Tawfik Daniel S, Rovnaghi Cynthia, Profit Jochen, Cornell Timothy T, Anand Kanwaljeet J S
Stanford University School of Medicine, Stanford, CA, USA.
Compr Psychoneuroendocrinol. 2023 May;14:100174. doi: 10.1016/j.cpnec.2023.100174. Epub 2023 Feb 1.
Measuring burnout relies on infrequent and subjective surveys, which often do not reflect the underlying factors or biological mechanisms that promote or prevent it. Burnout correlates with cortisol levels and dysregulation of the hypothalamic-pituitary-adrenal axis, but the chronology and strength of this relationship are unknown.
To determine the prevalence and feasibility of studying burnout in pediatric residents using hair cortisol and hair oxytocin concentrations.
/Methods: Longitudinal observational cohort study of pediatric residents. We assessed burnout using the Stanford Professional Fulfillment Index and hair cortisol (HCC), and hair oxytocin concentrations (HOC) at four 3-month intervals from January 2020-January 2021. We evaluated test-retest reliability, sensitivity to change using Pearson product-moment correlations, and relationships between burnout and hair biomarkers using hierarchical mixed-effects linear regression.
17 Pediatrics residents provided 78 wellness surveys and 54 hair samples. Burnout symptoms were present in 39 (50%) of the surveys, with 14 (82%) residents reporting burnout in at least one time point. The lowest (41%) and highest (60%) burnout prevalence occurred in 04/2020 and 01/2021, respectively. No significant associations between burnout scores and HCC (β -0.01, 95%CI: 0.14-0.13), HOC (β 0.06, 95%CI: 0.06-0.19), or the HCC:HOC ratio (β -0.04, 95%CI: 0.09-0.02) were noted in separate analyses. Intra-individual changes in hair cortisol concentration were not associated with changes in burnout score.
Burnout was prevalent among Pediatrics residents, with highest prevalence noted in January 2021. This pilot longitudinal study demonstrates the feasibility of evaluating burnout with stress and resilience biomarkers in Pediatrics residents.
职业倦怠的测量依赖于不频繁且主观的调查，这些调查往往无法反映促进或预防职业倦怠的潜在因素或生物学机制。职业倦怠与皮质醇水平及下丘脑 - 垂体 - 肾上腺轴功能失调相关，但这种关系的时间顺序和强度尚不清楚。
通过检测儿科住院医师头发中的皮质醇和催产素浓度，确定研究职业倦怠的患病率及可行性。
/方法：对儿科住院医师进行纵向观察队列研究。我们在2020年1月至2021年1月期间，每隔3个月评估一次儿科住院医师的职业倦怠情况，使用斯坦福职业成就感指数、头发皮质醇（HCC）和头发催产素浓度（HOC）。我们评估了重测信度、使用Pearson积差相关分析对变化的敏感性，以及使用分层混合效应线性回归分析职业倦怠与头发生物标志物之间的关系。
17名儿科住院医师提供了78份健康状况调查问卷和54份头发样本。在39份（50%）调查问卷中出现了职业倦怠症状，14名（82%）住院医师在至少一个时间点报告有职业倦怠。职业倦怠患病率最低（41%）和最高（60%）分别出现在2020年4月和2021年1月。在单独分析中，未发现职业倦怠评分与HCC（β -0.01，95%CI：0.14 - 0.13）、HOC（β 0.06，95%CI：0.06 - 0.19）或HCC:HOC比值（β -0.04，95%CI：0.09 - 0.02）之间存在显著关联。头发皮质醇浓度的个体内变化与职业倦怠评分的变化无关。
职业倦怠在儿科住院医师中普遍存在，2021年1月患病率最高。这项初步纵向研究证明了在儿科住院医师中使用压力和恢复力生物标志物评估职业倦怠的可行性。
