Clarke-Walper Kristina, Penix Elizabeth A, Trachtenberg Felicia, Simon Erica, Coleman Julia, Magnavita Ashley, Ortigo Kile, Regala Samantha, Marceau Lisa, Ruzek Josef I, Rosen Raymond C, Wilk Joshua E
Center for Military Psychiatry and Neurosciences Department of Military Psychiatry Walter Reed Army Institute of Research Silver Spring Maryland.
New England Research Institutes Watertown Massachusetts.
Psychiatr Res Clin Pract. 2020 Sep 9;2(1):3-9. doi: 10.1176/appi.prcp.20190004. eCollection 2020 Summer.
Burnout is widespread among behavioral health clinicians treating posttraumatic stress disorder (PTSD) among military populations. Intervention-based strategies have shown some benefit in addressing clinician burnout. One Web-based tool, the PTSD Clinicians Exchange, was designed to disseminate clinical best practices for the treatment of PTSD and facilitate self-care to mitigate burnout. This study sought to determine whether this tool could reduce burnout among clinicians treating military populations.
A total of 605 behavioral health clinicians from the U.S. Department of Veterans Affairs, the Department of Defense, and the community were enrolled in a randomized controlled trial to test the effectiveness of the PTSD Clinicians Exchange. Clinicians were assessed on demographic characteristics, practice patterns, and organizational support with an online survey at baseline and at 6 and 12 months. Burnout, secondary traumatic stress (STS), and compassion satisfaction were measured with the Professional Quality of Life Scale.
At baseline, no differences were observed in mean±SD burnout scores for the intervention (19.9±5.1) and control groups (20.2±5.4). Participation in the Exchange had no effect on burnout score at 12 months; burnout scores remained stable across the study period. In a multivariable stepwise regression model, older age, lower burnout at baseline, and lower STS scores and higher compassion satisfaction scores at 12 months were significantly associated with lower burnout scores.
The PTSD Clinicians Exchange did not mitigate burnout among clinicians, possibly because of the content provided, the dissemination mechanism, or participants' limited use of the Web site. These results can be used to inform and enhance future interventions.
职业倦怠在治疗军人创伤后应激障碍（PTSD）的行为健康临床医生中普遍存在。基于干预的策略在解决临床医生职业倦怠方面已显示出一定益处。一种基于网络的工具“PTSD临床医生交流平台”旨在传播PTSD治疗的临床最佳实践，并促进自我护理以减轻职业倦怠。本研究旨在确定该工具是否能降低治疗军人的临床医生的职业倦怠。
来自美国退伍军人事务部、国防部和社区的605名行为健康临床医生参与了一项随机对照试验，以测试PTSD临床医生交流平台的有效性。在基线、6个月和12个月时，通过在线调查对临床医生的人口统计学特征、执业模式和组织支持进行评估。使用职业生活质量量表测量职业倦怠、继发性创伤应激（STS）和同情满意度。
在基线时，干预组（19.9±5.1）和对照组（20.2±5.4）的平均±标准差职业倦怠得分未观察到差异。参与交流平台对12个月时的职业倦怠得分没有影响；在整个研究期间，职业倦怠得分保持稳定。在多变量逐步回归模型中，年龄较大、基线时职业倦怠较低、12个月时STS得分较低以及同情满意度得分较高与较低的职业倦怠得分显著相关。
PTSD临床医生交流平台并未减轻临床医生的职业倦怠，可能是由于所提供的内容、传播机制或参与者对该网站的使用有限。这些结果可用于为未来的干预措施提供信息并加以改进。
