Caterpillar Inc. Endowed Professor of Management, Bradley University, Peoria, IL, USA.
Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA.
BMC Health Serv Res. 2024 Jun 18;24(1):748. doi: 10.1186/s12913-024-11186-7.
Given the increasing prevalence of the physician burnout, this study provides new insights into the antecedents driving burnout and turnover intent. By introducing the concept of physician fortitude, we develop a valid and statistically-reliable measure that increases our understanding of these issues.
A two-sample design was employed. Using a sample of 909 physicians, Advanced Practice Providers (APPs) and healthcare leaders, exploratory factor analysis was employed to create a 12-item fortitude scale. In the second study, using a sample of 212 of practicing physicians, APPs and healthcare leaders, bivariate and tetrachoric correlations, and ordinary least square regression modeling were able to establish reliability and validity.
The fortitude scale shows sufficient reliability. Moreover, we found significant support for convergent and criterion-related validity. Fortitude was significantly related to all three subdimensions of burnout, including emotional exhaustion (r = -.62, p < .01), depersonalization (r = -.70, p < .01) and personal accomplishment (r = .65, p < .01), and turnover intent (r = -.55, p < .01). Moreover, the fortitude measure explained more variance in all three subdimensions of burnout and turnover intent compared to common measures, including grit, hardiness, mental toughness and resilience (p < .01).
Results from this study empirically demonstrate that fortitude is significantly related to burnout, and turnover intent. This new fortitude measure adds a new perspective to assist in the development of more effective interventions. Opportunities for future research are discussed.
鉴于医生职业倦怠的发病率不断上升，本研究为驱动倦怠和离职意愿的前因提供了新的见解。通过引入医生坚韧的概念，我们开发了一种有效且在统计学上可靠的衡量标准，从而增进了我们对这些问题的理解。
采用两样本设计。使用包括 909 名医生、高级执业医师（APP）和医疗保健领导者在内的样本，采用探索性因子分析创建了一个 12 项坚韧量表。在第二项研究中，使用包括 212 名执业医生、APP 和医疗保健领导者在内的样本，采用二元和四分相关以及普通最小二乘回归模型，建立了可靠性和有效性。
坚韧量表具有足够的可靠性。此外，我们发现收敛和效标关联效度有显著支持。坚韧与倦怠的所有三个子维度都显著相关，包括情绪疲惫（r=-.62，p<.01）、去人性化（r=-.70，p<.01）和个人成就感（r=-.65，p<.01）以及离职意愿（r=-.55，p<.01）。此外，与坚韧、毅力、心理韧性和适应力等常见衡量标准相比，坚韧衡量标准更能解释倦怠的所有三个子维度和离职意愿的更大方差（p<.01）。
本研究的结果从经验上证明，坚韧与倦怠和离职意愿显著相关。这种新的坚韧衡量标准为开发更有效的干预措施提供了新的视角。讨论了未来研究的机会。
