Wu Xueji, Ruan Huihong, Feng Xiaoying, Xie Chaojun, O'Donnell Ronald R, Zhang Zhoubin
Operating Office, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
Director Office, Dalong Primary Healthcare Center, Panyu, Guangzhou, Guangdong, China.
J Family Med Prim Care. 2025 Jan;14(1):126-131. doi: 10.4103/jfmpc.jfmpc_891_24. Epub 2025 Jan 13.
Primary healthcare workforce (PHCW) should be suffered from less burnout after the termination of the COVID-19 response. The current study compared the changes in the three dimensions of burnout in PHCW during and after the response.
Two convenience-sampling, online, cross-sectional questionnaire studies were conducted in local PHCW. Studies were administered in April 2022 and 8 months after the termination. Burnout was measured by the Chinese version of 15-item Maslach Burnout Inventory-General Survey, which assesses three dimensions: emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (reduced PA). The primary outcome was the prevalence of its three dimensions. Data on demographics, work environment, health conditions, and outlets for stress reduction were collected. We compared burnout and associated factors between the study periods by using Student's -test, Chi test, or Mann‒Whitney test. The association between factors and burnout was identified by a logistic regression model.
In total, 162 and 200 participants completed the questionnaires during and after the response. No significant differences in demographics, including age, gender, education attainment, work experience, or seniority level were observed. The prevalence of burnout-free status was similar (9.9% vs 12.5%, = 0.434) between the two periods. Severe burnout decreased from 45.7% to 0%, and moderate burnout nearly doubled after the response. The prevalence of EE decreased the most, by 55.0%, followed by that of DP, which decreased by 38.4% (all < 0.001); however, there was no difference in the prevalence of reduced PA (77.2% vs 74.5%, = 0.557). Logistic regression showed that promotion and alcohol consumption decreased the risk of EE. Considering leaving the job increases the risk of DP, a lower self-evaluated health score and more distress were associated with EE and DP. Exercise decreased the risk of reduced PA.
Inconsistent with the hypothesis, we found that severe burnout decreased, but moderate burnout increased in PHCWs after the response. EE and DP decreased more, but reduced PA had no change. Incentives, improved self-evaluated health conditions, alcohol consumption, and exercise ameliorate burnout. Healthcare policy makers must consider multiple effective ways to mitigate burnout in the post-epidemic era.
在新冠疫情应对结束后，基层医疗保健工作队伍（PHCW）的职业倦怠感应有所减轻。本研究比较了疫情应对期间及之后基层医疗保健工作队伍职业倦怠三个维度的变化。
对当地基层医疗保健工作者进行了两项便利抽样的在线横断面问卷调查研究。研究分别在2022年4月以及疫情应对结束8个月后进行。职业倦怠通过中文版15项马氏职业倦怠量表通用版进行测量，该量表评估三个维度：情感耗竭（EE）、去个性化（DP）和个人成就感降低（个人成就感降低）。主要结果是这三个维度的患病率。收集了人口统计学、工作环境、健康状况和减压途径的数据。我们使用学生t检验、卡方检验或曼-惠特尼检验比较了研究期间的职业倦怠及相关因素。通过逻辑回归模型确定因素与职业倦怠之间的关联。
总共162名和200名参与者在疫情应对期间及之后完成了问卷。在年龄、性别、教育程度、工作经验或资历水平等人口统计学方面未观察到显著差异。两个时期无职业倦怠状态的患病率相似（9.9%对12.5%，P = 0.434）。严重职业倦怠从45.7%降至0%，而中度职业倦怠在疫情应对后几乎翻倍。情感耗竭的患病率下降最多，为55.0%，其次是去个性化，下降了38.4%（均P < 0.001）；然而，个人成就感降低的患病率没有差异（77.2%对74.5%，P = 0.557）。逻辑回归显示晋升和饮酒降低了情感耗竭的风险。考虑离职会增加去个性化的风险，自我评价健康得分较低和更多困扰与情感耗竭和去个性化相关。锻炼降低了个人成就感降低的风险。
与假设不符的是，我们发现疫情应对后基层医疗保健工作者中严重职业倦怠有所下降，但中度职业倦怠有所增加。情感耗竭和去个性化下降更多，但个人成就感降低没有变化。激励措施、改善自我评价健康状况、饮酒和锻炼可改善职业倦怠。医疗保健政策制定者必须考虑多种有效方法来减轻疫情后时代的职业倦怠。
