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培训生的倦怠和幸福感:来自美国妇产科住院医师全国调查的结果。

Burnout and Well-Being in Trainees: Findings From a National Survey of US Obstetrics and Gynecology Residents.

机构信息

is Professor, Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, New York, USA.

is Professor, Departments of Obstetrics and Gynecology and Learning Health Sciences, University of Michigan, Ann Arbor, Michigan, USA.

出版信息

J Grad Med Educ. 2024 Oct;16(5):572-580. doi: 10.4300/JGME-D-23-00554.1. Epub 2024 Oct 15.

Abstract

Despite national attention on resident well-being, challenges persist. Effective solutions require greater understanding of personal and program factors. To explore burnout, resilience, self-reported mental health, and perceptions of the learning environment in a national sample of obstetrics and gynecology (OB/GYN) residents. An observational cross-sectional survey of OB/GYN residents taking the January 2022 national in-training examination included an abbreviated 2-item Maslach Burnout Inventory, a short version of the Connor-Davidson Resilience Scale, and subjective experience of other factors. Kruskal-Wallis and chi-square tests explored differences in outcomes and associations between variables. Among 5761 residents taking the examination, 3741 (64.9%) participated, with 2425 of 3741 (64.8%) reporting burnout, 2138 (57.2%) depression, 2651 (70.9%) anxiety, and 147 (3.9%) suicidal ideation. Women fared worse than men in terms of burnout (2105 of 3147, 66.9% vs 281 of 496, 56.7%, <.001), depression (1843 of 3147, 58.6% vs 256 of 496, 51.6%, =.004), anxiety (2318 of 3147, 73.7% vs 294 of 496, 59.3%, <.001), and resilience (5.9±2.1 vs 6.2±2.1, =.006). More nonbinary residents considered leaving residency (17 of 49, 34.7% vs 676 of 3147, 21.5% [women] and 108 of 496, 21.8% [men], =.008). Race-based differences were seen in depression, suicidal ideation, and thoughts of leaving residency. Increased binge drinking was reported with increasing postgraduate year. Among 614 residents reporting that well-being was not a priority in their program, 539 of 614 (87.8%) reported burnout, 469 of 614 (76.4%) depression, and 508 of 614 (82.7%) anxiety. Residents report high rates of mental health concerns, and these are worse among women, gender nonconforming individuals, Black residents, and those who perceive well-being is not a priority in their training program.

摘要

尽管人们对住院医师的幸福感给予了全国关注,但挑战依然存在。有效的解决方案需要更深入地了解个人和项目因素。本研究旨在调查全国妇产科住院医师样本中的职业倦怠、适应力、自我报告的心理健康状况和对学习环境的看法。本研究采用观察性横断面调查方法,对参加 2022 年 1 月全国住院医师培训考试的妇产科住院医师进行了调查,其中包括简短的 Maslach 职业倦怠量表 2 项、Connor-Davidson 适应力量表的简短版本以及其他因素的主观体验。Kruskal-Wallis 和卡方检验探索了结果之间的差异以及变量之间的关联。在参加考试的 5761 名住院医师中,有 3741 名(64.9%)参与了调查,其中 2425 名(64.8%)报告存在职业倦怠,2138 名(57.2%)报告抑郁,2651 名(70.9%)报告焦虑,147 名(3.9%)报告有自杀意念。女性在职业倦怠(3147 名中的 2105 名,66.9%比 496 名中的 281 名,56.7%,<.001)、抑郁(3147 名中的 1843 名,58.6%比 496 名中的 256 名,51.6%,=.004)、焦虑(3147 名中的 2318 名,73.7%比 496 名中的 294 名,59.3%,<.001)方面的表现均不如男性,适应力(5.9±2.1 比 6.2±2.1,=.006)方面的表现也较差。更多的非二元性别住院医师考虑离开住院医师培训(49 名中的 17 名,34.7%比 3147 名中的 676 名,21.5%[女性]和 496 名中的 108 名,21.8%[男性],=.008)。在抑郁、自杀意念和离开住院医师培训的想法方面,存在基于种族的差异。随着研究生年限的增加,报告暴饮的人数也随之增加。在 614 名报告幸福感不是其培训计划优先事项的住院医师中,539 名(87.8%)报告存在职业倦怠,469 名(76.4%)报告抑郁,508 名(82.7%)报告焦虑。住院医师报告了较高的心理健康问题发生率,其中女性、性别认同障碍者、非裔美国人和那些认为幸福感不是培训计划优先事项的人情况更为严重。

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