Dorcélus Ludentz, Etienne Vernet, Mathieu Emmanuel, Dorestant Kesnel, Saintérant Ornella
Hôpital Universitaire de Mirebalais, Mirebalais, Haïti
Hôpital Universitaire de Mirebalais, Mirebalais, Haïti.
BMJ Open. 2025 Apr 17;15(4):e087847. doi: 10.1136/bmjopen-2024-087847.
To investigate the prevalence and risk factors associated with burnout among residents and to explain their experiences with burnout.
Mixed-methods convergent parallel study with an explanatory follow-up.
One tertiary hospital in Mirebalais and one community hospital in Saint-Marc.
Of the 127 registered residents in both settings, 26 were excluded because they were on leave. Therefore, 101 were asked to participate. We received responses from 98 residents (response rate 97.02%).
Data collection took part in two stages: quantitative data collection was first made over a 2-week period in July 2023 using a questionnaire which included the Maslach Burnout Inventory. We simultaneously conducted a qualitative analysis based on three questions around which stress factors were related to work, personal fulfilment and social issues in the questionnaire. Second, following preliminary data results, one focus group was held with the seven chief residents to bring an in-depth understanding of the quantitative data analysis from the study questionnaire.
Sociodemographic and clinical factors linked to burnout for quantitative data. The themes explored for qualitative data were stress factors related to work, personal fulfilment and social issues. One focus group held with the chief residents explained, based on preliminary results, the main causes of burnout among medical residents, influencing factors, coping strategies and perspectives.
Five major findings emerged from the quantitative data, including the following: (a) burnout prevalence was 79.59%; (b) 43% of the residents estimated working more than 80 hours/week; (c) the group with the highest burnout rates were the second-year postgraduate residents (p=0.01); (d) paediatrics and family medicine residents had the highest mean score of emotional exhaustion (p=0.01); (e) general surgery/orthopaedics and paediatrics had the highest mean score of depersonalisation (p<0.01). For the qualitative data, five categories were linked to burnout: the residents' quality of life, their feelings of ineffectiveness, their regrets for choosing to do residency in Haiti, the hospital's admission policy and social factors.
Burnout prevalence was significantly high. The medical education department needs to implement initiatives that improve patient healthcare, boost the residents' morale and comply with accreditation standards. A cohort study or quality improvement project investigating the impact of interventions might also be suitable, or a study at different times of the academic year and in a less volatile period of time in Haiti might provide a more complete picture of the onset of this syndrome.
调查住院医师职业倦怠的患病率及相关危险因素，并阐释他们职业倦怠的经历。
采用解释性随访的混合方法收敛平行研究。
米雷巴莱的一家三级医院和圣马克的一家社区医院。
在这两家医院登记的127名住院医师中，26名因休假被排除。因此，邀请了101名参与。我们收到了98名住院医师的回复（回复率97.02%）。
数据收集分两个阶段进行：2023年7月，首先在两周内使用包含马氏职业倦怠量表的问卷进行定量数据收集。我们同时基于问卷中围绕工作、个人成就感和社会问题的三个与压力因素相关的问题进行了定性分析。其次，根据初步数据结果，与7名总住院医师进行了一次焦点小组讨论，以深入理解研究问卷的定量数据分析。
定量数据方面，与职业倦怠相关的社会人口统计学和临床因素。定性数据探索的主题是与工作、个人成就感和社会问题相关的压力因素。与总住院医师进行的一次焦点小组讨论根据初步结果解释了住院医师职业倦怠的主要原因、影响因素、应对策略和观点。
定量数据得出了五个主要发现，包括：(a)职业倦怠患病率为79.59%；(b)43%的住院医师估计每周工作超过80小时；(c)职业倦怠率最高的群体是二年级研究生住院医师（p=0.01）；(d)儿科和家庭医学住院医师情感耗竭的平均得分最高（p=0.01）；(e)普通外科/骨科和儿科去个性化的平均得分最高（p<0.01）。对于定性数据，有五类与职业倦怠相关：住院医师的生活质量、他们的无效感、他们对选择在海地做住院医师的遗憾、医院的入院政策和社会因素。
职业倦怠患病率显著较高。医学教育部门需要实施一些举措，改善患者医疗保健，提升住院医师的士气，并符合认证标准。一项调查干预措施影响的队列研究或质量改进项目可能也合适，或者在学年不同时间以及海地较稳定时期进行的研究可能会更全面地呈现这种综合征的发病情况。
