1S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
2"Turan" University, Almaty, Kazakhstan.
Georgian Med News. 2024 Jul-Aug(352-353):59-68.
Professional burnout is a significant issue in healthcare, particularly among primary healthcare (PHC) workers. This study aims to assess the prevalence and contributing factors to professional burnout among PHC workers in Kazakhstan, a country undergoing healthcare reforms and the implementation of new medical care standards.
This cross-sectional study was conducted from 2021 to 2023 across 324 medical organizations in Kazakhstan, including 232 organizations in 2021, 76 in 2022, and 16 in 2023. The study involved 10,459 participants: 2,595 doctors, 5,612 nurses, and 2,252 healthcare managers. Data were collected using a shortened version of the Maslach Burnout Inventory (MBI) questionnaire, assessing emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). Statistical analysis was performed using IBM SPSS Statistics version 22, employing binary logistic regression to evaluate the impact of various factors on burnout indicators.
The study found that young PHC workers aged 18-39 exhibited the highest levels of emotional exhaustion, with mean EE scores of 3.81±0.45 for doctors, 3.72±0.44 for nurses, and 3.72±0.44 for managers. In contrast, workers over 60 years old reported lower EE levels: 3.28±0.40 for doctors, 3.30±0.40 for nurses, and 3.38±0.41 for managers. Female PHC workers demonstrated lower risks of EE (OR=0.80, 95% CI [0.66, 0.97], p=0.022) and DP (OR=0.79, 95% CI [0.65, 0.96], p=0.025) compared to males, but also reported lower PA levels (OR=0.81, 95% CI [0.67, 0.99], p=0.027). Additionally, managers with postgraduate education had higher risks of EE (OR=1.25, 95% CI [1.05, 1.50], p=0.015), DP (OR=1.28, 95% CI [1.06, 1.54], p=0.013), and PA (OR=1.34, 95% CI [1.10, 1.63], p=0.015). Regional differences were also significant, with the highest PA levels observed in the Turkestan region (OR=1.4, 95% CI [1.14, 1.71], p=0.011), and the highest EE levels in Pavlodar (OR=1.33, 95% CI [1.11, 1.60], p=0.010).
The findings highlight significant variability in burnout levels among PHC workers in Kazakhstan, influenced by age, gender, education level, work experience, and geographic region. Younger workers and those with less experience are at higher risk of burnout, while regional disparities suggest the need for tailored interventions. Addressing these factors is crucial to improving job satisfaction and mental well-being among PHC workers in Kazakhstan.
评估哈萨克斯坦初级保健(PHC)工作者职业倦怠的流行率和促成因素,该国正在进行医疗改革并实施新的医疗保健标准。
这是一项在 2021 年至 2023 年期间在哈萨克斯坦的 324 家医疗机构进行的横断面研究,包括 2021 年的 232 家组织、2022 年的 76 家和 2023 年的 16 家。研究涉及 10459 名参与者:2595 名医生、5612 名护士和 2252 名医疗保健经理。使用 Maslach 倦怠量表(MBI)问卷的缩短版收集数据,评估情绪耗竭(EE)、去个性化(DP)和个人成就感(PA)。使用 IBM SPSS Statistics 版本 22 进行统计分析,采用二元逻辑回归评估各种因素对倦怠指标的影响。
研究发现,年龄在 18-39 岁的年轻 PHC 工作者表现出最高水平的情绪耗竭,医生的平均 EE 评分为 3.81±0.45,护士为 3.72±0.44,经理为 3.72±0.44。相比之下,60 岁以上的工人报告的 EE 水平较低:医生为 3.28±0.40,护士为 3.30±0.40,经理为 3.38±0.41。与男性相比,女性 PHC 工作者表现出较低的 EE(OR=0.80,95%CI[0.66,0.97],p=0.022)和 DP(OR=0.79,95%CI[0.65,0.96],p=0.025)风险,但报告的 PA 水平也较低(OR=0.81,95%CI[0.67,0.99],p=0.027)。具有研究生学历的经理表现出更高的 EE(OR=1.25,95%CI[1.05,1.50],p=0.015)、DP(OR=1.28,95%CI[1.06,1.54],p=0.013)和 PA(OR=1.34,95%CI[1.10,1.63],p=0.015)风险。区域差异也很显著,在突厥斯坦地区观察到最高的 PA 水平(OR=1.4,95%CI[1.14,1.71],p=0.011),在巴甫洛达尔地区观察到最高的 EE 水平(OR=1.33,95%CI[1.11,1.60],p=0.010)。
研究结果强调了哈萨克斯坦 PHC 工作者职业倦怠水平存在显著差异,受年龄、性别、教育水平、工作经验和地理位置的影响。年轻工人和经验较少的工人面临更高的倦怠风险,而地区差异表明需要采取有针对性的干预措施。解决这些因素对于提高哈萨克斯坦初级保健工作者的工作满意度和心理健康至关重要。