacted and were fuelled by an underlying 'reservoir'. Both constructs were linked by the degree of a trainee's value fulfilment, with burnout occurring when a trainee's wellbeing reservoir was depleted.

CONCLUSIONS

Participants in this study characterised burnout and wellbeing as multifaceted, connected constructs. Given the complexity of these constructs, preventive interventions should target both person and workplace-focused factors, with value fulfilment proposed as the basic change mechanism. A novel model that synthesises and advances previous research is offered based on these findings.

摘要

目的

尽管已有研究探讨了医学受训者的 burnout 风险因素,但对这一现象的个人经历和看法的探索却很少。同样,对于受训者的幸福感及其与 burnout 的关系,也很少有理论上的考虑。我们的研究旨在对这两个概念进行概念化。

方法

我们在一个后实证主义的认识论框架内进行这项研究,使用扎根理论来指导研究过程。参与者是从澳大利亚的一家普通实践培训组织中招募的。14 名受训者完成了访谈,而另外 5 个焦点小组则探讨了 33 名主管、教育者和培训协调员的观点。数据收集和分析同时进行,利用不断比较和三角测量。模板分析,采用迭代编码过程,用于生成感兴趣现象的概念模型。

结果

参与者将 burnout 描述为一种潜伏在光谱上的综合征,描述集中在七个主题下:情绪改变、表现受损、脱离、不满、疲惫、过度劳累和不知所措。幸福感被认为包括个人和职业领域,它们相互作用,并由一个潜在的“蓄水池”提供动力。这两个概念都与受训者的价值实现程度有关,当受训者的幸福感蓄水池枯竭时,就会发生 burnout。

结论

本研究的参与者将 burnout 和幸福感描述为多方面、相互关联的概念。鉴于这些概念的复杂性,预防干预措施应该针对人和工作场所的因素,价值实现被提议为基本的变化机制。根据这些发现,提出了一个综合和推进以前研究的新模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7663/10086955/45bf73c2e387/MEDU-57-243-g002.jpg

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