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COVID-19 大流行期间医生的疲惫和工作投入:资源和支持干预作用的纵向调查。

Physician exhaustion and work engagement during the COVID-19 pandemic: A longitudinal survey into the role of resources and support interventions.

机构信息

Department of Work and Organizational Psychology, University of Amsterdam, Amsterdam, The Netherlands.

Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.

出版信息

PLoS One. 2023 Feb 1;18(2):e0277489. doi: 10.1371/journal.pone.0277489. eCollection 2023.

Abstract

BACKGROUND

Physicians increasingly show symptoms of burnout due to the high job demands they face, posing a risk for the quality and safety of care. Job and personal resources as well as support interventions may function as protective factors when demands are high, specifically in times of crisis such as the COVID-19 pandemic. Based on the Job Demands-Resources theory, this longitudinal study investigated how monthly fluctuations in job demands and job and personal resources relate to exhaustion and work engagement and how support interventions are associated with these outcomes over time.

METHODS

A longitudinal survey consisting of eight monthly measures in the period 2020-2021, completed by medical specialists and residents in the Netherlands. We used validated questionnaires to assess job demands (i.e., workload), job resources (e.g., job control), personal resources (e.g., psychological capital), emotional exhaustion, and work engagement. Additionally, we measured the use of specific support interventions (e.g., professional support). Multilevel modeling and longitudinal growth curve modeling were used to analyze the data.

RESULTS

378 medical specialists and residents were included in the analysis (response rate: 79.08%). Workload was associated with exhaustion (γ = .383, p < .001). All job resources, as well as the personal resources psychological capital and self-judgement were associated with work engagement (γs ranging from -.093 to .345, all ps < .05). Job control and psychological capital attenuated the workload-exhaustion relationship while positive feedback and peer support strengthened it (all ps < .05). The use of professional support interventions (from a mental health expert or coach) was related to higher work engagement (estimate = .168, p = .032) over time. Participation in organized supportive group meetings was associated with higher exhaustion over time (estimate = .274, p = .006).

CONCLUSIONS

Job and personal resources can safeguard work engagement and mitigate the risk of emotional exhaustion. Professional support programs are associated with higher work engagement over time, whereas organized group support meetings are associated with higher exhaustion. Our results stress the importance of professional individual-level interventions to counteract a loss of work engagement in times of crisis.

摘要

背景

由于面临高工作要求,医生越来越多地出现倦怠症状,这对护理质量和安全构成了风险。在高需求时,工作和个人资源以及支持干预措施可能起到保护作用,特别是在像 COVID-19 大流行这样的危机时期。基于工作要求-资源理论,本纵向研究调查了每月工作要求的波动以及工作和个人资源与倦怠和工作投入的关系,以及随着时间的推移,支持干预措施如何与这些结果相关。

方法

这是一项纵向研究,包括 2020 年至 2021 年期间的 8 个月度测量,由荷兰的医学专家和住院医师完成。我们使用经过验证的问卷来评估工作要求(即工作量)、工作资源(例如工作控制)、个人资源(例如心理资本)、情绪衰竭和工作投入。此外,我们还测量了特定支持干预措施(例如专业支持)的使用情况。使用多水平模型和纵向增长曲线模型来分析数据。

结果

共纳入 378 名医学专家和住院医师进行分析(应答率:79.08%)。工作量与倦怠有关(γ=.383,p<0.001)。所有工作资源以及个人资源心理资本和自我判断都与工作投入有关(γ 值范围从-.093 到.345,所有 p<0.05)。工作控制和心理资本减弱了工作量-倦怠的关系,而积极反馈和同伴支持则加强了这种关系(所有 p<0.05)。专业支持干预措施(来自心理健康专家或教练)的使用与随着时间的推移工作投入的增加有关(估计值=.168,p=.032)。参加有组织的支持性小组会议与随着时间的推移倦怠感的增加有关(估计值=.274,p=.006)。

结论

工作和个人资源可以保护工作投入,降低情绪衰竭的风险。专业支持计划与随着时间的推移工作投入的增加有关,而有组织的小组支持会议与随着时间的推移倦怠感的增加有关。我们的研究结果强调了在危机时期进行专业的个人干预以防止工作投入下降的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31d3/9891506/2c3315e5e6e2/pone.0277489.g001.jpg

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