Goldhaber Nicole H, Chea Annie, Hekler Eric B, Zhou Wenjia, Fergerson Byron
Department of Surgery, School of Medicine, University of California, San Diego Health, La Jolla, CA, United States.
Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, United States.
JMIR Form Res. 2023 Jun 2;7:e45102. doi: 10.2196/45102.
Physician burnout is a multibillion-dollar issue in the United States. Despite its prevalence, burnout is difficult to accurately measure. Institutions generally rely on periodic surveys that are subject to recall bias. SMS text message-based surveys or assessments have been used in health care and have the advantage of easy accessibility and high response rates.
In this pilot project, we evaluated the utility of and participant engagement with a simple, longitudinal, and SMS text message-based mental health assessment system for physician-trainees at the study institution. The goal of the SMS text message-based assessment system was to track stress, burnout, empathy, engagement, and work satisfaction levels faced by users in their normal working conditions.
Three SMS text message-based questions per week for 5 weeks were sent to each participant. All data received were deidentified. Additionally, each participant had a deidentified personal web page to follow their scores as well as the aggregated scores of all participants over time. A 13-question optional survey was sent at the conclusion of the study to evaluate the usability of the platform. Descriptive statistics were performed.
In all, 81 participants were recruited and answered at least six (mean 14; median 14; range 6-16) questions for a total of 1113 responses. Overall, 10 (17%) out of 59 participants responded "Yes" to having experienced a traumatic experience during the study period. Only 3 participants ever answered being "Not at all satisfied" with their job. The highest number of responses indicating that participants were stressed or burnt out came on day 25 in the 34-day study period. There were mixed levels of concern for the privacy of responses. No substantial correlations were noted between responses and having experienced a traumatic experience during the study period. Furthermore, 12 participants responded to the optional feedback survey, and all either agreed or strongly agreed that the SMS text message-based assessment system was easy to use and the number of texts received was reasonable. None of the 12 respondents indicated that using the SMS text message-based assessment system caused stress.
Responses demonstrated that SMS text message-based mental health assessments are potentially useful for recording physician-trainee mental health levels in real time with minimal burden, but further study of SMS text message-based mental health assessments should address limitations such as improving response rates and clarifying participants' sense of privacy when using the SMS text message-based assessment system. The findings of this pilot study can inform the development of institution-wide tools for assessing physician burnout and protecting physicians from occupational stress.
在美国，医生职业倦怠是一个涉及数十亿美元的问题。尽管其普遍存在，但职业倦怠却难以准确衡量。各机构通常依赖定期调查，而这种调查容易受到回忆偏差的影响。基于短信的调查或评估已在医疗保健领域得到应用，具有易于获取和高回复率的优势。
在这个试点项目中，我们评估了一种简单、纵向且基于短信的心理健康评估系统对研究机构中医生实习生的效用以及参与者的参与度。基于短信的评估系统的目标是跟踪用户在正常工作条件下面临的压力、职业倦怠、同理心、工作投入度和工作满意度水平。
在5周时间里，每周向每位参与者发送3个基于短信的问题。所有收到的数据都进行了去识别化处理。此外，每位参与者都有一个去识别化的个人网页，以跟踪他们自己的分数以及所有参与者随时间的综合分数。在研究结束时发送了一份包含13个问题的可选调查问卷，以评估该平台的可用性。进行了描述性统计。
总共招募了81名参与者，他们至少回答了6个（平均14个；中位数14个；范围6 - 16个）问题，共收到1113份回复。总体而言，59名参与者中有10名（17%）回答在研究期间经历过创伤性事件。只有3名参与者曾回答对自己的工作“一点也不满意”。在为期34天的研究期间，第25天表明参与者感到压力或职业倦怠的回复数量最多。对于回复隐私的担忧程度不一。在回复与研究期间是否经历过创伤性事件之间未发现显著相关性。此外，12名参与者回复了可选的反馈调查，所有人都同意或强烈同意基于短信的评估系统易于使用且收到的短信数量合理。12名受访者中没有一人表示使用基于短信的评估系统会造成压力。
回复表明，基于短信的心理健康评估对于以最小负担实时记录医生实习生的心理健康水平可能有用，但对基于短信的心理健康评估的进一步研究应解决一些局限性，如提高回复率以及在使用基于短信的评估系统时澄清参与者的隐私意识。这项试点研究的结果可为开发全机构范围的评估医生职业倦怠和保护医生免受职业压力的工具提供参考。
