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住院医师和研究员的心理治疗与职业倦怠、抑郁及幸福感指标的关联:一项初步研究

The Association of Psychotherapy With Burnout, Depression, and Measures of Well-Being in Residents and Fellows: A Pilot Study.

作者信息

Zisook Sidney, Doran Neal, Downs Nancy, Shapiro Desiree, Haddad Angela, Lee Daniel, Newton Isabel, Kawasaki Julie, Nestsiarovich Anastasiya, Davidson Judy

出版信息

Acad Med. 2025 Feb 1;100(2):203-209. doi: 10.1097/ACM.0000000000005750. Epub 2024 May 1.

Abstract

PURPOSE

Resident physicians experience high rates of burnout and depression but rarely prioritize their well-being or seek mental health care. The Accreditation Council for Graduate Medical Education mandated that training programs prioritize resident wellness and emotional and mental health to ensure readily available and accessible mental health care. To help meet that requirement and circumvent barriers to accessing care, the University of California San Diego Healer Education Assessment & Referral (HEAR) Program offers residents and fellows short-term therapy for coping with challenges that threaten their well-being. This report describes the results of a pilot study designed to evaluate the feasibility and effectiveness of the HEAR Program's resident therapy program.

METHOD

The cohort included residents and fellows who completed at least 1 postbaseline assessment from January to May 2022. Measures of fulfillment, burnout, self-compassion, quality of life, depression, and suicidal ideation were assessed and compared before and up to 12 weeks after enrollment.

RESULTS

Of the 39 residents who consented to participation, 30 completed at least 1 postbaseline assessment. Most outcomes improved after therapy, with significant increases in fulfillment (mean [SE] coefficient, 0.24 [0.08]; z score, 2.86; P = .004), self-compassion (mean [SE] coefficient, 0.37 [0.07]; z score, 5.72; P < .001), and quality of life ( P < .001) and significant reductions in burnout (Stanford burnout scale: mean [SE] coefficient, -0.27 [0.07]; z score, -4.01; P < .001; single-item burnout scale: mean [SE] coefficient, -0.34 [0.08]; z score, -4.37; P < .001) and depression severity (mean [SE] coefficient, -1.08 [0.25]; z score, -4.36; P < .001).

CONCLUSIONS

This pilot study noted improvements in fulfillment, compassion, quality of life, and function, as well as reductions in burnout and depression severity, among resident physicians. Future studies in larger cohorts are needed to validate these findings and inform further optimization of this program.

摘要

目的

住院医师经历着较高程度的职业倦怠和抑郁,但他们很少将自身的幸福感置于优先位置或寻求心理健康护理。毕业后医学教育认证委员会规定,培训项目应将住院医师的健康以及情绪和心理健康置于优先地位,以确保提供随时可得且易于获得的心理健康护理。为了帮助满足这一要求并规避获得护理的障碍,加利福尼亚大学圣地亚哥分校的治疗师教育评估与转诊(HEAR)项目为住院医师和研究员提供短期治疗,以应对威胁他们幸福感的挑战。本报告描述了一项试点研究的结果,该研究旨在评估HEAR项目住院医师治疗项目的可行性和有效性。

方法

该队列包括在2022年1月至5月期间完成至少1次基线后评估的住院医师和研究员。在入组前及入组后长达12周的时间里,对成就感、职业倦怠、自我同情、生活质量、抑郁和自杀意念等指标进行评估和比较。

结果

在同意参与的39名住院医师中,30名完成了至少1次基线后评估。治疗后,大多数指标有所改善,成就感(平均[标准误]系数,0.24[0.08];z分数,2.86;P = 0.004)、自我同情(平均[标准误]系数,0.37[0.07];z分数,5.72;P < 0.001)和生活质量(P < 0.001)显著提高,职业倦怠(斯坦福职业倦怠量表:平均[标准误]系数,-0.27[0.07];z分数,-4.01;P < 0.001;单项职业倦怠量表:平均[标准误]系数,-0.34[0.08];z分数,-4.37;P < 0.001)和抑郁严重程度(平均[标准误]系数,-1.08[0.25];z分数,-4.36;P < 0.001)显著降低。

结论

这项试点研究指出,住院医师在成就感、同情心、生活质量和功能方面有所改善,职业倦怠和抑郁严重程度有所降低。需要在更大的队列中进行进一步研究,以验证这些发现并为该项目的进一步优化提供依据。

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