Li Henry, Dance Erica, Poonja Zafrina, Aguilar Leandro Solis, Colmers-Gray Isabelle
Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Acad Emerg Med. 2024 Dec;31(12):1243-1255. doi: 10.1111/acem.14994. Epub 2024 Jul 31.
Emergency physicians have the highest rates of burnout among all specialties. Existing burnout tools include the Copenhagen Burnout Inventory (CBI) and single-item measures from the Maslach Burnout Inventory (MBI). While both were designed to measure burnout, how they conceptualize this phenomenon differs and their agreement is unclear. Given the close conceptual relationship between emotional regulation strategies such as distancing and distraction with the MBI subscale of depersonalization, we examined agreement between the two inventories and association with emotional regulation strategies as a lens to explore the conceptualization of burnout.
We conducted a cross-sectional survey of adult and pediatric emergency physicians and trainees in Canada. Survey questions were pretested using written feedback and cognitive interviews. "Frequent use" of an emotional regulation strategy was "most" or "all" shifts (≥4 on 5-point Likert scale). Burnout was defined as mean ≥50/100 on the CBI and scoring ≥5 (out of 7) on at least one of the single-item measures from the MBI. Associations with burnout were examined using multivariable logistic regression.
Of 147 respondents, 44.2% were positive for burnout on the CBI and 44.9% on the single-item measures from the MBI. Disagreement was 21.1% overall, ranging from 12.5% for older (≥55 years) physicians to 30.2% for younger (<35 years) physicians. Use of distraction and use of distancing were strongly associated with burnout on the single-item measures (adjusted odds ratio [aOR] 14.4, 95% confidence interval [CI] 3.4-60.8]) and CBI (aOR 10.1, 95% CI 2.5-39.8, respectively.
Despite near-equal rates of burnout, agreement between the CBI and single-item measures from the MBI varies and was lower for younger emergency physicians/trainees. While emotional regulation strategies were felt to be important in supporting a career in emergency medicine, they were strongly associated with burnout. Future research is needed to better understand this phenomenon and which tools to use to measure burnout.
在所有专科中，急诊医生职业倦怠率最高。现有的职业倦怠评估工具包括哥本哈根职业倦怠量表（CBI）和马氏职业倦怠量表（MBI）中的单项测量指标。虽然二者都旨在测量职业倦怠，但它们对这一现象的概念化方式不同，且二者的一致性尚不清楚。鉴于诸如疏离和分心等情绪调节策略与MBI去个性化子量表之间存在密切的概念关系，我们研究了这两种量表之间的一致性以及与情绪调节策略的关联，以此作为探索职业倦怠概念化的一个视角。
我们对加拿大的成人及儿科急诊医生和实习医生进行了一项横断面调查。调查问题通过书面反馈和认知访谈进行了预测试。情绪调节策略的“频繁使用”是指“大多数”或“全部”班次（5分李克特量表上≥4分）。职业倦怠被定义为CBI平均得分≥50/100，以及在MBI的至少一项单项测量指标上得分≥5（满分7分）。使用多变量逻辑回归分析职业倦怠的关联因素。
在147名受访者中，CBI显示44.2%的人存在职业倦怠，MBI的单项测量指标显示44.9%的人存在职业倦怠。总体不一致率为21.1%，年龄较大（≥55岁）的医生不一致率为12.5%，年龄较小（<35岁）的医生不一致率为30.2%。在单项测量指标上，使用分心和疏离策略与职业倦怠密切相关（调整后的优势比[aOR]为14.4，95%置信区间[CI]为3.4 - 60.8），在CBI上也是如此（aOR分别为10.1，95% CI为2.5 - 39.8）。
尽管职业倦怠率近乎相同，但CBI与MBI单项测量指标之间的一致性存在差异，年轻的急诊医生/实习医生的一致性更低。虽然情绪调节策略被认为对从事急诊医学职业很重要，但它们与职业倦怠密切相关。未来需要开展研究以更好地理解这一现象以及使用哪些工具来测量职业倦怠。
