Factors associated with resilience to and recovery from burnout: a prospective, multi-institutional study of US medical students
Factors associated with resilience to and recovery from burnout: a prospective, multi-institutional study of US medical students
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DOI：
10.1111/j.1365-2923.2010.03754.x
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发表时间：
2010-10-01
影响因子：
6
通讯作者：
Shanafelt, Tait D.
中科院分区：
文献类型：
--
作者：
Dyrbye, Liselotte N.;Power, David V.;Shanafelt, Tait D.
背景倦怠在医学生中普遍存在，是随后严重考虑辍学和自杀意念的预测因子。了解的因素，防止倦怠需要指导学生wellness programmes.METHODS共1321名医学生参加五个机构进行了纵向研究（2006-2007年）。这些调查包括标准化的工具，以评估倦怠，生活质量，疲劳和压力。其他项目探讨了社会支持，学习气氛，生活事件，就业状况和人口统计学。在任何一个时间点没有倦怠的学生（弹性学生）与那些在一个或两个时间点表示倦怠的学生（弱势学生）进行了比较，使用Wilcoxon Mann Whitney检验或Fisher精确检验。同样，在第一个时间点上，也比较了恢复者和慢性倦怠者之间的差异。Logistic回归模型进行评估的独立变量和弹性之间的关联，并恢复burnus.Results总体而言，792（60.0%）的学生完成了倦怠量表在这两个时间点。弹性（290/792 [36.6%]）和脆弱（502/792 [63.4%]）学生之间的人口统计学特征没有差异。弹性学生不太可能经历抑郁，生活质量更高，不太可能被雇用，经历更少的压力生活事件，报告更高水平的社会支持，更积极地感知他们的学习氛围，经历更少的压力和疲劳（所有p < 0.05）比脆弱的学生。在多变量分析，感知学生教育作为一个优先考虑的教职员工，经历较少的压力，不被雇用，是一个少数民族的因素独立相关的恢复burnus.CONCLUSIONS可修改的个人因素和学习气候特征，包括就业状况，压力水平和学生教育的优先考虑的教职员工的看法与医学生的脆弱性倦怠。
CONTEXT Burnout is prevalent among medical students and is a predictor of subsequent serious consideration of dropping out of medical school and suicide ideation. Understanding of the factors that protect against burnout is needed to guide student wellness programmes.METHODS A total of 1321 medical students attending five institutions were studied longitudinally (2006-2007). The surveys included standardised instruments to evaluate burnout, quality of life, fatigue and stress. Additional items explored social support, learning climate, life events, employment status and demographics. Students who did not have burnout at either time-point (resilient students) were compared with those who indicated burnout at one or both time-points (vulnerable students) using a Wilcoxon Mann Whitney test or Fisher's exact test. Similarly, the differences between those who recovered and those who were chronically burned out were also compared in students with burnout at the first time-point. Logistic regression modelling was employed to evaluate associations between the independent variables and resiliency to and recovery from burnout.RESULTS Overall, 792 (60.0%) students completed the burnout inventory at both time-points. No differences in demographic characteristics were observed between resilient (290/792 [36.6%]) and vulnerable (502/792 [63.4%]) students. Resilient students were less likely to experience depression, had a higher quality of life, were less likely to be employed, had experienced fewer stressful life events, reported higher levels of social support, perceived their learning climate more positively and experienced less stress and fatigue (all p < 0.05) than vulnerable students. On multivariable analysis, perceiving student education as a priority for faculty staff, experiencing less stress, not being employed and being a minority were factors independently associated with recovery from burnout.CONCLUSIONS Modifiable individual factors and learning climate characteristics including employment status, stress level and perceptions of the prioritising of student education by faculty members relate to medical students' vulnerability to burnout.