美国麻醉师的职业倦怠率及危险因素分析

背景：

医生的职业倦怠在医学上普遍存在，与医生生活质量较差和关爱质量下降有关。关于麻醉医生职业倦怠的患病率和危险因素的数据有限。本研究的目的是提高对麻醉医生职业倦怠的理解，识别与麻醉医生职业倦怠相关的工作场所和个人因素，并量化他们的关联强度。

方法：

在2020年3月，作者调查了美国麻醉医师协会的麻醉医师成员。使用马斯拉克职业倦怠量表（MBI-HSS）来评估职业倦怠。还调查询问了工作场所和个人因素。主要研究问题是评估职业倦怠的高风险率（MBI-HSS量表情感耗竭子量表至少得分27分和/或去人性化子量表至少得分10分）以及倦怠综合征（展示了符合WHO定义的所有三个职业倦怠维度）。次要研究问题的是确定相关的危险因素。

结果：

在联系的28,677名麻醉医生中，13.6%的（3,898）完成了调查；59.2%（3898名中的2307人）存在倦怠高风险13.8%，（3,898人中的539人）符合职业倦怠综合症的标准。在多变量分析中，认为工作时缺乏支持（OR，6.7；95%CI，5.3至8.5）；工作时间大于或等于40小时（OR，2.22；95%CI，1.80至2.75）；女同性恋、男同性恋、双性恋、变性人、同性恋/质疑、双性人和无性恋地位（优势比，2.21；95%可信区间，1.35-3.63），感知到的人员短缺（优势比2.06；95%可信区间1.76至2.42）与职业倦怠高风险独立相关。工作支持（OR 10.0；95%CI5.4-18.3）和家庭（OR 2.13；95%CI1.69-2.69）与倦怠综合征的相关性最强。

结论：

麻醉医生的职业倦怠患病率很高，工作场所因素的权重很大。作者确定了职业倦怠的风险因素，特别是工作场所的感知支持，在那里集中的干预可能是有效地减少职业倦怠。

原始文献来源：

Afonso AM, Cadwell JB, Staffa SJ, et al. Burnout Rate and Risk Factors among Anesthesiologists in the United States. Anesthesiology. 2021 May 1;134(5):683-696.

Burnout Rate and Risk Factors among Anesthesiologists in the United States

Abstract

Background:

Physician burnout, widespread across medicine, is linked to

poorer physician quality of life and reduced quality of care. Data on prevalence of and risk factors for burnout among anesthesiologists are limited.The objective of the current study was to improve understanding of burnout in anesthesiologists, identify workplace and personal factors associated with burnout among anesthesiologists, and quantify their strength of association.

Methods: During March 2020, the authors surveyed member anesthesiologists of the American Society of Anesthesiologists. Burnout was assessed using the Maslach Burnout Inventory Human Services Survey. Additional survey questions queried workplace and personal factors. The primary research question was to assess rates of high risk for burnout (scores of at least 27 on the emotional exhaustion subscale and/or at least 10 on the depersonalization subscale of the Maslach Burnout Inventory Human Services Survey) and burnout syndrome (demonstrating all three burnout dimensions, consistent with the World Health Organization definition). The secondary research question was to identify associated risk factors.

Results: Of 28,677 anesthesiologists contacted, 13.6% (3,898) completed the survey; 59.2% (2,307 of 3,898) were at high risk of burnout, and 13.8%(539 of 3,898) met criteria for burnout syndrome. On multivariable analysis, perceived lack of support at work (odds ratio, 6.7; 95% CI, 5.3 to 8.5);working greater than or equal to 40 h/week (odds ratio, 2.22; 95% CI, 1.80 to 2.75); lesbian, gay, bisexual, transgender/transsexual, queer/questioning,intersex, and asexual status (odds ratio, 2.21; 95% CI, 1.35 to 3.63); and perceived staffing shortages (odds ratio, 2.06; 95% CI, 1.76 to 2.42) were independently associated with high risk for burnout. Perceived lack of support at work (odds ratio, 10.0; 95% CI, 5.4 to 18.3) and home (odds ratio, 2.13;95% CI, 1.69 to 2.69) were most strongly associated with burnout syndrome.

Conclusions: The prevalence of burnout among anesthesiologists is high,with workplace factors weighing heavily. The authors identified risk factors for burnout, especially perceived support in the workplace, where focused interventions may be effective in reducing burnout.