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美国的新冠疫情与医生职业倦怠:一项全国性调查的横断面和纵向证据

COVID-19 and Physician Burnout in the United States: Cross-Sectional and Longitudinal Evidence From a National Survey.

作者信息

Sarode Anuja L, Hu Xiaochu, Dill Michael J

机构信息

Summa Health, Research and Innovation, DISCOVER Center, Akron, Ohio, USA.

Workforce Studies, the Association of American Medical Colleges, Washington, DC, USA.

出版信息

Health Serv Res. 2025 Aug 13:e70003. doi: 10.1111/1475-6773.70003.

Abstract

OBJECTIVE

To evaluate the impact of the COVID-19 pandemic on physician burnout.

STUDY SETTING AND DESIGN

This observational study spanned from 2019 to 2022, involving active US physicians from various settings. We applied logistic regression to cross-sectional data to examine the associations between COVID-19-affected aspects of physicians' work and practice and physician burnout, and used repeated measures of ANOVA on longitudinal data to determine changes in burnout before and during COVID-19.

DATA SOURCES AND ANALYTIC SAMPLE

Both cross-sectional (n = 5917) and longitudinal data (n = 2429) were drawn from the Association of American Medical Colleges (AAMC)'s National Sample Survey of Physicians (NSSP), collected in 2019 and 2022. Burnout was measured using a Maslach Burnout Inventory item, while COVID-19-affected aspects were reported in 2022.

PRINCIPAL FINDINGS

In 2022, 31.68% of respondents reported burnout once a week or higher. One in five physicians (19.43%) reported that COVID affected at least one aspect of their work status, while 67.77% reported that it affected at least one aspect of their practice. Cross-sectional analysis found that high burnout was reported by 30.41% of physicians whose work was not affected by COVID-19, compared to 37.00% (95% CI: 32.20-41.79, p = 0.015) among those who reported at least one affected aspect. Similarly, high burnout was reported by 27.19% of physicians with no COVID-affected practice aspects and 33.83% (95% CI: 31.42-36.24, p = 0.002) of those with at least one affected aspect. Longitudinal analysis revealed a 0.07 (p = 0.001) increase in burnout frequency on the 0-4 scale from 2019 to 2022. Increased work hours (b = 0.01, p < 0.001) and transitioning from other specialties into primary care specialties (b = 0.15, p < 0.001) significantly contributed to increased burnout.

CONCLUSIONS

These findings quantify the detrimental effects of COVID-19-related work and practice changes on burnout and provide insights for policymakers and healthcare organizations to develop targeted strategies to mitigate the negative impacts of future public health crises.

摘要

目的

评估新冠疫情对医生职业倦怠的影响。

研究背景与设计

这项观察性研究涵盖2019年至2022年,涉及美国不同工作环境下的在职医生。我们对横断面数据应用逻辑回归,以检验医生工作和执业中受新冠影响的方面与医生职业倦怠之间的关联,并对纵向数据使用重复测量方差分析来确定新冠疫情之前和期间职业倦怠的变化。

数据来源与分析样本

横断面数据(n = 5917)和纵向数据(n = 2429)均取自美国医学院协会(AAMC)的医生全国抽样调查(NSSP),于2019年和2022年收集。职业倦怠采用马氏职业倦怠量表项目进行测量,而受新冠影响的方面则在2022年进行报告。

主要发现

2022年,31.68%的受访者报告每周至少出现一次职业倦怠。五分之一的医生(19.43%)报告新冠影响了他们工作状态的至少一个方面,而67.77%的医生报告新冠影响了他们执业的至少一个方面。横断面分析发现,工作未受新冠影响的医生中有30.41%报告有高度职业倦怠,而报告至少有一个受影响方面的医生中这一比例为37.00%(95%置信区间:32.20 - 41.79,p = 0.015)。同样,执业未受新冠影响的医生中有27.19%报告有高度职业倦怠,而至少有一个受影响方面的医生中这一比例为33.83%(95%置信区间:31.42 - 36.24,p = 0.002)。纵向分析显示,从2019年到2022年,职业倦怠频率在0 - 4量表上增加了0.07(p = 0.001)。工作时长增加(b = 0.01,p < 0.001)以及从其他专科转向初级保健专科(b = 0.15,p < 0.001)显著导致职业倦怠增加。

结论

这些发现量化了与新冠相关的工作和执业变化对职业倦怠的有害影响,并为政策制定者和医疗保健组织提供了见解,以制定有针对性的策略来减轻未来公共卫生危机的负面影响。

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