From the Department of Surgery (L.H.), University of Chicago Medicine, Chicago, IL; Department of Surgery (L.C.T.), Northwestern University, Chicago, IL; Department of Surgery (P.P.), Loyola University Medical Center, Maywood, IL; Department of Surgery (A.T.), Northshore University Health System, Evanston, IL; Department of Surgery (S.K.), Advocate Health Care, Chicago, IL; Department of Surgery (G.C.), Mount Sinai Hospital, Chicago, IL; Department of Trauma and Burn Surgery (M.K.), John H. Stroger Jr. Hospital of Cook County, Chicago, IL; Department of Surgery (J.D.), Advocate Christ Medical Center, Chicago, IL; and Department of Surgery (D.H.), University of Chicago Medicine and Section of Trauma and Acute Care Surgery, Chicago, IL.
J Trauma Acute Care Surg. 2024 Aug 1;97(2):183-188. doi: 10.1097/TA.0000000000004223. Epub 2024 Jan 10.
Compassion fatigue (CF), the physical, emotional, and psychological impact of helping others, is composed of three domains: compassion satisfaction (CS), secondary traumatic stress (STS), and burnout (BO). Trauma surgeons (TSs) experience work-related stress resulting in high rates of CF, which can manifest as physical and psychological disorders. We hypothesized that TSs experience CF and there are potentially modifiable systemic factors to mitigate its symptoms.
All TSs in a major metropolitan area were eligible. Personal and professional demographic information was obtained. Each participant completed six validated surveys: (1) Professional Quality of Life scale, (2) Perceived Stress Scale, (3) Multidimensional Scale of Perceived Social Support, (4) Adverse Childhood Events Questionnaire, (5) Brief Coping Inventory, and (6) Toronto Empathy Questionnaire. Compassion fatigue subscale risk scores (low, <23; moderate, 23-41; high, >41) were recorded. Linear regression analysis assessed the demographic and environmental factors association with BO, STS, and CS. Variables significant on univariate analysis were included in multivariate models to determine the independent influence on BO, STS, and CS. Significance was p ≤ 0.05.
There were 57 TSs (response rate, 75.4% [n = 43]; White, 65% [n = 28]; male, 67% [n = 29]). Trauma surgeons experienced CF (BO, 26 [interquartile range (IQR), 21-32]; STS, 23 [IQR, 19-32]; CS, 39 [IQR, 34-45]). The Perceived Stress Scale score was significantly associated with increased BO (coefficient [coef.], 0.52; 95% confidence interval [CI], 0.28-0.77) and STS (coef., 0.44; 95% CI, 0.15-0.73), and decreased CS (coef., -0.51; 95% CI, -0.80 to -0.23) ( p < 0.01). Night shifts were associated with higher BO (coef., 1.55; 95% CI, 0.07-3.03; p = 0.05); conversely, day shifts were associated with higher STS (coef., 1.94; 95% CI, 0.32-3.56; p = 0.03). Higher Toronto Empathy Questionnaire scores were associated with greater CS (coef., 0.33; 95% CI, 0.12-0.55; p < 0.01).
Trauma surgeons experience moderate BO and STS associated with modifiable system- and work-related stressors. Efforts to reduce CF should focus on addressing sources of workplace stress and promoting empathic care.
Prognostic and Epidemiological; Level III.
同情疲劳（CF）是指帮助他人的身体、情感和心理影响，由三个领域组成：同情满足（CS）、二次创伤应激（STS）和倦怠（BO）。创伤外科医生（TS）经历与工作相关的压力，导致 CF 发生率较高，其表现为身体和心理障碍。我们假设 TS 会经历 CF，并且存在潜在的可改变的系统性因素来减轻其症状。
所有在主要大都市地区的 TS 都符合条件。获得个人和专业人口统计学信息。每位参与者完成六项经过验证的调查：（1）专业生活质量量表，（2）感知压力量表，（3）多维感知社会支持量表，（4）不良童年经历问卷，（5）简短应对量表，（6）多伦多同理心问卷。记录 CF 亚量表风险评分（低，<23；中度，23-41；高，>41）。线性回归分析评估了人口统计学和环境因素与 BO、STS 和 CS 的关联。单变量分析中显著的变量被纳入多变量模型，以确定对 BO、STS 和 CS 的独立影响。显著水平为 p≤0.05。
共有 57 名 TS（应答率，75.4%[n=43]；白种人，65%[n=28]；男性，67%[n=29]）。创伤外科医生经历 CF（BO，26[四分位距（IQR），21-32]；STS，23[IQR，19-32]；CS，39[IQR，34-45]）。感知压力量表得分与 BO（系数[coef.]，0.52；95%置信区间[CI]，0.28-0.77）和 STS（coef.，0.44；95% CI，0.15-0.73）增加显著相关，与 CS 减少显著相关（coef.，-0.51；95% CI，-0.80 至-0.23）（p<0.01）。夜班与更高的 BO 相关（coef.，1.55；95% CI，0.07-3.03；p=0.05）；相反，白班与更高的 STS 相关（coef.，1.94；95% CI，0.32-3.56；p=0.03）。更高的多伦多同理心问卷得分与更高的 CS 相关（coef.，0.33；95% CI，0.12-0.55；p<0.01）。
创伤外科医生经历中度 BO 和 STS，与可改变的系统和工作相关压力源相关。减少 CF 的努力应侧重于解决工作场所压力源并促进同理心护理。
预后和流行病学；III 级。
