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分娩与接生临床医生对创伤性临床经历的影响及对系统性支持的需求的看法。

Labor and Delivery Clinician Perspectives on Impact of Traumatic Clinical Experiences and Need for Systemic Supports.

机构信息

Department of Psychiatry, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA.

Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA.

出版信息

Matern Child Health J. 2023 Sep;27(9):1651-1662. doi: 10.1007/s10995-023-03708-2. Epub 2023 Jun 6.

Abstract

OBJECTIVES

Few studies have elucidated the impact of work-related trauma on labor and delivery clinician or considered whether it may be a cause of burnout. This study aims to elicit labor and delivery clinician perspectives on the impact of exposure to traumatic births on their professional quality of life.

METHODS

Labor and delivery clinicians (physicians, midwives, nurse practitioners, and nurses; n = 165) were recruited to complete an online questionnaire on experiences with traumatic births. The questionnaire contained measures from the Maslach Burnout Inventory and the professional quality of life scale version 5. Some participants completed an optional free-text prompt to recommend ways to support clinicians after traumatic births (n = 115). Others opted into a semi-structured phone interview (n = 8). Qualitative data was analyzed using a modified grounded theory approach.

RESULTS

Self-reported adequate institutional support for clinicians after a traumatic birth was positively correlated with compassion satisfaction (r = 0.21, p < 0.01) and negatively correlated with secondary traumatic stress (r = - 0.27, p < 0.01), and burnout (r = - 0.26, p < 0.01). Qualitative themes included lack of system-wide and leadership support, lack of access to mental health resources, and suboptimal workplace culture as contributors toward secondary traumatic stress and burnout. Participants recommended proactive leadership, consistent debriefing protocols, trauma education, and improved access to counseling.

CONCLUSIONS FOR PRACTICE

Multi-level barriers prevented labor and delivery clinicians from accessing needed mental health support after exposure to traumatic births. Proactive investment in healthcare system supports for clinicians may improve clinician professional quality of life.

摘要

目的

很少有研究阐明工作相关创伤对分娩临床医生的影响,也很少有研究考虑其是否可能是导致倦怠的原因。本研究旨在了解分娩临床医生对接触创伤性分娩对其职业生活质量的影响的看法。

方法

招募分娩临床医生(医生、助产士、执业护士和护士;n=165)完成有关创伤性分娩经历的在线问卷。问卷包含来自马斯拉赫倦怠量表和职业生活质量量表第 5 版的测量指标。一些参与者完成了一个可选的自由文本提示,以推荐在创伤性分娩后支持临床医生的方法(n=115)。其他人选择进行半结构化电话访谈(n=8)。使用改进的扎根理论方法对定性数据进行分析。

结果

自我报告的机构在创伤性分娩后为临床医生提供足够的支持与同情满足感呈正相关(r=0.21,p<0.01),与继发性创伤应激呈负相关(r=-0.27,p<0.01),与倦怠呈负相关(r=-0.26,p<0.01)。定性主题包括缺乏系统范围和领导力支持、缺乏获得心理健康资源的机会以及工作场所文化不佳,这些都是导致继发性创伤应激和倦怠的因素。参与者建议采取积极主动的领导力、一致的汇报协议、创伤教育和改善咨询机会。

实践结论

多层次的障碍阻止了分娩临床医生在接触创伤性分娩后获得所需的心理健康支持。积极投资于医疗保健系统对临床医生的支持可能会提高临床医生的职业生活质量。

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