Center for General Medicine Education, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
BMC Med Educ. 2024 Jun 14;24(1):660. doi: 10.1186/s12909-024-05644-3.
Ambiguity tolerance specific to the clinical context - in contrast to ambiguity tolerance as a personality trait - may vary with experience and has received considerable attention. Although this tolerance appears to be related to burnout and work engagement, few studies have examined this association among physicians. Thus, we aimed to examine the relationships between clinical context-specific ambiguity tolerance, burnout, and work engagement among physicians in Japan.
We conducted a nationwide cross-sectional study in Japan. We invited family physicians from 14 family medicine residency programs and physicians with specialties other than family medicine from monitors of an Internet survey company to participate in the study. We measured ambiguity tolerance in the clinical context using the Japanese version of the Tolerance of Ambiguity in Medical Students and Doctors (J-TAMSAD) scale, burnout using the Japanese version of the Burnout Assessment Scale (BAT-J), and work engagement using the Utrecht Work Engagement Scale (UWES). We performed a multivariable linear regression analysis to determine whether the J-TAMSAD scale score was associated with the BAT-J and UWES scores.
383 respondents were included in the analysis. After adjustment for possible confounders, clinical context-specific ambiguity tolerance showed a dose-dependent negative association with burnout (adjusted mean difference -0.39, 95% confidence interval (CI) -0.56 to -0.22 for the highest J-TAMSAD score quartile compared with the lowest). Ambiguity tolerance in the clinical context also showed a dose-dependent positive association with work engagement (adjusted mean difference 0.83, 95% CI 0.49 to 1.16 for the highest J-TAMSAD score quartile compared with the lowest).
Our study showed that tolerance for ambiguity in the clinical context was negatively associated with burnout, and positively associated with work engagement. These findings will be useful in developing interventions aimed at preventing burnout and promoting work engagement among physicians.
与作为人格特质的模糊容忍度相比，特定于临床环境的模糊容忍度可能会因经验而异，因此受到了相当多的关注。尽管这种容忍度似乎与倦怠和工作投入有关，但很少有研究检查过医生群体中的这种关联。因此，我们旨在研究日本医生中特定于临床环境的模糊容忍度、倦怠和工作投入之间的关系。
我们在日本进行了一项全国性的横断面研究。我们邀请了来自 14 个家庭医学住院医师培训计划的家庭医生以及互联网调查公司监测员的其他专业医生参加研究。我们使用日本版医学生和医生模糊容忍度量表（J-TAMSAD）测量临床环境中的模糊容忍度，使用日本版倦怠评估量表（BAT-J）测量倦怠，使用乌得勒支工作投入量表（UWES）测量工作投入。我们进行了多变量线性回归分析，以确定 J-TAMSAD 量表评分是否与 BAT-J 和 UWES 评分相关。
383 名受访者被纳入分析。在调整了可能的混杂因素后，特定于临床环境的模糊容忍度与倦怠呈剂量依赖性负相关（调整后的平均差异为 -0.39，95%置信区间（CI）为 -0.56 至 -0.22，最高 J-TAMSAD 评分四分位与最低四分位相比）。临床环境中的模糊容忍度也与工作投入呈剂量依赖性正相关（调整后的平均差异为 0.83，95%置信区间（CI）为 0.49 至 1.16，最高 J-TAMSAD 评分四分位与最低四分位相比）。
我们的研究表明，临床环境中的模糊容忍度与倦怠呈负相关，与工作投入呈正相关。这些发现将有助于制定预防医生倦怠和促进工作投入的干预措施。
