Li Zejun, Pu Peng, Wu Min, Wang Xin, Xu Huixue, Zhang Xiaoyu, Deng Qijian, Yang Winson Fuzun, Liu Yueheng, Wang Qianjin, Li Manyun, Hao Yuzhu, He Li, Wang Yunfei, Wu Qiuxia, Tang Yi-Yuan, Liu Tieqiao
Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Ann Med. 2025 Dec;57(1):2476042. doi: 10.1080/07853890.2025.2476042. Epub 2025 Mar 12.
Despite the high prevalence of mental stress among physicians, reliable screening tools are scarce. This study aimed to evaluate the capability of the Physician Well-Being Index (PWBI) in identifying distress and adverse consequences among Chinese physicians.
This cross-sectional online survey recruited 2803 physicians from Southern Mainland China snowball sampling between October and December 2020. Data on socio-demographic characteristics, the PWBI, mental distress (including quality of life [QOL], burnout, sleepiness, fatigue and suicidal ideation) and adverse outcomes (medical errors and turnover intention) were collected. Chi-square tests and logistic regression were used for data analysis.
Seven items of the PWBI (emotional exhaustion, depression, stress, poor mental and physical QOL, low work meaning and dissatisfaction with work-life integration) were independently associated with low QOL (all < 0.05). Physicians with lower QOL were more likely to endorse each item (OR: 1.76-5.86) and less likely to have favourable index scores (all < 0.001). Assuming a prevalence of 29.2% for low QOL, the PWBI could reduce the post-test probability to 6.9% or increase it to 70.8%. Physicians scoring ≥4 on the PWBI were at increased risk (likelihood ratio >1) for experiencing various mental distress, with sensitivity exceeding 80% in detecting burnout, depression, high stress and anxiety. Additionally, the PWBI score helped stratify physicians' likelihood of reporting medical errors and turnover intention.
This study provides preliminary insights into the validity and utility of the 9-item PWBI as a screening tool for assessing distress and well-being among Chinese physicians, helping identify those at higher risk of medical errors or turnover. However, these findings should be interpreted with caution due to the limited sample size.
尽管医生群体中精神压力的患病率很高，但可靠的筛查工具却很匮乏。本研究旨在评估医生幸福感指数（PWBI）在中国医生中识别困扰及不良后果的能力。
这项横断面在线调查于2020年10月至12月间通过雪球抽样从中国大陆南部招募了2803名医生。收集了社会人口学特征、PWBI、精神困扰（包括生活质量[QOL]、职业倦怠、嗜睡、疲劳和自杀意念）及不良后果（医疗差错和离职意向）的数据。采用卡方检验和逻辑回归进行数据分析。
PWBI的七个项目（情感耗竭、抑郁、压力、精神和身体生活质量差、工作意义低以及对工作与生活融合的不满）与低生活质量独立相关（均<0.05）。生活质量较低的医生更有可能认可每个项目（比值比：1.76 - 5.86），且获得良好指数评分的可能性较小（均<0.001）。假设低生活质量的患病率为29.2%，PWBI可将检验后概率降低至6.9%或提高至70.8%。PWBI得分≥4的医生经历各种精神困扰的风险增加（似然比>1），在检测职业倦怠、抑郁、高压力和焦虑方面的敏感性超过80%。此外，PWBI得分有助于对医生报告医疗差错和离职意向的可能性进行分层。
本研究为9项PWBI作为评估中国医生困扰和幸福感的筛查工具的有效性和实用性提供了初步见解，有助于识别医疗差错或离职风险较高的医生。然而，由于样本量有限，这些发现应谨慎解读。
