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用于捕捉和衡量医生幸福感的核心结局集应包括哪些结局?一项德尔菲研究。

Which outcomes should be included in a core outcome set for capturing and measuring doctor well-being? A Delphi study.

作者信息

Simons Gemma, Klepacz Naomi, Baldwin David S

机构信息

University of Southampton Faculty of Medicine, Southampton, UK.

Hampshire and Isle of Wight NHS Foundation Trust, Southampton, UK.

出版信息

BMJ Open. 2025 May 13;15(5):e094973. doi: 10.1136/bmjopen-2024-094973.

DOI:10.1136/bmjopen-2024-094973
PMID:40360398
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12083382/
Abstract

OBJECTIVES

To develop a core outcome set (COS) to capture and measure the well-being of doctors working in the National Health Service (NHS).

DESIGN

An online Delphi study.

SETTING

UK NHS.

PARTICIPANTS

Participants from four stakeholder groups: (1) those who might use the COS in research, (2) organisations that measure/capture NHS staff well-being, (3) professionals with experience managing NHS staff well-being and (4) NHS doctors were identified through authorship of relevant publications, attendee lists of doctor well-being conferences and meetings, professional bodies, participation in a previous study and recommendations from others. They were recruited via email.

INTERVENTIONS

A two-stage process: (1) creating a list of 43 well-being outcomes informed by a systematic review of well-being measurement instruments, a survey of UK doctors and two doctor engagement workshops and (2) an online Delphi study (with two rounds) to reach consensus. Outcomes were rated on a 9-point Likert scale; 'consensus' was reached when ≥75% agreed that an outcome was critical for inclusion in the COS.

RESULTS

52 participants completed both Delphi rounds. Seven well-being outcomes met the threshold for inclusion in the COS: general well-being, health, personal safety, job satisfaction, morale, life work balance and good clinical practice.

CONCLUSIONS

Use of the COS has the potential to reduce heterogeneity and standardise the capture and measurement of doctor well-being, and ensure outcomes important to all stakeholders are reported.

TRIAL REGISTRATION

This study was prospectively registered with the Core Outcome Measures in Effectiveness Trial initiative at www.comet-initiative.org (Registration: 1577).

摘要

目标

制定一套核心结局集(COS),以捕捉和衡量在国民健康服务体系(NHS)工作的医生的幸福感。

设计

在线德尔菲研究。

背景

英国国民健康服务体系。

参与者

来自四个利益相关者群体的参与者:(1)可能在研究中使用该核心结局集的人员;(2)衡量/获取国民健康服务体系工作人员幸福感的组织;(3)有管理国民健康服务体系工作人员幸福感经验的专业人员;(4)通过相关出版物的作者身份、医生幸福感会议和活动的参会名单、专业团体、参与之前的研究以及他人推荐确定的国民健康服务体系医生。通过电子邮件招募他们。

干预措施

分两个阶段进行:(1)通过对幸福感测量工具的系统评价、对英国医生的调查以及两次医生参与研讨会,创建一份包含43项幸福感结局的清单;(2)进行两轮在线德尔菲研究以达成共识。结局按照9分制李克特量表进行评分;当≥75%的人认为某一结局对于纳入核心结局集至关重要时,即达成“共识”。

结果

52名参与者完成了两轮德尔菲研究。七项幸福感结局达到了纳入核心结局集的阈值:总体幸福感、健康、个人安全、工作满意度、士气、生活工作平衡以及良好的临床实践。

结论

使用该核心结局集有可能减少异质性,使医生幸福感的捕捉和测量标准化,并确保报告对所有利益相关者都重要的结局。

试验注册

本研究已在www.comet - initiative.org的有效性试验核心结局测量倡议中进行了前瞻性注册(注册号:1577)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f502/12083382/42a90d3e3354/bmjopen-15-5-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f502/12083382/42a90d3e3354/bmjopen-15-5-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f502/12083382/42a90d3e3354/bmjopen-15-5-g001.jpg

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Relationship between working conditions and psychological distress experienced by junior doctors in the UK during the COVID-19 pandemic: a cross-sectional survey study.
英国 COVID-19 大流行期间初级医生工作条件与心理困扰的关系:一项横断面调查研究。
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Review finds core outcome set uptake in new studies and systematic reviews needs improvement.综述发现,新研究和系统评价中核心结局集的采用情况有待改善。
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