Morita Takako, Muroya Saki, Takahashi Osamu, Ohde Sachiko
Graduate School of Public Health and Clinical Epidemiology St. Luke's International University, Tokyo, Japan.
JMA J. 2023 Jul 14;6(3):292-299. doi: 10.31662/jmaj.2023-0004. Epub 2023 Jul 4.
The coronavirus disease 2019 (COVID-19) pandemic has significantly affected healthcare workers' mental health worldwide, leading to the intention to resign. Japanese medical residents were no exception to the impact of COVID-19. This study aimed to illustrate how the COVID-19 pandemic affected medical residents' intention to resign.
A cross-sectional study was conducted for Postgraduate Year (PGY)1-5 medical residents in Japan using an internet survey from March 11 to March 18, 2021. During this survey, the Japanese government declared a second-time state of emergency on January 7, 2021, and all restrictions were expanded nationwide until March 21, 2021. Medical residents were categorized into two groups (intention to resign group [IR] or no intention to resign group [NIR]) based on their intention to resign. Multivariate logistic regression analysis was conducted to elucidate the risk factors for the intention to resign.
354 medical residents were enrolled in this study (response rate: 40.2%). Ninety-two medical residents (26.0 %) were categorized into IR and 262 (74.0%) into NIR. According to multivariate logistic regression analysis, those who did not have mental support at their hospital had 2.95 times greater chance of intending to resign (Adjusted odds ratio [AOR] = 2.95, 95% confidence interval (CI) [1.42-6.15]). Medical residents who engaged in patients with COVID-19 (AOR = 2.13, 95% Cl [1.08-4.18]) and PGY5 (AOR = 3.38, 95% Cl [1.51-7.56]) had a higher likelihood of intending to resign among residents in all PGY.
One in four medical residents intended to resign during the COVID-19 pandemic. Particularly, PGY5 and medical residents who treated patients with COVID-19 were found at risk of having the intention to resign. At times of crisis, such as the COVID-19 epidemic, establishing a mental health support system that targets high-risk residents is critical.
2019年冠状病毒病（COVID-19）大流行对全球医护人员的心理健康产生了重大影响，导致他们产生辞职意向。日本的住院医师也未能免受COVID-19的影响。本研究旨在阐明COVID-19大流行如何影响住院医师的辞职意向。
于2021年3月11日至3月18日对日本1至5年级的住院医师进行了一项横断面研究，采用网络调查。在这项调查期间，日本政府于2021年1月7日宣布第二次紧急状态，所有限制措施在全国范围内扩大至2021年3月21日。根据住院医师的辞职意向，将他们分为两组（辞职意向组[IR]或无辞职意向组[NIR]）。进行多因素逻辑回归分析以阐明辞职意向的危险因素。
354名住院医师参与了本研究（回复率：40.2%）。92名住院医师（26.0%）被归类为IR组，262名（74.0%）被归类为NIR组。根据多因素逻辑回归分析，在医院没有获得心理支持的住院医师辞职意向的可能性高出2.95倍（调整优势比[AOR]=2.95，95%置信区间[CI][1.42 - 6.15]）。接触COVID-19患者的住院医师（AOR = 2.13，95%CI[1.08 - 4.18]）和5年级住院医师（AOR = 3.38，95%CI[1.51 - 7.56]）在所有年级的住院医师中辞职意向的可能性更高。
在COVID-19大流行期间，四分之一的住院医师打算辞职。特别是，发现5年级住院医师和治疗COVID-19患者的住院医师有辞职意向的风险。在COVID-19疫情等危机时期，建立针对高风险住院医师的心理健康支持系统至关重要。
