Risk and Resilience Factors Associated with Resident Burnout
Risk and Resilience Factors Associated with Resident Burnout
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DOI：
10.1007/s40596-016-0628-6
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发表时间：
2017-04-01
影响因子：
2.5
通讯作者：
Denninger, John W.
中科院分区：
文献类型：
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作者：
Chaukos, Deanna;Chad-Friedman, Emma;Denninger, John W.
目的 我们调查了假设的风险和复原力因素及其与城市教学医院第一年医学和精神病学住院医师职业倦怠的关系，以帮助指导制定旨在减少职业倦怠的干预措施。方法我们使用了 Maslach 职业倦怠量表 (MBI)、感知压力量表 10、慢性病治疗疲劳量表功能评估、宾夕法尼亚州立大学忧虑问卷、患者健康问卷 9（抑郁症）在 6 月份开始临床轮换之前，对第一年医学和精神病学住院医师进行了修订后的生活取向测试（乐观）、自我效能问卷、认知和情感正念量表、人际反应指数观点采择量表（同理心）和现状测量 - A 部分。 结果 响应率为 91 %（75 名住院医师中的 68 名）。十九名受访者 (28%) 符合 MBI 衡量的职业倦怠标准。倦怠的居民在评估感知压力（科恩 d = 0.97；p = 0.004）、疲劳（d = 0.79；p = 0.018）、担忧（d = 0.88；p = 0.0009）和抑郁症状（d = 0.84；p = 0.035）的自我报告测量中得分较高，而在评估正念的问卷中得分较低（d = -0.63；p = 0.029）和应对能力（d = -0.79；p = 0.003）。 结论 在使用自我报告措施的横断面评估中，我们发现近三分之一的第一年住院医师在开始实习之前经历过倦怠。他们表现出较低水平的正念和应对技巧，以及较高水平的抑郁症状、疲劳、担忧和压力。这些初步发现应该鼓励项目启动和研究结合正念和自我意识应对策略的课程，以增强或防止倦怠，以及认知行为辅导策略，以抵消存在的倦怠症状。
Objective We investigated hypothesized risk and resilience factors and their association with burnout in first year medicine and psychiatry residents at an urban teaching hospital in order to help guide the development of interventions targeted at reducing burnout.Methods We administered the Maslach Burnout Inventory (MBI), Perceived Stress Scale-10, Functional Assessment of Chronic Illness Therapy-Fatigue Scale, Penn State Worry Questionnaire, Patient Health Questionnaire-9 (depression symptoms), Revised Life Orientation Test (optimism), Self-Efficacy Questionnaire, Cognitive and Affective Mindfulness Scale, Interpersonal Reactivity Index Perspective-Taking Scale (empathy), and Measure of Current Status-Part A to first year medicine and psychiatry residents prior to initiation of clinical rotations in June.Results The response rate was 91 % (68 of 75 residents). Nineteen respondents (28 %) met criteria for burnout as measured by the MBI. Residents with burnout scored higher on self-report measures assessing perceived stress (Cohen's d = 0.97; p = 0.004), fatigue (d = 0.79; p = 0.018), worry (d = 0.88; p = 0.0009), and depression symptoms (d = 0.84; p = 0.035) and scored lower on questionnaires assessing mindfulness (d = -0.63; p = 0.029) and coping ability (d = -0.79; p = 0.003).Conclusions In a cross-sectional assessment using self-report measures, we found that nearly a third of first year residents prior to starting their internships experience burnout. They exhibit lower levels of mindfulness and coping skills and higher levels of depression symptoms, fatigue, worry, and stress. These preliminary findings should encourage programs to initiate and study curricula that combine mindfulness and self-awareness coping strategies to enhance or protect against burnout as well as cognitive behavioral coaching strategies to offset symptoms of burnout when present.