工作超负荷与倦怠以及在 COVID-19 期间离开医疗保健劳动力的意愿之间的关联。
The Association of Work Overload with Burnout and Intent to Leave the Job Across the Healthcare Workforce During COVID-19.
机构信息
Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
University of Wisconsin School of Nursing, Madison, USA.
出版信息
J Gen Intern Med. 2023 Jun;38(8):1920-1927. doi: 10.1007/s11606-023-08153-z. Epub 2023 Mar 23.
BACKGROUND
Burnout has risen across healthcare workers during the pandemic, contributing to workforce turnover. While prior literature has largely focused on physicians and nurses, there is a need to better characterize and identify actionable predictors of burnout and work intentions across healthcare role types.
OBJECTIVE
To characterize the association of work overload with rates of burnout and intent to leave (ITL) the job in a large national sample of healthcare workers.
DESIGN
Cross-sectional survey study conducted between April and December 2020.
SETTING
A total of 206 large healthcare organizations.
PARTICIPANTS
Physicians, nurses, other clinical staff, and non-clinical staff.
MEASURES
Work overload, burnout, and ITL.
RESULTS
The sample of 43,026 respondents (mean response rate 44%) was comprised of 35.2% physicians, 25.7% nurses, 13.3% other clinical staff, and 25.8% non-clinical staff. The overall burnout rate was 49.9% (56.0% in nursing, 54.1% in other clinical staff, 47.3% in physicians, and 45.6% in non-clinical staff; p < 0.001 for difference). ITL was reported by 28.7% of healthcare workers, with nurses most likely to report ITL (41.0%), followed by non-clinical staff (32.6%), other clinical staff (32.1%), and physicians (24.3%) (p < 0.001 for difference). The prevalence of perceived work overload ranged from 37.1% among physicians to 47.4% in other clinical staff. In propensity-weighted models, work overload was significantly associated with burnout (adjusted risk ratio (ARR) 2.21 to 2.90) and intent to leave (ARR 1.73 to 2.10) across role types.
LIMITATIONS
Organizations' participation in the survey was voluntary.
CONCLUSIONS
There are high rates of burnout and intent to leave the job across healthcare roles. Proactively addressing work overload across multiple role types may help with concerning trends across the healthcare workforce. This will require a more granular understanding of sources of work overload across different role types, and a commitment to matching work demands to capacity for all healthcare workers.
背景
在疫情期间，医护人员的 burnout 现象普遍增加，导致员工流失率上升。尽管先前的文献主要集中在医生和护士身上，但我们需要更好地描述和确定 across healthcare role types 的 burnout 和离职意向的可操作预测因素。
目的
在大型医疗保健工作者样本中，描述工作负荷与 burnout 发生率和离职意向（ITL）之间的关联。
设计
2020 年 4 月至 12 月进行的横断面调查研究。
设置
共 206 家大型医疗保健机构。
参与者
医生、护士、其他临床人员和非临床人员。
措施
工作负荷、burnout 和 ITL。
结果
样本包括 43026 名受访者（平均响应率为 44%），其中 35.2%为医生，25.7%为护士，13.3%为其他临床人员，25.8%为非临床人员。总体 burnout 率为 49.9%（护理 56.0%，其他临床人员 54.1%，医生 54.1%，非临床人员 47.3%；不同组别间差异有统计学意义，p<0.001）。28.7%的医护人员报告了离职意向，护士最有可能报告离职意向（41.0%），其次是非临床人员（32.6%）、其他临床人员（32.1%）和医生（24.3%）（不同组别间差异有统计学意义，p<0.001）。感知到的工作负荷过重的患病率范围为医生的 37.1%至其他临床人员的 47.4%。在倾向评分加权模型中，工作负荷过重与 burnout（调整风险比（ARR）为 2.21 至 2.90）和离职意向（ARR 为 1.73 至 2.10） across role types 显著相关。
局限性
组织参与调查是自愿的。
结论
across healthcare roles 存在较高的 burnout 率和离职意向。 across role types 积极应对工作负荷过重问题可能有助于缓解 across the healthcare workforce 的不良趋势。这将需要更深入地了解不同角色类型的工作负荷来源，并承诺为所有 healthcare workers 匹配工作需求和能力。
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