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肿瘤学与姑息治疗医护人员的职业倦怠与情感依恋

Burnout and attachment in oncology and palliative care healthcare professionals.

作者信息

Gonçalves Florbela, Gaudencio Margarida, Castelo Branco Miguel, Viana Joaquim

机构信息

Universidade da Beira Interior Faculdade de Ciencias da Saude, Covilha, Portugal

Instituto Portugues de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Coimbra, Portugal.

出版信息

BMJ Support Palliat Care. 2024 Dec 19;14(e3):e2843-e2855. doi: 10.1136/spcare-2023-004694.

Abstract

OBJECTIVES

Examine the prevalence of burn-out in health professionals working in a hospital dedicated to patients with cancer. Explore the relationship between attachment style and burn-out in healthcare professionals working in Oncology and Palliative Care.

METHODS

Cross-sectional descriptive and correlational study with a sample of 337 health professionals working in a tertiary hospital dedicated to oncology care. The evaluation protocol included a sociodemographic questionnaire, two burn-out (Copenhagen Burnout Inventory (CBI) and Maslach Burnout Inventory) and attachment (Adult Attachment Scale) scales. Statistical analysis was performed by IBM SPSS Statistics V.25. The tests were performed at a significance level of 5%.

RESULTS

In the sample, there is a predominance of professionals working in oncology services (76,8%). Comparing professionals who work in oncology services and palliative care, it appears that just over half have high levels of personal burn-out, however the groups do not differ significantly (53.5% vs 56.8%, p=0.619); the same is observed in work-related (p=0.626) and patient-related burn-out (p=0.672). The number of hours per week in which one has the perception that is exposed to suffering is positively correlated with personal, work-related burn-out and exhaustion (p<0.05). Correlating the two burn-out scales in the sample, it is observed that higher levels of personal, work-related and patient-related burn-out are associated with higher levels of emotional exhaustion and depersonalisation, as well as lower levels of personal accomplishment (p<0.001). Considering the correlation between the burn-out dimensions and attachment scale, it appears that high levels of exhaustion, depersonalisation, personal, work-related and patient-related burn-out were associated with higher levels of anxiety (p<0.001). Similar results were found in the palliative care professionals sample.

CONCLUSIONS

The constant exposure to the suffering of others places high emotional demands on oncology and palliative care professionals, making them vulnerable to burn-out. Burn-out is a multifactorial process, that involves individual characteristics with environmental effects. There are no significant differences between Oncology and Palliative Care professionals. Higher levels of personal, work-related and patient-related burn-out are associated with higher levels of anxiety. These results suggest that an anxious attachment style increases the risk of burn-out . In the sample, the most important predictor of burn-out was the number of hours per week exposed to suffering. In order to prevent burn-out, there is a growing evidence that suggests mindfulness, exercise, high-quality sleep and pursuit of happiness can improve burn-out in healthcare professionals. This work brings the advantage of using two burn-out assessment scales (particularly CBI scale), in addition to trying to correlate the level of burn-out and attachment in professionals exposed to suffering.

摘要

目的

调查一家癌症专科医院医护人员职业倦怠的患病率。探讨肿瘤学和姑息治疗领域医护人员的依恋风格与职业倦怠之间的关系。

方法

采用横断面描述性和相关性研究,样本为337名在一家三级肿瘤专科医院工作的医护人员。评估方案包括一份社会人口学问卷、两份职业倦怠量表(哥本哈根职业倦怠量表(CBI)和马氏职业倦怠量表)以及一份依恋量表(成人依恋量表)。使用IBM SPSS Statistics V.25进行统计分析。检验在5%的显著性水平下进行。

结果

在样本中,肿瘤科室的专业人员占多数(76.8%)。比较肿瘤科室和姑息治疗科室的专业人员,似乎略超过一半的人有较高水平的个人职业倦怠,然而两组之间没有显著差异(53.5%对56.8%,p = 0.619);在工作相关的职业倦怠(p = 0.626)和患者相关的职业倦怠方面(p = 0.672)也是如此。每周感觉自己暴露于痛苦中的小时数与个人、工作相关的职业倦怠和疲惫呈正相关(p < 0.05)。对样本中的两个职业倦怠量表进行相关性分析,发现个人、工作相关和患者相关的职业倦怠水平越高,与情感耗竭和去个性化水平越高以及个人成就感水平越低相关(p < 0.001)。考虑职业倦怠维度与依恋量表之间的相关性,似乎高水平的疲惫、去个性化、个人、工作相关和患者相关的职业倦怠与高水平的焦虑相关(p < 0.001)。在姑息治疗专业人员样本中也发现了类似结果。

结论

持续接触他人的痛苦对肿瘤学和姑息治疗专业人员提出了很高的情感要求,使他们容易出现职业倦怠。职业倦怠是一个多因素过程,涉及个体特征和环境影响。肿瘤学和姑息治疗专业人员之间没有显著差异。个人、工作相关和患者相关的职业倦怠水平越高,与焦虑水平越高相关。这些结果表明,焦虑的依恋风格会增加职业倦怠的风险。在样本中,职业倦怠最重要的预测因素是每周暴露于痛苦中的小时数。为了预防职业倦怠,越来越多的证据表明,正念、锻炼、高质量睡眠和追求幸福可以改善医护人员的职业倦怠。这项研究的优势在于使用了两个职业倦怠评估量表(特别是CBI量表),此外还试图将职业倦怠水平与接触痛苦的专业人员的依恋情况进行关联。

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