Factors associated with burnout among US neurosurgery residents: a nationwide survey
Factors associated with burnout among US neurosurgery residents: a nationwide survey
复制标题
DOI：
10.3171/2017.9.jns17996
复制
发表时间：
2018-11-01
影响因子：
4.1
通讯作者：
Klimo, Paul, Jr.
中科院分区：
文献类型：
--
作者：
Attenello, Frank J.;Buchanan, Ian A.;Klimo, Paul, Jr.
目的 医生过度的不满和压力会导致职业倦怠，从而导致工作效率、护理质量、患者满意度和治疗依从性下降。鉴于其危害的多重性以及对劳动力保留的损害，以及医生日益短缺，职业倦怠近年来引起了广泛关注。作者通过一项全国性调查，正式评估了神经外科实习生的职业倦怠情况。 方法 2015 年 6 月至 11 月期间，向美国神经外科医生协会数据库中的居民发放了一份包含 86 项的调查问卷。问题评估了个人和工作场所压力源、指导、职业满意度和职业倦怠。使用先前验证的 Maslach 倦怠量表来评估倦怠。使用单变量和多变量逻辑回归确定与倦怠相关的因素。 结果 已完成调查的答复率为 21% (346/1643)。大多数居民为男性（78%）、26-35岁（92%）、有稳定关系（70%）、没有孩子（73%）。受访者在所有住院医师年中的分布均匀。 81% 的居民对自己的职业选择感到满意，尽管 41% 的居民曾在某个时候认真考虑过辞职。总体倦怠率为67%。在多变量分析中，与倦怠相关的显着因素包括手术室暴露不足（OR 7.57，p = 0.011）、敌对教师（OR 4.07，p = 0.008）和工作之外的社会压力源（OR 4.52，p = 0.008）。在多元回归模型中，有意义的指导可以防止倦怠（OR 0.338，p = 0.031）。 结论 神经外科受训者的倦怠率和职业满意度却异常高。虽然有几个因素可以预测职业倦怠，包括手术暴露不足和社会压力源，但有意义的指导被证明可以防止职业倦怠。已记录的职业倦怠对患者护理和医疗保健经济的负面影响需要进一步研究潜在的解决方案来遏制其上升。
OBJECTIVE Excessive dissatisfaction and stress among physicians can precipitate burnout, which results in diminished productivity, quality of care, and patient satisfaction and treatment adherence. Given the multiplicity of its harms and detriments to workforce retention and in light of the growing physician shortage, burnout has garnered much attention in recent years. Using a national survey, the authors formally evaluated burnout among neurosurgery trainees.METHODS An 86-item questionnaire was disseminated to residents in the American Association of Neurological Surgeons database between June and November 2015. Questions evaluated personal and workplace stressors, mentorship, career satisfaction, and burnout. Burnout was assessed using the previously validated Maslach Burnout Inventory. Factors associated with burnout were determined using univariate and multivariate logistic regression.RESULTS The response rate with completed surveys was 21% (346/1643). The majority of residents were male (78%), 26-35 years old (92%), in a stable relationship (70%), and without children (73%). Respondents were equally distributed across all residency years. Eighty-one percent of residents were satisfied with their career choice, although 41% had at some point given serious thought to quitting. The overall burnout rate was 67%. In the multivariate analysis, notable factors associated with burnout included inadequate operating room exposure (OR 7.57, p = 0.011), hostile faculty (OR 4.07, p = 0.008), and social stressors outside of work (OR 4.52, p = 0.008). Meaningful mentorship was protective against burnout in the multivariate regression models (OR 0.338, p = 0.031).CONCLUSIONS Rates of burnout and career satisfaction are paradoxically high among neurosurgery trainees. While several factors were predictive of burnout, including inadequate operative exposure and social stressors, meaningful mentorship proved to be protective against burnout. The documented negative effects of burnout on patient care and health care economics necessitate further studies for potential solutions to curb its rise.