The Impact of Stigma and Personal Experiences on the Help-Seeking Behaviors of Medical Students With Burnout
The Impact of Stigma and Personal Experiences on the Help-Seeking Behaviors of Medical Students With Burnout
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DOI：
10.1097/acm.0000000000000655
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发表时间：
2015-07-01
影响因子：
7.4
通讯作者：
Shanafelt, Tait D.
中科院分区：
文献类型：
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作者：
Dyrbye, Liselotte N.;Eacker, Anne;Shanafelt, Tait D.
目的 由于医学生中职业倦怠的高发率及其与职业和个人后果的关联，作者评估了职业倦怠医学生的寻求帮助行为，并将他们的耻辱感与美国普通民众和同龄人的耻辱感进行了比较。 方法 作者于 2012 年对六所医学院的学生进行了调查。他们使用经过验证的仪器测量了职业倦怠、抑郁症状和生活质量，并探讨了寻求帮助的行为、感知到的耻辱、个人经历以及寻求帮助的态度心理健康治疗。结果 在 2,449 名受邀学生中，873 名（35.6%）做出了回应。三分之一的倦怠受访者（154/454；33.9%）在过去 12 个月内因情绪/心理健康问题寻求帮助。与没有倦怠的受访者相比，有倦怠的受访者更有可能同意或强烈同意 10 个感知耻辱项目中的 8 个。过去 12 个月内寻求帮助的倦怠受访者报告观察到导师对寻求帮助的学生做出负面评价的可能性是前者的两倍（比值比 [OR] 2.06 [95% 置信区间 (CI) 1.25-3.39]，P < .01）。他们也更有可能观察到同龄人向其他人透露学生的情绪/心理健康问题（OR 1.63 [95% CI 1.08-2.47]，P = .02）。与一般人群 (44.3%) 和同龄人 (38.8%) 相比，肯定会因严重情绪问题寻求专业帮助的受访者比例 (235/872; 26.9%) 较小。结论 只有三分之一的职业倦怠医学生寻求帮助。感知到的耻辱、负面的个人经历和隐藏的课程可能有所贡献。
Purpose Because of the high prevalence of burnout among medical students and its association with professional and personal consequences, the authors evaluated the help-seeking behaviors of medical students with burnout and compared their stigma perceptions with those of the general U.S. population and age-matched individuals.Method The authors surveyed students at six medical schools in 2012. They measured burnout, symptoms of depression, and quality of life using validated instruments and explored help-seeking behaviors, perceived stigma, personal experiences, and attitudes toward seeking mental health treatment.Results Of 2,449 invited students, 873 (35.6%) responded. A third of respondents with burnout (154/454; 33.9%) sought help for an emotional/mental health problem in the last 12 months. Respondents with burnout were more likely than those without burnout to agree or strongly agree with 8 of 10 perceived stigma items. Respondents with burnout who sought help in the last 12 months were twice as likely to report having observed supervisors negatively judge students who sought care (odds ratio [OR] 2.06 [95% confidence interval (CI) 1.25-3.39], P < .01). They also were more likely to have observed peers reveal a student's emotional/mental health problem to others (OR 1.63 [95% CI 1.08-2.47], P = .02). A smaller percentage of respondents would definitely seek professional help for a serious emotional problem (235/872; 26.9%) than of the general population (44.3%) and age-matched individuals (38.8%).Conclusions Only a third of medical students with burnout seek help. Perceived stigma, negative personal experiences, and the hidden curriculum may contribute.