Section of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.
GenderCare Center, Boston Medical Center, Boston, Massachusetts.
JAMA Netw Open. 2024 Nov 4;7(11):e2443937. doi: 10.1001/jamanetworkopen.2024.43937.
Few studies have explored the association between sexual and gender minority (SGM) status and occupational well-being among health care workers.
To assess the prevalence of burnout, professional fulfillment, intent to leave, anxiety, and depression by self-reported SGM status.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional survey study collected data from October 2019 to July 2021, from 8 academic medical institutions participating in the Healthcare Professional Well-Being Academic Consortium. The survey, including questions on SGM status, was administered to attending physicians and trainees. Statistical analyses were performed from June 1, 2023, to February 29, 2024.
SGM status was determined via self-reported sexual orientation and gender identity.
Primary outcomes measured were the Professional Fulfillment Index (burnout and professional fulfillment), intent to leave, and self-reported anxiety and depression using the Patient-Reported Outcomes Measurement Information System short-form 4-item measure.
Of 20 541 attendings and 6900 trainees, 8376 attendings and 2564 trainees responded and provided SGM status. Of these respondents, 386 attendings (4.6%) and 212 trainees (8.3%) identified as SGM. Compared with their non-SGM peers, SGM attendings had a lower prevalence of professional fulfillment (133 of 386 [34.5%] vs 3200 of 7922 [40.4%]) and a higher prevalence of burnout (181 of 382 [47.4%] vs 2791 of 7883 [35.4%]) and intent to leave (125 of 376 [33.2%] vs 2433 of 7873 [30.9%]) (all P < .001). Compared with their non-SGM peers, SGM trainees had a lower prevalence of professional fulfillment (63 of 211 [29.9%] vs 833 of 2333 [35.7%]) and a higher prevalence of burnout (108 of 211 [51.2%] vs 954 of 2332 [40.9%]) (both P < .001). After adjusting for age and race and ethnicity, SGM attendings had higher odds of burnout than their non-SGM peers (adjusted odds ratio, 1.57 [95% CI, 1.27-1.94]; P < .001). Results for burnout were similar among the SGM trainees compared with their non-SGM peers (adjusted odds ratio, 1.47 [1.10-1.96]; P = .01).
In this cross-sectional survey study of academic physicians and trainees, SGM attendings and trainees had higher levels of burnout and lower levels of professional fulfillment. SGM attendings had greater intent to leave than their non-SGM peers, but trainees did not. These disparities represent an opportunity for further exploration to retain SGM health care workers.
很少有研究探讨性少数群体和性别少数群体（SGM）身份与医疗保健工作者职业幸福感之间的关系。
通过自我报告的 SGM 身份评估倦怠、专业满意度、离职意向、焦虑和抑郁的患病率。
设计、地点和参与者：这项横断面调查研究于 2019 年 10 月至 2021 年 7 月在参与医疗保健专业人员幸福感学术联盟的 8 所学术医疗机构中进行，从这些机构中收集数据。调查包括 SGM 身份问题，并向主治医生和受训者发放。统计分析于 2023 年 6 月 1 日至 2024 年 2 月 29 日进行。
SGM 身份通过自我报告的性取向和性别认同来确定。
主要结果是职业满意度指数（倦怠和专业满意度）、离职意向以及使用患者报告的结果测量信息系统 4 项措施自我报告的焦虑和抑郁。
在 20541 名主治医生和 6900 名受训者中，有 8376 名主治医生和 2564 名受训者做出了回应并提供了 SGM 身份。在这些应答者中，386 名主治医生（4.6%）和 212 名受训者（8.3%）自我认同为 SGM。与非 SGM 同龄人相比，SGM 主治医生的专业满意度较低（386 人中的 133 人[34.5%] vs 7922 人中的 3200 人[40.4%]），倦怠率较高（382 人中的 181 人[47.4%] vs 7883 人中的 2791 人[35.4%]），离职意向较高（376 人中的 125 人[33.2%] vs 7873 人中的 2433 人[30.9%]）（均 P<0.001）。与非 SGM 同龄人相比，SGM 受训者的专业满意度较低（211 人中的 63 人[29.9%] vs 2333 人中的 833 人[35.7%]），倦怠率较高（211 人中的 108 人[51.2%] vs 2332 人中的 954 人[40.9%]）（均 P<0.001）。在调整年龄和种族后，SGM 主治医生的倦怠可能性比非 SGM 同龄人高（调整后的优势比，1.57[95%CI，1.27-1.94]；P<0.001）。与非 SGM 同龄人相比，SGM 受训者的倦怠结果相似（调整后的优势比，1.47[1.10-1.96]；P=0.01）。
在这项对学术医生和受训者的横断面调查研究中，SGM 主治医生和受训者的倦怠程度较高，专业满意度较低。SGM 主治医生比非 SGM 同龄人更有离职意向，但受训者没有。这些差异代表着进一步探索留住 SGM 医疗保健工作者的机会。
