Stanford University, Stanford, California, United States.
Spaulding Rehabilitation Hospital, Boston, Massachusetts, United States.
PM R. 2023 May;15(5):541-551. doi: 10.1002/pmrj.12961.
Multiple national studies suggest that, among physicians, physiatrists are at increased risk for occupational burnout.
To identify characteristics of the work environment associated with professional fulfillment and burnout among U.S. physiatrists.
Between May and December 2021, a mixed qualitative and quantitative approach was used to identify factors contributing to professional fulfillment and burnout in physiatrists.
Online interviews, focus groups, and survey.
Physiatrists in the AAPM&R Membership Masterfile.
Burnout and professional fulfillment assessed using the Stanford Professional Fulfillment Index.
Individual interviews with 21 physiatrists were conducted to identify domains that contributed to professional fulfillment followed by focus groups for further definition. Based on themes identified, scales were identified or developed to evaluate: control over schedule (6 items; Cronbach's alpha = 0.86); integration of physiatry into patient care (3 items; Cronbach's alpha = 0.71); personal-organizational values alignment (3 items; Cronbach's alpha = 0.90); meaningfulness of physiatrist clinical work (6 items; Cronbach's alpha = 0.90); teamwork and collaboration (3 items; Cronbach's alpha = 0.89). Of 5760 physiatrists contacted in the subsequent national survey, 882 (15.4%) returned surveys (median age 52 years; 46.1% women). Overall, 42.6% (336 of 788) experienced burnout and 30.6% (244 of 798) had high levels of professional fulfillment. In multivariable analysis, each one-point improvement in control over schedule (odds ratio [OR] = 1.96; 95% confidence interval [CI] = 1.45-2.69), integration of physiatry into patient care (OR = 1.77; 95% CI = 1.32-2.38), personal-organizational values alignment (OR = 1.92; 95% CI = 1.48-2.52), meaningfulness of physiatrist clinical work (OR = 2.79; 95% CI = 1.71-4.71) and teamwork and collaboration score (OR = 2.11; 95% CI = 1.48-3.03) was independently associated with higher likelihood of professional fulfillment.
Control over schedule, optimal integration of physiatry into clinical care, personal-organizational values alignment, teamwork, and meaningfulness of physiatrist clinical work are strong and independent drivers of occupational well-being in U.S. physiatrists. Variation in these domains by practice setting and subspecialty suggests tailored approaches are needed to promote professional fulfillment and reduce burnout among U.S. physiatrists.
多项全国性研究表明，在医生中，理疗医师的职业倦怠风险增加。
确定与美国理疗医师职业满足感和倦怠相关的工作环境特征。
2021 年 5 月至 12 月期间，采用混合定性和定量方法，确定导致理疗医师职业满足感和倦怠的因素。
在线访谈、焦点小组和调查。
AAPM&R 会员主文件中的理疗医师。
使用斯坦福职业满足度指数评估倦怠和职业满足度。
对 21 名理疗医师进行了个人访谈，以确定有助于职业满足感的领域，然后进行焦点小组进一步定义。根据确定的主题，确定或开发了评估以下内容的量表：对日程的控制（6 项；克朗巴赫系数 α=0.86）；理疗融入患者护理（3 项；克朗巴赫系数 α=0.71）；个人-组织价值观一致性（3 项；克朗巴赫系数 α=0.90）；理疗临床工作的意义（6 项；克朗巴赫系数 α=0.90）；团队合作（3 项；克朗巴赫系数 α=0.89）。在随后的全国调查中，联系了 5760 名理疗医师，其中 882 名（15.4%）返回了调查（中位数年龄 52 岁；46.1%为女性）。总体而言，42.6%（788 人中的 336 人）经历了倦怠，30.6%（798 人中的 244 人）具有较高的职业满足感。多变量分析显示，对日程的控制每提高 1 分（优势比 [OR] = 1.96；95%置信区间 [CI] = 1.45-2.69），将理疗融入患者护理（OR = 1.77；95% CI = 1.32-2.38），个人-组织价值观一致性（OR = 1.92；95% CI = 1.48-2.52），理疗临床工作的意义（OR = 2.79；95% CI = 1.71-4.71）和团队合作评分（OR = 2.11；95% CI = 1.48-3.03）与更高的职业满足感独立相关。
对日程的控制、将理疗最佳融入临床护理、个人-组织价值观一致性、团队合作以及理疗临床工作的意义是美国理疗医师职业幸福感的有力且独立的驱动因素。实践环境和亚专业领域的这些差异表明，需要采取有针对性的方法来促进美国理疗医师的职业满足感并减少倦怠。
