Ramirez A J, Graham J, Richards M A, Cull A, Gregory W M
Guy's Hospital, London, UK.
Lancet. 1996 Mar 16;347(9003):724-8. doi: 10.1016/s0140-6736(96)90077-x.
Burnout and psychiatric morbidity among gastroenterologists, surgeons, radiologists, and oncologists in the UK have been estimated by means of a questionnaire-based survey. The relationship between consultants' mental health and their job stress and satisfaction, as well as their job and demographic characteristics, were also examined.
Psychiatric morbidity was estimated using the 12-item General Health Questionnaire. The three components of burnout-emotional exhaustion, depersonalization, and low personal accomplishment-were assessed using the Maslach Burnout Inventory. Job stress and satisfaction were measured using study-specific questions.
Of 1133 consultants, 882 (78%) returned questionnaires. The estimated prevalence of psychiatric morbidity was 27%, with no significant differences between the four specialist groups. Radiologists reported the highest level of burnout in terms of low personal accomplishment. Job satisfaction significantly protected consultants' mental health against job stress. Three sources of stress were associated with both burnout and psychiatric morbidity; feeling overloaded, and its effect on home life; feeling poorly managed and resourced; and dealing with patients' suffering. Burnout was also associated with low satisfaction in three domains: relationships with patients, relatives and staff; professional status/esteem; intellectual stimulation. In addition, being aged 55 years or less and being single were independent risk factors for burnout. Burnout was also more prevalent among consultants who felt insufficiently trained in communication and management skills.
Consultants' mental health is likely to be protected against the high demands of medical practice by maintaining or enhancing job satisfaction, and by providing training in communication and management skills.
通过一项基于问卷的调查对英国胃肠病学家、外科医生、放射科医生和肿瘤学家的职业倦怠和精神疾病发病率进行了评估。还研究了顾问医生的心理健康与其工作压力和满意度之间的关系,以及他们的工作和人口统计学特征。
使用12项一般健康问卷评估精神疾病发病率。使用马氏职业倦怠量表评估职业倦怠的三个组成部分——情感耗竭、去个性化和低个人成就感。使用特定研究问题测量工作压力和满意度。
在1133名顾问医生中,882名(78%)返回了问卷。估计精神疾病发病率为27%,四个专科组之间无显著差异。就低个人成就感而言,放射科医生报告的职业倦怠水平最高。工作满意度显著保护顾问医生的心理健康免受工作压力影响。三种压力源与职业倦怠和精神疾病发病率均相关;感觉负担过重及其对家庭生活的影响;感觉管理不善和资源不足;以及应对患者的痛苦。职业倦怠还与三个领域的低满意度相关:与患者、亲属和工作人员的关系;职业地位/自尊;智力刺激。此外,年龄在55岁及以下和单身是职业倦怠的独立危险因素。在沟通和管理技能方面感觉培训不足的顾问医生中,职业倦怠也更为普遍。
通过维持或提高工作满意度,以及提供沟通和管理技能培训,可能会保护顾问医生的心理健康,使其免受医疗实践高要求的影响。