Well-Being in Residency: A Systematic Review.
Well-Being in Residency: A Systematic Review.
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DOI：
10.4300/jgme-d-15-00764.1
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发表时间：
2016-12-01
影响因子：
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通讯作者：
Raj, Kristin S
中科院分区：
文献类型：
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作者：
Raj, Kristin S
背景：近年来，医生职业倦怠率有所上升，培训中的医生报告职业倦怠水平较高。 目的：对住院医师幸福感研究的回顾旨在识别与幸福感相关的因素，总结幸福感促进干预措施，并为未来的研究工作提供框架。 方法：使用关键词搜索 PubMed、PsycINFO 和 MEDLINE。纳入的研究是在 1989 年至 2014 年间进行的。检索产生了 82 篇文章，其中 26 篇符合纳入标准，并使用医学教育研究质量工具进行了评估。结果：文章测量了居民的幸福感以及相关因素、预测因素、影响、障碍以及改善幸福感的干预措施。心理健康研究中确定的因素——自主性、能力建设和强烈的社会关联性——与居民的幸福感相关。睡眠和远离工作的时间与居民的幸福感有关。毅力预示着幸福，而更大的幸福与同理心的增强相关。关注健康和应对技能的干预措施似乎可以改善福祉，尽管 3 项研究干预措施的研究受到小样本和单点管理的限制。结论：该领域研究发展的一个重要步骤是制定居民福祉的明确定义和衡量构建的量表。大多数（n=17，65%）现有研究都是对与幸福感相关的因素进行横断面分析。本综述总结的文献表明，未来的研究应重点关注横断面研究中确定的因素，包括睡眠、应对机制、居民自主权、能力建设和增强的社会关联性。
BACKGROUND: Rates of physician burnout have increased in recent years, and high burnout levels are reported by physicians in training.OBJECTIVE: This review of the research on resident well-being seeks to identify factors associated with well-being, summarize well-being promotion interventions, and provide a framework for future research efforts.METHODS: Keywords were used to search PubMed, PsycINFO, and MEDLINE. Studies included were conducted between 1989 and 2014. The search yielded 82 articles, 26 which met inclusion criteria, and were assessed using the Medical Education Research Study Quality Instrument.RESULTS: Articles measured resident well-being and associated factors, predictors, effects, barriers, as well as interventions to improve well-being. Factors identified in psychological well-being research-autonomy, building of competence, and strong social relatedness-are associated with resident well-being. Sleep and time away from work are associated with greater resident well-being. Perseverance is predictive of well-being, and greater well-being is associated with increased empathy. Interventions focused on health and coping skills appear to improve well-being, although the 3 studies that examined interventions were limited by small samples and single site administration.CONCLUSIONS: An important step in evolving research in this area entails the development of a clear definition of resident well-being and a scale for measuring the construct. The majority (n=17, 65%) of existing studies are cross-sectional analyses of factors associated with well-being. The literature summarized in this review suggests future research should focus on factors identified in cross-sectional studies, including sleep, coping mechanisms, resident autonomy, building competence, and enhanced social relatedness.