德国神经科住院医师和专科医生经历的与工作相关的压力事件和职业倦怠：来自全国性调查的患病率、原因及应对策略

Work-related stressful events and burnout experienced by residents and specialists in German neurology: prevalence, causes, and coping strategies derived from a nationwide survey.

作者信息

Piel Johannes Heinrich Alexander, Biesalski Anne-Sophie, Wolke Robin, Rogge Annette, Topka Helge, Klein Matthias, Ploner Christoph Johannes, Andres Frank, Berg Daniela

机构信息

Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Department of Neurology, Ruhr-University Bochum, St. Josef Hospital, Bochum, Germany.

出版信息

Neurol Res Pract. 2025 Jul 28;7(1):52. doi: 10.1186/s42466-025-00415-x.

DOI:10.1186/s42466-025-00415-x

PMID:40722043

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12306127/

Abstract

BACKGROUND

Burnout is an increasing challenge and highly prevalent among healthcare professionals. Time-critical emergencies, high workload, the second-victim phenomenon, and moral distress have been identified as key risk factors of burnout. However, measures to mitigate the impact of stressful events have not yet been fully utilized and data in Germany is still limited.

METHODS

To address this gap, the Young Neurology section of the German Neurological Society conducted a nationwide survey between October 7 and November 18, 2024, assessing 318 Neurology residents and 175 Neurology specialists. The study examined the frequency of stressful events, risk factors, coping mechanisms, and burnout severity.

RESULTS

Stressful events occurred monthly and most often in emergency rooms, intensive care units, and general wards. Most residents were at risk of burnout and often lacked direct supervision during critical incidents. Common training-independent causes were high patient numbers, the second-victim phenomenon, and poor communication. Knowledge and skill related causes were specific to residents. Burnout was independently correlated to the frequency of stressful events, job satisfaction, institutional factors, age, number of children, and debriefing offer. While job satisfaction was generally good, 30% of participants thought about changing the employer and 10% about leaving Neurology. Dysfunctional coping strategies including the use of alcohol and medication were common and significantly correlated with increased burnout risk. The most relevant mitigation strategies were structured onboarding, debriefing, and improvement of processes.

CONCLUSION

Our findings confirm high burnout rates, particularly during residency, and highlight the urgent need for targeted intervention.

TRIAL REGISTRATION

The study was registered in the German Clinical Trial Register (DRKS-ID DRKS00035214) on 7 October 2024.

摘要

背景

职业倦怠是一个日益严峻的挑战，在医疗保健专业人员中极为普遍。时间紧迫的紧急情况、高工作量、“二次受害者”现象以及道德困扰已被确定为职业倦怠的关键风险因素。然而，减轻压力事件影响的措施尚未得到充分利用，德国的相关数据仍然有限。

方法

为了填补这一空白，德国神经病学协会青年神经病学分会于2024年10月7日至11月18日进行了一项全国性调查，评估了318名神经科住院医师和175名神经科专科医生。该研究调查了压力事件的发生频率、风险因素、应对机制以及职业倦怠的严重程度。

结果

压力事件每月都会发生，最常出现在急诊室、重症监护病房和普通病房。大多数住院医师有职业倦怠的风险，在危急事件期间往往缺乏直接监督。常见的与培训无关的原因是患者数量多、“二次受害者”现象以及沟通不畅。与知识和技能相关的原因则因住院医师而异。职业倦怠与压力事件的频率、工作满意度、机构因素、年龄、子女数量以及汇报机会独立相关。虽然工作满意度总体良好，但30%的参与者考虑更换雇主，10%的参与者考虑离开神经科领域。包括饮酒和使用药物在内的功能失调应对策略很常见，并且与职业倦怠风险增加显著相关。最相关的缓解策略包括结构化入职培训、汇报以及流程改进。