Explaining burnout and the intention to leave the profession among health professionals - a cross-sectional study in a hospital setting in Switzerland.
Explaining burnout and the intention to leave the profession among health professionals - a cross-sectional study in a hospital setting in Switzerland.
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DOI：
10.1186/s12913-018-3556-1
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发表时间：
2018-10-19
影响因子：
2.8
通讯作者：
Hämmig O
中科院分区：
文献类型：
--
作者：
Hämmig O
职业倦怠和离开职业的意图经常在医疗保健环境中被研究，而这些结果以前没有在不同的卫生专业中被一起调查过。本研究旨在探讨一般卫生专业人员，特别是护士和医生中与工作相关的职业倦怠和离职意向的解释因素或预测因素。采用瑞士德语区2015/16年6家公立医院和康复诊所1840名员工的横断面调查数据。采用多元逻辑分析和逐步线性回归分析来估计不同工作负荷和工作压力源对这些结果的相对风险（优势比）和标准化效应（beta系数），并研究它们之间可能存在的中介作用。平均而言，十二分之一的卫生专业人员表现出越来越严重的倦怠症状，六分之一的人经常考虑离开这个行业。时间上、身体上、情感上和精神上的工作量和工作压力与职业倦怠症状和离职念头密切相关。然而，在努力-回报和工作-生活失衡的情况下，倦怠症状增加和频繁离职念头的相对风险最高。事实上，这两种与工作有关的压力测量方法部分甚至很大程度上调节了暴露（工作量、工作压力）与结果之间的关系，并且被发现是所有方法中最强的预测因子。而工作与生活不平衡最能预测卫生专业人员的职业倦怠症状(β =。35)，尤其是医生(β =。48)，努力-回报不平衡最能预测离开职业的想法（β = 0.31 - 36）。在主要卫生专业和两种结果之间的完全指定的回归模型中解释了很大一部分差异。然而，解释差异最明显的是医生的倦怠症状（43.3%）和护士和助产士频繁离职的想法（28.7%）。减少工作量和工作压力，特别是奖励工作中的挫折，以及卫生专业人员在将工作和私人生活结合起来方面的困难，可能有助于防止他们产生倦怠和/或离开该行业，从而减少卫生保健机构的人员流动、提前退休、职业结束和人员不足。
Burnout and the intention to leave the profession are frequently studied outcomes in healthcare settings that have not been investigated together and across different health professions before. This study aimed to examine work-related explanatory factors or predictors of burnout and the intention to leave the profession among health professionals in general, and nurses and physicians in particular. Cross-sectional survey data of 1840 employees of six public hospitals and rehabilitation clinics recorded in 2015/16 in German-speaking Switzerland were used. Multiple logistic and stepwise linear regression analyses were performed to estimate the relative risks (odds ratios) and standardized effects (beta coefficients) of different workloads and work-related stressors on these outcomes and to study any possible mediation between them. On average, one in twelve health professionals showed increased burnout symptoms and every sixth one thought frequently of leaving the profession. Temporal, physical, emotional and mental workloads and job stresses were strongly and positively associated with burnout symptoms and thoughts of leaving the profession. However, the relative risks of increased burnout symptoms and frequent thoughts of leaving the profession were highest in the case of effort-reward and work-life imbalances. In fact, these two work-related stress measures partly or even largely mediated the relationships between exposures (workloads, job stresses) and outcomes and were found to be the strongest predictors of all. Whereas a work-life imbalance most strongly predicted burnout symptoms among health professionals (β = .35), and particularly physicians (β = .48), an effort-reward imbalance most strongly predicted thoughts of leaving the profession (β = .31–36). A substantial part of the variance was explained in the fully specified regression models across both major health professions and both outcomes. However, explained variance was most pronounced for burnout symptoms of physicians (43.3%) and for frequent thoughts of leaving the profession among nurses and midwives (28.7%). Reducing workload and job stress, and particularly reward frustration at work, as well as the difficulties in combining work and private lives among health professionals, may help to prevent them from developing burnout and/or leaving the profession and consequently also to reduce turnover, early retirement, career endings and understaffing in healthcare settings.
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影响因子：
3.4
作者：
Borritz, M;Rugulies, R;Kristensen, TS
通讯作者：
Kristensen, TS
影响因子：
2.8
作者：
Buessing, Arndt;Falkenberg, Zarah;Poier, Desiree
通讯作者：
Poier, Desiree
影响因子：
2.9
作者：
Haemmig, Oliver;Brauchli, Rebecca;Bauer, Georg F.
通讯作者：
Bauer, Georg F.
影响因子：
3
作者：
Van Gerven, Eva;Elst, Tinne Vander;Vanhaecht, Kris
通讯作者：
Vanhaecht, Kris
影响因子：
9.9
作者：
Netemeyer, RG;Boles, JS;McMurrian, R
通讯作者：
McMurrian, R