From the Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Canada.
St John of God Midland Public and Private Hospitals, Perth, Australia.
Anesth Analg. 2024 Aug 1;139(2):375-384. doi: 10.1213/ANE.0000000000006870. Epub 2024 Feb 2.
Burnout, depression, and anxiety are increasingly recognized as common among health care providers. Risks for these conditions are exacerbated in low-resource settings by excessive workload, high disease burden, resource shortage, and stigma against mental health issues. Based on discussions and requests to learn more about burnout during the Vital Anaesthesia Simulation Training (VAST), our team developed VAST Wellbeing, a 1-day course for health care providers in low-resource settings to recognize and mitigate burnout and to promote personal and professional well-being.
This mixed-methods study used quantitative pre- and postcourse surveys using validated mental health measures and qualitative semistructured interviews to explore participants' experience of VAST Wellbeing during and after the course. Quantitative outcomes included burnout and professional fulfillment as measured by the Professional Fulfillment Index and general well-being as measured by the Warwick-Edinburgh Mental Wellbeing Scale.
Twenty-six participants from 9 countries completed the study. In the immediate postcourse survey, study participants rated the course overall as "very good" (60.7%) and "excellent" (28.6%). Quantitative analysis showed no statistical differences in levels of work exhaustion, interpersonal disengagement, burnout, professional fulfillment, or general mental well-being 2 months after the course. Five themes on the impact of VAST Wellbeing were identified during qualitative analysis: (1) raising awareness, breaking taboos; (2) not feeling alone; (3) permission and capacity for personal well-being; (4) workplace empowerment; and (5) VAST Wellbeing was relevant, authentic, and needed.
Causes of burnout are complex and multidimensional. VAST Wellbeing did not change measures of burnout and fulfillment 2 months postcourse but did have a meaningful impact by raising awareness, reducing stigma, fostering connection, providing skills to prioritize personal well-being, and empowering people to seek workplace change.
burnout(职业倦怠)、depression(抑郁)和 anxiety(焦虑)在医疗保健提供者中越来越被认为是常见的。在资源匮乏的环境中,由于工作量过大、疾病负担高、资源短缺以及对心理健康问题的污名化,这些情况的风险加剧。基于在 Vital Anaesthesia Simulation Training(VAST)期间关于 burnout 的讨论和了解更多信息的请求,我们的团队为资源匮乏环境中的医疗保健提供者开发了 VAST Wellbeing,这是一门为期 1 天的课程,旨在识别和减轻 burnout 并促进个人和专业幸福感。
这项混合方法研究使用了经过验证的心理健康测量工具进行定量的课前和课后调查,并使用定性半结构化访谈来探索参与者在课程期间和课程结束后对 VAST Wellbeing 的体验。定量结果包括 burnout 和专业满意度,分别由 Professional Fulfillment Index 和 Warwick-Edinburgh Mental Wellbeing Scale 衡量。
来自 9 个国家的 26 名参与者完成了这项研究。在课程结束后的即时调查中,研究参与者总体上对课程的评价为“非常好”(60.7%)和“优秀”(28.6%)。定量分析显示,课程结束后 2 个月,工作倦怠、人际脱节、职业倦怠、专业满意度或一般心理健康水平没有统计学差异。在定性分析中确定了 VAST Wellbeing 的五个影响主题:(1)提高认识,打破禁忌;(2)不再感到孤独;(3)允许和有能力追求个人幸福感;(4)赋予工作场所权力;(5)VAST Wellbeing 是相关的、真实的和必要的。
burnout 的原因是复杂和多维度的。VAST Wellbeing 并没有改变课程结束后 2 个月的 burnout 和满意度衡量标准,但通过提高认识、减少污名化、促进联系、提供优先考虑个人幸福感的技能以及赋予人们寻求工作场所变革的权力,产生了有意义的影响。