麻醉科住院医师职业倦怠现状调查与研究

Investigation and research of current burnout status on anesthesiology residents

中文关键词: 住院医师规范化培训  住院医师  职业倦怠  心理弹性  调查问卷

英文关键词: Standardized residency training  Resident  Burnout  Psychological resilience  Surveys and questionnaires

中文摘要:

      
目的： 采用调查问卷收集国内麻醉科住院医师的职业倦怠现状，分析影响职业倦怠的相关因素。
方法： 选择全国218家医院的麻醉专科共2 651名在职在岗的麻醉科住院医师为研究对象。通过问卷星设计和发放电子问卷，收集人口统计学特征、职业相关特征、心理弹性评分（康纳-戴维森复原力量表）。采用职业倦怠量表（MBI-HSS）对医师职业倦怠情况进行评估。对发生职业倦怠和非职业倦怠的医师进行组间比较，并采用多因素Logistic回归分析医师职业倦怠的危险因素。
结果： 本次问卷有效回收1 990份，回收率77.7%。住院医师职业倦怠发生率为53.4%（1 063/1 990）。与未发生职业倦怠的住院医师比较，职业倦怠的医师女性比例、三级医院比例、未婚比例、遇到有挑战的病例频率、参与值班和有科研任务比例明显升高，每周工作时间明显延长（P<0.05）。多元Logistic回归分析结果显示，女性（OR=1.58，95%CI 1.28～1.97，P<0.01）、工作时间延长（OR=1.62， 95%CI 1.45～1.81，P<0.01）、遇到有挑战的病例频率延长（OR=1.11，95%CI 1.11～1.40，P<0.01）是职业倦怠的危险因素，心理弹性评分升高是职业倦怠的保护因素（OR=0.86，95%CI 0.84～0.88，P<0.01）。
结论： 麻醉科住院医师职业倦怠发生率偏高，应重点关注并针对提升心理弹性且设计切实可行的预防规范措施，保证住院医师群体的身心健康。

英文摘要:

      
Objective: This study aims to investigate the current status of burnout among anesthesiology residents, and to explore its influencing factors and potential interventions.
Methods: A total of 2 651 practicing anesthesiology residents from 218 hospitals nationwide were included in this study. Demographic characteristics, occupational features, and psychological resilience scores(Connor-Davidson resilience scale) were collected using a questionnaire distributed electronically. The Maslach burnout inventory-human service survey (MBI-HSS) was used to assess burnout. A comparison between groups with and without occupational burnout was conducted. Multiple logistic regression analysis was used to identify risk factors for burnout among anesthesiology residents .
Results: Out of the expected 2 651 questionnaires, 1 990 valid responses were received (response rate 77.7%). The prevalence of burnout among the residents was 53.4%(1 063/1 990). Compared with residents without occupational burnout, those with burnout had a significantly higher proportion of females, working in tertiary hospitals, unmarried individuals, frequency of encountering challenging patients, participating in on-call duty, and research tasks, and had a significantly longer weekly working hours (P < 0.05). Multivariate logistic regression analysis indicated that female (OR = 1.58, 95% CI 1.28-1.97, P < 0.01), longer working hours (OR = 1.62, 95% CI 1.45-1.81, P < 0.01), and higher frequency of encountering challenging patients (OR = 1.11, 95% CI 1.11-1.40, P < 0.01) were risk factors for occupational burnout. High levels of psychological resilience was protective factor against burnout (OR = 0.86, 95% CI 0.84-0.88, P < 0.01).
Conclusion: The occurrence of burnout among anesthesiology residents is high. It is crucial to focus on and design practical preventive measures to enhance psychological resilience, ensuring healthy physical and mental development of the resident community.