Identifying and Prioritizing Workplace Climate Predictors of Burnout Among VHA Primary Care Physicians.
Identifying and Prioritizing Workplace Climate Predictors of Burnout Among VHA Primary Care Physicians.
复制标题
DOI：
10.1007/s11606-021-07006-x
复制
发表时间：
2022-01
影响因子：
5.7
通讯作者：
Wong ES
中科院分区：
文献类型：
--
作者：
Sterling R;Rinne ST;Reddy A;Moldestad M;Kaboli P;Helfrich CD;Henrikson NB;Nelson KM;Kaminetzky C;Wong ES
职业倦怠，或与工作有关的压力，影响了超过一半的美国医生，初级保健医生（PCP）经历了一些最高的利率在医学。我们的研究分析了全国性的调查数据，以确定和优先考虑工作场所的气候预测在一个大型综合卫生系统的PCP之间的倦怠。对退伍军人健康管理局（VHA）2013-2017年全体员工调查（AES）年度调查数据的观察性研究。在研究期间，AES应答率范围为56%至60%。自变量和因变量从单独的随机样本中测量。按报告年份，在设施层面汇总了110个VHA实践地点的PCP的8，456份个人层面回复。我们使用了半自动LASSO程序，以确定工作场所的气候措施，更有影响力的预测倦怠和评估的相对重要性，使用Shapely值分解。自认为是PCP的VHA员工。因变量包括两个二分法的测量倦怠：情绪耗竭和人格解体。独立措施包括30项与工作场所气候各方面有关的调查措施（例如，工作量、领导力、满意度）。我们确定了七个有影响力的工作场所气候预测情绪疲惫和九个人格解体的预测。除了少数例外，较高的预测因子的一致性/满意度得分与较低的倦怠可能性相关。情绪衰竭的大部分解释变量可归因于工作量（32.6%），组织满意度（28.2%）和组织支持（19.4%）的看法。人格解体的大部分解释的变化是由于工作量（25.3%），组织满意度（22.9%），和连接到VHA使命（20.7%）。确定工作场所气候的相对重要性是重要的卫生组织资源的分配，以减轻和防止PCP工作场所内的倦怠。在资源有限的情况下，努力减少感知工作量和提高组织满意度可能是卫生组织解决医生倦怠的最大杠杆点。在线版本包含补充材料，可通过10.1007/s11606-021-07006-x获取。
Burnout, or job-related stress, affects more than half of all US physicians, with primary care physicians (PCPs) experiencing some of the highest rates in medicine. Our study analyzes national survey data to identify and prioritize workplace climate predictors of burnout among PCPs within a large integrated health system. Observational study of annual survey data from the Veterans Health Administration (VHA) All Employee Survey (AES) for 2013–2017. AES response rate ranged from 56 to 60% during the study period. Independent and dependent variables were measured from separate random samples. In total, 8,456 individual-level responses among PCPs at 110 VHA practice sites were aggregated at the facility level by reporting year. We used the semi-automated LASSO procedure to identify workplace climate measures that were more influential in predicting burnout and assessed relative importance using the Shapely value decomposition. VHA employees that self-identify as PCPs. Dependent variables included two dichotomous measures of burnout: emotional exhaustion and depersonalization. Independent measures included 30 survey measures related to dimensions of workplace climate (e.g., workload, leadership, satisfaction). We identified seven influential workplace climate predictors of emotional exhaustion and nine predictors of depersonalization. With few exceptions, higher agreement/satisfaction scores for predictors were associated with a lower likelihood of burnout. The majority of explained variation in emotional exhaustion was attributable to perceptions of workload (32.6%), organization satisfaction (28.2%), and organization support (19.4%). The majority of explained variation in depersonalization was attributable to workload (25.3%), organization satisfaction (22.9%), and connection to VHA mission (20.7%). Identifying the relative importance of workplace climate is important for the allocation of health organization resources to mitigate and prevent burnout within the PCP workplace. In a context of limited resources, efforts to reduce perceived workload and improve organization satisfaction may represent the biggest leverage points for health organizations to address physician burnout. The online version contains supplementary material available at 10.1007/s11606-021-07006-x.
登录
查看更多内容
影响因子：
5.7
作者：
Rinne, Seppo T.;Mohr, David C.;Charns, Martin P.
通讯作者：
Charns, Martin P.
影响因子：
2.7
作者：
Chen, Jiahua;Chen, Zehua
通讯作者：
Chen, Zehua
影响因子：
9.7
作者：
Bodenheimer, Thomas S.;Smith, Mark D.
通讯作者：
Smith, Mark D.
影响因子：
5.7
作者：
Helfrich, Christian D.;Simonetti, Joseph A.;Nelson, Karin M.
通讯作者：
Nelson, Karin M.
影响因子：
2.9
作者：
Dewa CS;Loong D;Bonato S;Trojanowski L
通讯作者：
Trojanowski L