Jalloh Mohamed B, Naveed Asad, Johnson Sylnata A A, Bah Abdul Karim, Jegede Adesola G, Barrie Fatmata B, Virk Amrit, Sillah Arthur
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Division of General Surgery, St Michael's Hospital, Unity Health, Toronto, Ontario, Canada.
PLOS Glob Public Health. 2024 Sep 16;4(9):e0003739. doi: 10.1371/journal.pgph.0003739. eCollection 2024.
In Sierra Leone, physicians face a high risk of burnout due to systemic challenges, with studies suggesting a gap in recognizing and addressing this condition. We explored public-sector physicians' experiences and perceptions of the organizational structures and characteristics needed to help them thrive in a resource-limited practice setting. We conducted in-depth, semi-structured interviews with 24 public sector physicians across Western Area Urban (Freetown), Bo, Kono, and Kambia districts in Sierra Leone. Thematic content analysis was carried out using both deductive and inductive techniques to generate codes and identify key themes. Physicians in Sierra Leone face multifaceted challenges that significantly impact both healthcare delivery and personal well-being. Our findings reveal that overwhelming workload and stringent schedules contribute to burnout, directly compromising patient care quality. The emotional burden of caring for patients with economic constraints in accessing treatment further exacerbates physician stress. Limited resources, such as insufficient medical supplies and personnel, foster a sense of helplessness among clinicians, leading to detachment and cynicism towards their ability to effect change. In the absence of formal institutional support, physicians often rely on peer support to manage burnout. These challenges collectively undermine physicians' ability to provide optimal care, as the emotional and physical toll affects their decision-making and engagement with patients. Within Sierra Leone's resource-constrained healthcare context, systemic reforms are necessary to address the root causes of physician burnout, and to improve patient care. Our findings suggest that implementing formal support structures, including counselling services and mentorship programs, is crucial. Improving working conditions through better resource allocation and infrastructure development is essential. Developing strategies to address the emotional burden of care, including robust training programs, could enhance physician well-being, reduce burnout, and consequently improve the overall quality of patient care in Sierra Leone's public health sector.
在塞拉利昂，由于系统性挑战，医生面临着职业倦怠的高风险，研究表明在认识和应对这种状况方面存在差距。我们探讨了公共部门医生对有助于他们在资源有限的执业环境中蓬勃发展所需的组织结构和特征的经历和看法。我们对塞拉利昂西部地区城市（弗里敦）、博城、科诺区和坎比亚区的24名公共部门医生进行了深入的半结构化访谈。使用演绎和归纳技术进行主题内容分析，以生成代码并确定关键主题。塞拉利昂的医生面临多方面的挑战，这些挑战对医疗服务提供和个人幸福感都产生了重大影响。我们的研究结果表明，压倒性的工作量和严格的日程安排导致职业倦怠，直接损害了患者护理质量。照顾经济上难以获得治疗的患者所带来的情感负担进一步加剧了医生的压力。有限的资源，如医疗用品和人员不足，在临床医生中滋生了一种无助感，导致他们对自己实现变革的能力产生疏离感和愤世嫉俗的态度。在缺乏正式机构支持的情况下，医生往往依靠同行支持来应对职业倦怠。这些挑战共同削弱了医生提供最佳护理的能力，因为情感和身体上的损耗影响了他们的决策以及与患者的互动。在塞拉利昂资源有限的医疗环境中，进行系统性改革以解决医生职业倦怠的根本原因并改善患者护理是必要的。我们的研究结果表明，实施正式的支持结构，包括咨询服务和指导计划，至关重要。通过更好地分配资源和发展基础设施来改善工作条件至关重要。制定应对护理情感负担的策略，包括强有力的培训计划，可以提高医生的幸福感，减少职业倦怠，从而提高塞拉利昂公共卫生部门患者护理的整体质量。
