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住院医师职业倦怠的两年纵向横断面评估:应激、满意度、运动及电子病历系统影响的探索

A Two-Year Longitudinal, Cross-Sectional Evaluation of Resident Physician Burnout: An Exploration of the Effects of Stress, Satisfaction, Exercise and EMR.

作者信息

Dziadkowiec Oliwier, Durbin Jeffery S, Novak Megan L, Patt-Rappaport Ziva, Guldner Gregory

机构信息

HCA Healthcare Graduate Medical Education, MidAmerica Division.

HCA Healthcare Graduate Medical Education, Continental Division.

出版信息

HCA Healthc J Med. 2021 Apr 28;2(2):123-132. doi: 10.36518/2689-0216.1254. eCollection 2021.

Abstract

BACKGROUND

There is a need for better understanding of trajectory of burnout in clinical training and what factors are associated with resident well-being and burnout overtime. This study examined medical resident burnout and physical activity throughout different times of the academic year, across several different medical specialties and postgraduate years (PGY), over two years.

METHODS

A resident wellness survey was administered throughout five different waves from summer 2018 to winter 2020. A total of 493 survey responses from seven subspecialties completed the survey. We used 474 responses for quantitative statistical analysis and 138 for qualitative thematic analysis.

RESULTS

The average response rate was 47%, and ranged between 40% (Wave 3) and 56% (Wave 1). Three analyses were conducted: the first demonstrated significantly higher Satisfaction in Wave 1 as opposed to Wave 2. The second analysis showed significant correlations between Overall, Satisfaction, and Stress scores and exercise-based questions for female, male, and primary care cohorts of residents. The third analysis showed that in 2018, interns and non-interns differed on Stress but did not differ on Satisfaction or Overall scores.

CONCLUSIONS

Similar levels of satisfaction, stress, and overall well-being were reported at different times in the academic year and from year to year. Exercise was not consistently related to resident well-being outcomes. These findings suggest a need for targeted interventions based on post-graduate year, time in the academic year and well-being drivers.

摘要

背景

有必要更好地了解临床培训中职业倦怠的轨迹,以及哪些因素与住院医师的幸福感和长期职业倦怠相关。本研究在两年时间内,考察了不同学年时间段、多个不同医学专业和研究生年级(PGY)的住院医师职业倦怠和身体活动情况。

方法

在2018年夏季至2020年冬季的五个不同阶段进行了住院医师健康状况调查。来自七个亚专业的493份调查问卷完成了调查。我们使用474份回复进行定量统计分析,138份进行定性主题分析。

结果

平均回复率为47%,范围在40%(第3阶段)至56%(第1阶段)之间。进行了三项分析:第一项分析表明,与第2阶段相比,第1阶段的满意度显著更高。第二项分析显示,总体、满意度和压力得分与住院医师女性、男性和初级保健队列中基于运动的问题之间存在显著相关性。第三项分析表明,在2018年,实习生和非实习生在压力方面存在差异,但在满意度或总体得分方面没有差异。

结论

在学年的不同时间以及不同年份,报告的满意度、压力和总体幸福感水平相似。运动与住院医师的幸福感结果并非始终相关。这些发现表明需要根据研究生年级、学年时间和幸福感驱动因素进行有针对性的干预。

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