"A slap in the face": Institutional betrayal, burnout, and career choice regret among frontline health care workers serving COVID-19 patients.
"A slap in the face": Institutional betrayal, burnout, and career choice regret among frontline health care workers serving COVID-19 patients.
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“一记耳光”：为COVID-19患者服务的一线医护人员的制度背叛、倦怠和职业选择遗憾。
DOI：
10.1002/jts.22967
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发表时间：
2023
影响因子：
3.3
通讯作者：
Veenema,TenerGoodwin
中科院分区：
文献类型：
--
作者：
Park,Soim;Closser,Svea;Cooney,ErinE;Atkins,Kaitlyn;Thrul,Johannes;McDonald,KathrynM;Langhinrichsen-Rohling,Jennifer;Veenema,TenerGoodwin
2019冠状病毒病大流行对医护人员和医院工作人员（HHW）的身心健康造成了严重影响。为提供COVID-19护理，卫生保健工作者期望医疗保健机构支持设备和资源，确保患者和提供者的安全，并倡导员工的需求。不这样做被定义为体制背叛。本研究采用混合方法，旨在探讨为COVID-19患者服务的HHWs的制度背叛经历，以及自我报告的制度背叛与职业倦怠和职业选择后悔之间的关联。在2020年7月至2021年1月期间，在美国城市医疗保健系统工作的HHWs参与了在线调查（n= 1，189）和半结构化访谈（n= 67）。在1,075名量化参与者中，57.8%的人支持机构背叛。定性参与者描述了挫折感时，该机构没有优先考虑他们的安全，同时报告他们认为从系统中获得的补偿不足，并认为领导层没有充分满足他们的需求。支持长期违反信任的参与者报告了更多的倦怠和更强烈的辞职意图。定量而言，与没有认可相比，机构背叛认可与倦怠的3倍高几率相关，aOR= 2.94，95%CI [2.22，3.89]，职业选择后悔的4倍高几率相关，aOR= 4.31，95%CI [3.15，5.89]。制定战略，以防止，解决和修复机构背叛HHWs可能是至关重要的，以防止和减少倦怠，并增加工作的动力，在公共卫生突发事件期间和之后。
The COVID‐19 pandemic has exacted a physical and mental health toll on health care and hospital workers (HHWs). To provide COVID‐19 care, HHWs expected health care institutions to support equipment and resources, ensure safety for patients and providers, and advocate for employees’ needs. Failure to do these acts has been defined as institutional betrayal. Using a mixed‐methods approach, this study aimed to explore the experience of institutional betrayal in HHWs serving COVID‐19 patients and the associations between self‐reported institutional betrayal and both burnout and career choice regret. Between July 2020 and January 2021, HHWs working in an urban U.S. health care system participated in an online survey (n= 1,189) and semistructured interview (n= 67). Among 1,075 quantitative participants, 57.8% endorsed institutional betrayal. Qualitative participants described frustration when the institution did not prioritize their safety while reporting they perceived receiving inadequate compensation from the system and felt that leadership did not sufficiently respond to their needs. Participants who endorsed prolonged breaches of trust reported more burnout and stronger intent to quit their job. Quantitatively, institutional betrayal endorsement was associated with 3‐fold higher odds of burnout, aOR= 2.94, 95% CI [2.22, 3.89], and 4‐fold higher odds of career choice regret, aOR= 4.31, 95% CI [3.15, 5.89], compared to no endorsement. Developing strategies to prevent, address, and repair institutional betrayal in HHWs may be critical to prevent and reduce burnout and increase motivation to work during and after public health emergencies.
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