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南非农村地区医疗保健提供者职业倦怠的相关因素。

Factors associated with burnout among healthcare providers in a rural context, South Africa.

机构信息

School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.

出版信息

Afr J Prim Health Care Fam Med. 2024 Jan 23;16(1):e1-e10. doi: 10.4102/phcfm.v16i1.4163.

Abstract

BACKGROUND

Healthcare providers (HCPs) are at risk of burnout in sub-Saharan Africa. However, there is little research in rural and primary care settings.

AIM

To evaluate burnout and its associated factors among public sector HCPs in South Africa.

SETTING

Primary health care clinics, community health centres and district hospitals in Nkomazi Local Municipality, Mpumalanga province.

METHODS

Quantitative study design using a cross-sectional survey. Healthcare providers (n = 1139) working in Nkomazi Local Municipality were invited to participate. Burnout was assessed using the Maslach Burnout Inventory. A demographic and occupational questionnaire, the General Help-Seeking Questionnaire and the Health and Safety Executive Indicator Tool were used.

RESULTS

A total of 302 HCPs, between 23 and 61 years, mostly female (n = 252; 83.44%) and nurses (n = 235; 77.81%) participated. High burnout was observed for Emotional Exhaustion (median score 26 [IQR {interquartile range}: 34-16]) and Personal Accomplishment (median score 29 [IQR: 34-25]). Most participants (n = 215; 71.19%) would seek help if they had an emotional problem. Bivariate analysis revealed significant associations between workplace demands, control, management support, peer support, relationships, role and change with all subscales of burnout. Multivariate regression analysis found that Personal Accomplishment improved by 0.49 (95% CI: 0.10-0.89) for every point in improved work demands, by 0.84 (95% CI: 0.01-1.67) for every point towards improved management support and by 1.19 (95% CI: 0.48-1.90) for every point towards having an improved role.

CONCLUSIONS

During 2022, HCPs working in a rural area in South Africa displayed high levels of burnout for Emotional Exhaustion and Personal Accomplishment but not for Depersonalisation.Contributions: Improvements in work demands, managerial support and role clarity may reduce burnout among HCP in a rural, primary care setting.

摘要

背景

在撒哈拉以南非洲,医疗保健提供者(HCPs)面临着职业倦怠的风险。然而,在农村和初级保健环境中,相关研究很少。

目的

评估南非公立部门 HCP 的职业倦怠及其相关因素。

地点

姆普马兰加省恩科马蒂地方自治市的初级保健诊所、社区保健中心和地区医院。

方法

采用横断面调查的定量研究设计。邀请在恩科马蒂地方自治市工作的医疗保健提供者(n=1139)参与研究。使用 Maslach 倦怠量表评估倦怠情况。使用人口统计学和职业问卷、一般求助问卷和健康与安全执行指标工具。

结果

共有 302 名 HCP 参与了研究,年龄在 23 至 61 岁之间,大多数为女性(n=252;83.44%)和护士(n=235;77.81%)。情绪耗竭(中位数得分 26 [IQR{四分位距}:34-16])和个人成就感(中位数得分 29 [IQR:34-25])的倦怠程度较高。大多数参与者(n=215;71.19%)如果有情绪问题会寻求帮助。单变量分析显示,工作场所需求、控制、管理支持、同伴支持、关系、角色和变化与所有倦怠亚量表之间存在显著关联。多变量回归分析发现,个人成就感每提高 1 分(95%CI:0.10-0.89),工作需求就会提高 0.49 分;管理支持每提高 1 分(95%CI:0.01-1.67),个人成就感就会提高 0.84 分;角色每改善 1 分(95%CI:0.48-1.90),个人成就感就会提高 1.19 分。

结论

2022 年,在南非农村地区工作的 HCP 表现出较高的情绪耗竭和个人成就感倦怠水平,但去人格化倦怠水平较低。贡献:改善工作需求、管理支持和角色清晰度可能会降低农村初级保健环境中 HCP 的倦怠水平。

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