COVID-19 大流行期间医院医护人员 burnout 相关因素：一项横断面 CRACoV-HHS 研究。

Factors associated with burnout among hospital-based healthcare workers during the COVID-19 pandemic: A cross-sectional CRACoV-HHS study.

机构信息

Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland.

The University Hospital in Cracow, Kraków, Poland.

出版信息

J Clin Nurs. 2024 Jan;33(1):304-321. doi: 10.1111/jocn.16654. Epub 2023 Feb 15.

DOI:10.1111/jocn.16654

PMID:36792068

Abstract

AIMS

To assess the prevalence of burnout and associated factors among healthcare workers (HCWs) working in a hospital admitting patients with COVID-19.

BACKGROUND

Burnout among HCWs is related to age, gender and occupation. However, little is known about organisational factors associated with burnout during the COVID-19 pandemic.

DESIGN

A cross-sectional study of 1412 hospital HCWs (748 nurses) was carried out via online survey during the COVID-19 pandemic between 4 and 19 January 2021.

METHODS

The Maslach Burnout Inventory-Human Services Survey, the Checklist Individual Strength questionnaire, the interRAI items covering mental health, the WHO questionnaire items assessing HCWs' preparedness and exposure to SARS-CoV-2 were used. Univariable and multivariable linear regression analyses were conducted to clarify factors associated with emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). This study adheres to the STROBE guidelines.

RESULTS

Burnout prevalence varied from 10.0% to 22.0%. Most respondents (83.6%) reported low PA, 22.9% high EE and 18.7% high DP. Nurses and physicians had the highest levels of EE and DP. Staff exposed or uncertain if exposed to contaminated patients' body fluids and materials had higher levels of burnout. Preparedness (training) (b = 1.15; 95%CI 0.26 to 2.05) and adherence to infection prevention and control procedures (b = 1.57; 95%CI 0.67 to 2.47) were associated with higher PA, and accessibility of personal protective equipment (PPE) (b = -1.37; 95%CI -2.17 to -0.47) was related to lower EE. HCWs working in wards for patients with COVID-19 reported lower EE (b = -1.39; 95%CI -2.45 to -0.32). HCWs who contracted COVID-19 reported lower DP (b = -0.71, 95%CI -1.30 to -0.12).

CONCLUSIONS

Organisational factors such as better access to PPE, training, and adherence to infection prevention and control procedures were associated with a lower level of burnout.

RELEVANCE TO CLINICAL PRACTICE

Healthcare managers should promote strategies to reduce burnout among HCWs with regard to preparedness of all staff.

摘要

目的

评估在收治 COVID-19 患者的医院工作的医护人员（HCWs）中 burnout 的发生率及其相关因素。

背景

HCWs 的 burnout 与年龄、性别和职业有关。然而，在 COVID-19 大流行期间，与 burnout 相关的组织因素知之甚少。

设计

这是一项横断面研究，于 2021 年 1 月 4 日至 19 日 COVID-19 大流行期间通过在线调查对 1412 名医院 HCWs（748 名护士）进行了调查。

方法

使用 Maslach Burnout Inventory-Human Services Survey、Checklist Individual Strength 问卷、涵盖心理健康的 interRAI 项目、评估 HCWs 准备情况和接触 SARS-CoV-2 的 WHO 问卷项目。进行单变量和多变量线性回归分析以阐明与情绪疲惫（EE）、去人性化（DP）和个人成就感（PA）相关的因素。本研究遵循 STROBE 指南。

结果

burnout 发生率为 10.0%至 22.0%。大多数受访者（83.6%）报告 PA 较低，22.9%报告 EE 较高，18.7%报告 DP 较高。护士和医生的 EE 和 DP 水平最高。接触或不确定是否接触受污染患者体液和材料的员工 burnout 水平更高。准备情况（培训）（b=1.15；95%CI 0.26 至 2.05）和遵守感染预防和控制程序（b=1.57；95%CI 0.67 至 2.47）与较高的 PA 相关，而个人防护设备（PPE）的可及性（b=-1.37；95%CI -2.17 至 -0.47）与较低的 EE 相关。在收治 COVID-19 患者的病房工作的 HCWs 报告的 EE 较低（b=-1.39；95%CI -2.45 至 -0.32）。感染 COVID-19 的 HCWs 报告 DP 较低（b=-0.71；95%CI -1.30 至 -0.12）。