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住院医师职业倦怠与工作条件、精神心理决定因素和医疗差错的关联:一项横断面研究。

Resident physician burnout and association with working conditions, psychiatric determinants, and medical errors: A cross-sectional study.

机构信息

Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Environmental Medicine and Occupational Medicine Excellent Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

出版信息

PLoS One. 2024 Oct 30;19(10):e0312839. doi: 10.1371/journal.pone.0312839. eCollection 2024.

DOI:10.1371/journal.pone.0312839
PMID:39475932
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11524500/
Abstract

Burnout has become a significant occupational concern for resident physicians, primarily attributed to chronic workplace stressors, inadequate work-life balance, high expectation from attending staffs, steep learning curve, and limited patient care experience. The study aimed to investigate the prevalence and associated factors of burnout in medical residents. This cross-sectional study was conducted online questionnaire of all specialists in a university hospital from September to October 2022. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey for Medical Personnel. The data collection encompassed information on socio-demographics, working conditions, psychiatric issues, and medical errors as potential predictive variables. To analyze the association between these factors and burnout, a confounder summary score model was employed in four separate models utilizing multivariable logistic regression. A total of 238 participants, the average age of participants was 28.1 years (SD 2.7), and 56.2% of them were female. Weekly working hours averaged 75 (SD 21.8). Burnout prevalence was 46.3%. This prevalence was characterized by high levels of emotional exhaustion (57.1%) and depersonalization (36.1%), along with low levels of personal accomplishment (52.4%). Summary of association in each domain with burnout were as follow: demographic determinants, (adjusted odds ratio (aOR) 2.80, 95% CI 1.68-4.64), working conditions (aOR 2.97, 95% CI 1.54-5.71), psychiatric determinants (aOR 2.47, 95% CI 1.77-3.45) medical errors (aOR 2.14, 95% CI 1.05-4.34). Medical residency training programs should provide a supportive system that actively monitors and addresses depressive symptoms. Implementing preventive measures, such as increasing pay rates, can play a role in mitigating burnout.

摘要

burnout 已成为住院医师的一个重要职业关注点,主要归因于慢性工作压力源、工作与生活平衡不足、主治医生的高期望、陡峭的学习曲线以及有限的患者护理经验。本研究旨在调查住院医师 burnout 的患病率及相关因素。这项横断面研究于 2022 年 9 月至 10 月期间通过在线问卷对一家大学医院的所有专家进行。使用 Maslach Burnout Inventory-Human Services Survey for Medical Personnel 评估 burnout。数据收集包括社会人口统计学、工作条件、精神问题和医疗错误等潜在预测变量的信息。为了分析这些因素与 burnout 之间的关联,采用多变量逻辑回归在四个独立模型中使用混杂因素综合评分模型。共有 238 名参与者,参与者的平均年龄为 28.1 岁(SD 2.7),其中 56.2%为女性。每周工作时间平均为 75 小时(SD 21.8)。burnout 的患病率为 46.3%。这种患病率的特点是情绪耗竭水平较高(57.1%)和去人性化水平较高(36.1%),而个人成就感水平较低(52.4%)。每个领域与 burnout 相关的关联总结如下:人口统计学决定因素(调整后的优势比(aOR)2.80,95%CI 1.68-4.64)、工作条件(aOR 2.97,95%CI 1.54-5.71)、精神决定因素(aOR 2.47,95%CI 1.77-3.45)、医疗错误(aOR 2.14,95%CI 1.05-4.34)。住院医师培训计划应提供一个支持系统,积极监测和处理抑郁症状。实施预防措施,如提高薪酬水平,可以在缓解 burnout 方面发挥作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f005/11524500/7198831ab91d/pone.0312839.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f005/11524500/56d9ac290007/pone.0312839.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f005/11524500/7198831ab91d/pone.0312839.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f005/11524500/56d9ac290007/pone.0312839.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f005/11524500/7198831ab91d/pone.0312839.g002.jpg

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