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美国医护人员 burnout 预测因素:系统综述。

Predictors of burnout among US healthcare providers: a systematic review.

机构信息

RAND Corporation, Santa Monica, California, USA

RAND Corporation, Santa Monica, California, USA.

出版信息

BMJ Open. 2022 Aug 25;12(8):e054243. doi: 10.1136/bmjopen-2021-054243.

Abstract

OBJECTIVE

One potential barrier to optimal healthcare may be provider burnout or occupational-related stress in the workplace. The objective of this study is to conduct a systematic review to identify the predictors of burnout among US. healthcare providers.

DESIGN

Systematic review using in-depth critical appraisal to assess risk of bias and present the quality of evidence in synthesised results from the prognostic studies.

DATA SOURCES

We searched 11 databases, registries, existing reviews and contacted experts through 4 October 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

We included all studies evaluating potential predictors and documenting the presence and absence of associations with burnout assessed as a multidimensional construct. We excluded studies that relied solely on a single continuous subscale of burnout. Data were abstracted from eligible studies and checked for accuracy by a content expert and a methodologist.

DATA EXTRACTION AND SYNTHESIS

Two reviewers independently screened citations and full-text publications using predetermined eligibility criteria.

RESULTS

The 141 identified studies evaluated a range of burnout predictors. Findings for demographic characteristics were conflicting or show no association. Workplace factors, such as workload, work/life balance, job autonomy and perceived support from leadership, had stronger associations with risk for burnout. Mental health factors, such as anxiety, and physical health risks may increase the risk, although the direction of these associations is unclear as few prospective studies exist to address this question. Factors such as social support appear to have a protective effect.

CONCLUSION

We found the most evidence for workplace, mental health and psychosocial factors in predicting burnout but limited evidence for other potential predictors. However, more prospective studies are needed to improve our understanding about how to prevent provider burnout.

PROSPERO REGISTRATION NUMBER

CRD4202014836.

摘要

目的

医疗保健的一个潜在障碍可能是提供者在工作场所的倦怠或与职业相关的压力。本研究的目的是进行系统评价,以确定美国医疗保健提供者倦怠的预测因素。

设计

使用深入的批判性评估进行系统评价,以评估偏倚风险,并从预后研究的综合结果中呈现证据质量。

数据来源

我们于 2021 年 10 月 4 日之前在 11 个数据库、注册处、现有综述中进行了检索,并通过联系专家进行了检索。

选择研究的资格标准

我们纳入了所有评估潜在预测因素并记录与倦怠相关的存在和不存在的研究,倦怠被评估为多维结构。我们排除了仅依赖倦怠单一连续子量表的研究。从合格研究中提取数据,并由内容专家和方法学家检查准确性。

数据提取和综合

两名审查员使用预定的合格标准独立筛选引用和全文出版物。

结果

确定的 141 项研究评估了一系列倦怠预测因素。关于人口统计学特征的研究结果存在冲突或没有关联。工作场所因素,如工作量、工作/生活平衡、工作自主性和领导支持感知,与倦怠风险的关联更强。心理健康因素,如焦虑和身体健康风险可能会增加风险,尽管由于几乎没有前瞻性研究来解决这个问题,这些关联的方向尚不清楚。社会支持等因素似乎具有保护作用。

结论

我们发现,在预测倦怠方面,工作场所、心理健康和心理社会因素的证据最多,但其他潜在预测因素的证据有限。然而,需要更多的前瞻性研究来提高我们对如何预防提供者倦怠的理解。

前瞻性注册编号

CRD4202014836。

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