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探索医疗保健专业人员的职业倦怠和不确定性:罕见病背景下的路径分析

Exploring burnout and uncertainty in healthcare professionals: a path analysis within the context of rare diseases.

作者信息

Zybarth David, Inhestern Laura, Bergelt Corinna

机构信息

Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany.

出版信息

Front Public Health. 2025 Feb 27;13:1417771. doi: 10.3389/fpubh.2025.1417771. eCollection 2025.

Abstract

Burnout among physicians has gained increasing attention in recent years. This issue arises not only from stressful working conditions and individual factors but also from the correlation between burnout and physicians' tolerance of uncertainty. This association could be particularly important in the context of rare diseases, which inherently present greater uncertainty. To date, no studies have explored this topic. Our exploratory study aimed to investigate the associations between uncertainty and burnout scores among physicians while considering secondary factors associated with rare diseases and COVID-related stress. Although not the primary focus, we included COVID-related stress due to its impact during the ongoing pandemic. We conducted an online survey using the Physicians' Reaction to Uncertainty Scale (PRU) and the Oldenburg Burnout Inventory (OLBI). Experience with rare diseases was quantified by assessing the weekly working hours devoted to patients with such conditions. We conducted a path analysis, initially using a fully recursive model and subsequently eliminating non-significant paths. 128 physicians ( = 73 female) participated in the survey, with 31% of them displaying significant burnout scores. Notably, significant associations were found between the PRU subscale anxiety and both dimensions of burnout, as well as between the PRU subscale disclosure to patients and the burnout dimension of exhaustion. COVID-related stress was also significantly associated with exhaustion, while experience with rare diseases was significantly associated with disengagement. No correlation was observed between experience with rare diseases and uncertainty scores. The model demonstrated an excellent fit (RMSEA = 0.055). Our results show that physician burnout is a pressing issue and confirm the association between anxiety due to uncertainty and increased burnout scores.

摘要

近年来,医生职业倦怠问题日益受到关注。这个问题不仅源于紧张的工作条件和个人因素,还源于职业倦怠与医生对不确定性的容忍度之间的关联。在罕见病领域,这种关联可能尤为重要,因为罕见病本身就存在更大的不确定性。迄今为止,尚无研究探讨过这个话题。我们的探索性研究旨在调查医生中不确定性与职业倦怠得分之间的关联,同时考虑与罕见病及新冠相关压力有关的次要因素。尽管不是主要关注点,但由于新冠疫情期间的影响,我们将新冠相关压力纳入了研究。我们使用医生对不确定性的反应量表(PRU)和奥尔登堡职业倦怠量表(OLBI)进行了一项在线调查。通过评估每周用于诊治罕见病患者的工作时长来量化罕见病诊疗经验。我们进行了路径分析,最初使用完全递归模型,随后剔除无显著意义的路径。128名医生(73名女性)参与了调查,其中31%的人表现出显著的职业倦怠得分。值得注意的是,PRU焦虑子量表与职业倦怠的两个维度之间均存在显著关联,PRU向患者披露子量表与倦怠的耗竭维度之间也存在显著关联。新冠相关压力也与耗竭显著相关,而罕见病诊疗经验与倦怠的去人格化维度显著相关。未观察到罕见病诊疗经验与不确定性得分之间存在相关性。该模型显示出极佳的拟合度(RMSEA = 0.055)。我们的研究结果表明,医生职业倦怠是一个紧迫的问题,并证实了因不确定性导致的焦虑与职业倦怠得分升高之间的关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af5f/11903758/8af3c3e53502/fpubh-13-1417771-g001.jpg

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