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新型冠状病毒肺炎疫情期间对 burnout 的认知及其对学术型医院医师的影响,以及机构对抗 burnout 和改善健康的策略。

Perception of Burnout and Its Impact on Academic Hospitalists During COVID-19 and Institutional Strategies to Combat Burnout and Improve Wellness.

机构信息

Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin,

Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.

出版信息

WMJ. 2023 Dec;122(5):394-398.

Abstract

INTRODUCTION

Physician burnout has been alarmingly high, particularly among general internal medicine, which displays some of the highest rates. A recent study of academic hospitalists reported a higher level of burnout (62%) than the rates found in similar studies, but with agreement about factors leading to burnout, consequences of burnout, and importance of steps to prevent burnout. This study seeks to expand upon these results by investigating the impact of COVID-19 on burnout among hospitalists and uncovering the perspectives of frontline clinicians to formulate effective mitigation strategies.

METHODS

Academic hospitalists were recruited to participate in a series of focus group interviews. The questions focused on contributors to burnout, the impact of COVID-19, and strategies to improve wellness and reduce burnout. The focus groups were audio-recorded, transcribed, and coded for emergent themes using Taguette, an open-source qualitative data analysis software.

RESULTS

Burnout-inducing themes included workload, bureaucratic hurdles, and lack of control. COVID-19-specific themes included fear of exposing family and social isolation. The most common mitigation strategy was to increase social interactions to foster a sense of community. Additional solutions included adhering to a census cap of patients, streamlining clinical work, and providing avenues for two-way communication between leadership and clinicians to share concerns and elicit feedback.

CONCLUSIONS

Streamlining clinical work allows more time for patient care. Enhancing community and fostering collaboration in decision-making allows clinicians to feel more empowered. A crucial first step to combat burnout is to encourage a work environment that values clinician well-being and proactively works to increase job satisfaction.

摘要

简介

医生倦怠现象令人震惊,尤其是在内科领域,其倦怠率更高。最近一项针对学术医院医生的研究报告称,倦怠率(62%)高于类似研究中的发现,但对于导致倦怠的因素、倦怠的后果以及预防倦怠的重要性,研究人员的看法一致。本研究通过调查 COVID-19 对医院医生倦怠的影响,并揭示一线临床医生的观点,以制定有效的缓解策略,进一步探讨了这一结果。

方法

招募学术医院医生参加一系列焦点小组访谈。问题集中在导致倦怠的因素、COVID-19 的影响以及改善健康和减少倦怠的策略。使用 Taguette(一种开源定性数据分析软件)对焦点小组进行录音、转录和编码,以提取主题。

结果

导致倦怠的主题包括工作量、官僚障碍和缺乏控制。COVID-19 特有的主题包括担心暴露给家人和社交孤立。最常见的缓解策略是增加社交互动,以培养社区意识。其他解决方案包括坚持患者人数上限、简化临床工作,以及提供领导和临床医生之间双向沟通的途径,以分享关注并征求反馈。

结论

简化临床工作可以为患者护理留出更多时间。增强社区和在决策中培养协作精神,可以使临床医生感到更有权力。应对倦怠的关键第一步是鼓励重视临床医生健康并积极提高工作满意度的工作环境。

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