Ilaria Shawen, Coppola Kristen M, Copeland Liesel, Kim Sarang, Fanning Christine, Sharma Ranita, Rashid Hanin
Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ 08854, USA.
Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08903, USA.
Healthcare (Basel). 2024 Oct 16;12(20):2059. doi: 10.3390/healthcare12202059.
Burnout is a well-recognized problem among resident physicians. The COVID-19 pandemic impacted the dynamics of the patient/resident relationship and introduced new stressors for medical trainees, such as new restrictions in the hospital, increased patient death, and uncertainty around safety. There is limited research on the implementation of group therapy for residents to address issues of wellbeing and burnout during the pandemic. In response to perceived burnout amongst internal medicine residents, a university-based internal medicine residency program in the Northeast United States implemented process groups, a form of group therapy, in the curriculum. These sessions were held hourly once every five weeks for each cohort of twelve residents during the academic year. We sought to measure resident burnout and identify themes that impacted wellbeing to facilitate the intervention of process groups during the pandemic. In 2021 and 2022, internal medicine residents were invited to complete the Maslach Burnout Inventory (MBI) and answer two open-ended questions about the factors that most negatively and positively influenced their wellness. Of the 134 participants, 82% had high emotional exhaustion or depersonalization. The most prevalent themes hindering wellness were negative personal interactions at work, most notably rude behavior by patients, unsupportive attendings, residency program expectations, and work intensity. Findings unique to the pandemic include social isolation from family, distress from poor outcomes, and fear of contracting or spreading the virus. The most prevalent themes for supporting wellness were personal life, camaraderie, professional satisfaction, and program structured support. Our findings suggest that programs can tailor structured support to improve wellness, despite the presence of significant stressors.
职业倦怠是住院医师中一个广为人知的问题。新冠疫情影响了医患关系的动态，并给医学实习生带来了新的压力源，比如医院里新的限制措施、患者死亡率上升以及安全方面的不确定性。关于为住院医师实施团体治疗以解决疫情期间的身心健康和职业倦怠问题的研究有限。针对内科住院医师中察觉到的职业倦怠问题，美国东北部一所大学的内科住院医师培训项目在课程中实施了过程团体治疗，这是团体治疗的一种形式。在学年期间，每12名住院医师为一组，每五周进行一次，每次一小时。我们试图衡量住院医师的职业倦怠程度，并确定影响身心健康的主题，以便在疫情期间促进过程团体治疗的干预。在2021年和2022年，邀请内科住院医师完成马氏职业倦怠量表（MBI），并回答两个开放式问题，即对他们的健康最有负面影响和正面影响的因素。在134名参与者中，82%的人有高度的情感耗竭或去人格化。阻碍健康的最普遍主题是工作中的负面人际互动，最明显的是患者的粗鲁行为、不支持的上级、住院医师培训项目的期望以及工作强度。疫情特有的发现包括与家人的社会隔离、不良结果带来的痛苦以及对感染或传播病毒的恐惧。支持健康的最普遍主题是个人生活、同志情谊、职业满意度和项目的结构化支持。我们的研究结果表明，尽管存在重大压力源，各项目仍可以调整结构化支持以改善健康状况。
