目的 了解不同类别规范化培训医师(简称规培医师)职业倦怠状况及其影响因素。方法 2020年4月采用基本情况调查表和中文版Maslach职业倦怠量表对某大学17家附属医院和教学医院的全体规培医师进行问卷调查。比较不同类别和培训专业的规培医师职业倦怠各维度评分,并采用二元logistic回归分析职业倦怠影响因素。结果 共收到有效问卷 3 531份,规培医师职业倦怠3个维度情绪耗竭、去个性化、成就感低落评分依次为(10.24±6.82)分、(5.60±4.84)分、(13.36±8.12)分,职业倦怠总体检出率为53.2%(1 878/3 531)。以住院医师为参照,临床医学硕士专业学位研究生职业倦怠风险较高(OR=1.40,95%CI:1.14~1.71);工作量越大发生职业倦怠的风险越高(OR=1.26,95%CI:1.19~1.34);受疫情影响程度越大越容易引发职业倦怠(OR=1.24,95%CI:1.14~1.34),以上差异均具有统计学意义(P＜0.05)。结论 不同类别规培医师职业倦怠存在差异,临床医学硕士专业学位研究生以及全科、妇产科等规培医师职业倦怠风险较高。培训管理部门应提高关注度,加强人文关怀,通过多种途径减缓规培医师职业倦怠。
Objective To investigate the current status of physician burnout and influencing factors of residents undergoing standardized training. Methods A questionnaire survey was conducted among all residents-in-training in 17 affiliated hospitals and teaching hospitals of a university by using basic information form and the Chinese version of Maslach Burnout inventory-general survey in April 2020. The scores of each dimension of burnout among residents-in-training of different categories and training specialties were compared, and the relevant influencing factors were analyzed by binary logistic regression. Results A total of 3 531 valid questionnaires were received. The average scores of three dimensions of burnout, emotional exhaustion, depersonalization, and personal accomplishment were (10.24±6.82), (5.60±4.84), and (13.36±8.12), respectively. The overall detection rate of burnout among residents-in-training was 53.2% (1 878/3 531). Using resident undergoing standardized training as a reference point, the risk of burnout was higher in postgraduates in clinical specialties (OR=1.40, 95%CI: 1.14~1.71); with greater workload (OR=1.26, 95%CI: 1.19~1.34); and when the impact of the epidemic was greater (OR=1.24, 95%CI: 1.14~1.34); the above differences were all statistically significant (P<0.05). Conclusions There were differences in burnout among different types of residents undergoing standardized training, and the risk of burnout is higher among postgraduates in clinical specialties and residents in general practice, obstetrics and gynecology, etc. Educational management departments should increase their attention, strengthen humanistic care, and reduce burnout through multiple approaches.
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