Burnout and Stress Among US Surgery Residents: Psychological Distress and Resilience
Burnout and Stress Among US Surgery Residents: Psychological Distress and Resilience
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DOI：
10.1016/j.jamcollsurg.2017.10.010
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发表时间：
2018-01-01
影响因子：
5.2
通讯作者：
Epel, Elissa S.
中科院分区：
文献类型：
--
作者：
Lebares, Carter C.;Guvva, Ekaterina V.;Epel, Elissa S.
背景：医生的职业倦怠影响心理健康、工作表现和患者预后。外科住院医师是职业倦怠的高危时期。我们研究了职业倦怠和心理特征，可以有助于倦怠的脆弱性和弹性在一组surgical studients.Study设计：在线调查分发到2016年9月所有ACGME认证的普通外科课程。职业倦怠采用简化的Maslach职业倦怠量表进行评估。对压力、焦虑、抑郁、恢复力、正念和酒精使用进行了评估和分析。优势比（OR）被用来确定假定的风险和弹性factors.Results的大小：在566外科住院医生谁参加了调查，倦怠的患病率为69%，同样驱动的情绪衰竭和人格解体。感知压力和痛苦症状（抑郁，自杀意念和焦虑）在不同的训练水平上都很高，但在实验室几年内有所改善。较高的倦怠与高压力（OR 7.8; p < 0.0001）、抑郁（OR 4.8; p < 0.0001）和自杀意念（OR 5.7; p < 0.0001）相关。相比之下，倾向性正念与较低的倦怠风险有关（OR 0.24; p < 0.0001），应激（OR 0.15; p < 0.0001），焦虑（OR 0.21; p < 0.0001），自杀意念（OR 0.25; p < 0.0001），抑郁症结论：高水平的倦怠，严重的压力，和痛苦的症状，经历了整个普通外科培训，在实验室几年的一些改善。在这项横断面研究中，倦怠和高压力的受训者患抑郁症和自杀意念的风险增加。较高的气质正念与较低的倦怠风险，严重的压力和痛苦症状相关，支持正念训练在外科住院期间促进恢复力的潜力。(C)2017年美国外科医生学会。爱思唯尔公司出版All rights reserved.
BACKGROUND: Burnout among physicians affects mental health, performance, and patient outcomes. Surgery residency is a high-risk time for burnout. We examined burnout and the psychological characteristics that can contribute to burnout vulnerability and resilience in a group of surgical trainees.STUDY DESIGN: An online survey was distributed in September 2016 to all ACGME-accredited general surgery programs. Burnout was assessed with an abbreviated Maslach Burnout Inventory. Stress, anxiety, depression, resilience, mindfulness, and alcohol use were assessed and analyzed for prevalence. Odds ratios (ORs) were used to determine the magnitude of presumed risk and resilience factors.RESULTS: Among 566 surgical residents who participated in the survey, prevalence of burnout was 69%, equally driven by emotional exhaustion and depersonalization. Perceived stress and distress symptoms (depression, suicidal ideation, and anxiety) were notably high across training levels, but improved during lab years. Higher burnout was associated with high stress (OR 7.8; p < 0.0001), depression (OR 4.8; p < 0.0001), and suicidal ideation (OR 5.7; p < 0.0001). In contrast, dispositional mindfulness was associated with lower risk of burnout (OR 0.24; p < 0.0001), stress (OR 0.15; p < 0.0001), anxiety (OR 0.21; p < 0.0001), suicidal ideation (OR 0.25; p < 0.0001), and depression (OR 0.26; p = 0.0003).CONCLUSIONS: High levels of burnout, severe stress, and distress symptoms are experienced throughout general surgery training, with some improvement during lab years. In this cross-sectional study, trainees with burnout and high stress were at increased risk for depression and suicidal ideation. Higher dispositional mindfulness was associated with lower risk of burnout, severe stress, and distress symptoms, supporting the potential of mindfulness training to promote resilience during surgery residency. (C) 2017 by the American College of Surgeons. Published by Elsevier Inc. All rights reserved.