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Burnout in Trauma Surgeons During the COVID-19 Pandemic: a Long-standing Problem Worsens. COVID-19大流行期间创伤外科医生的职业倦怠:一个长期存在的问题恶化。
IF 0.7 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.1007/s40719-022-00247-z
Prerna Ladha, Alaina M Lasinski, Ali M Kara, Theresa Relation, Esther S Tseng

Purpose of review: Physician burnout is well-described in the literature. We analyze the effects of the COVID-19 pandemic on burnout in trauma and acute care surgeons (TACS).

Recent findings: Along with other healthcare workers and trainees, TACS faced unprecedented clinical, personal, and professional challenges in treating a novel pathogen and were uniquely affected due to their skillset as surgeons, intensivists, and leaders. The pandemic and its consequences have increased burnout and are suspected to have worsened PTSD and moral injury among TACS. The healthcare system is just beginning to grapple with these problems.

Summary: COVID-19 significantly added to the pre-existing burden of burnout among TACS. We offer prevention and mitigation strategies. Furthermore, to build upon the work done by individuals and organizations, we urge that national institutions address burnout from a regulatory standpoint.

回顾的目的:医生的职业倦怠在文献中有很好的描述。我们分析了COVID-19大流行对创伤和急症护理外科医生(TACS)职业倦怠的影响。最近的发现:与其他医护人员和培训生一样,TACS在治疗新型病原体方面面临着前所未有的临床、个人和专业挑战,由于他们作为外科医生、重症监护医生和领导者的技能,他们受到了独特的影响。疫情及其后果加剧了tac群体的倦怠,并被怀疑加剧了PTSD和道德伤害。医疗保健系统才刚刚开始努力解决这些问题。总结:COVID-19显著增加了tac患者原有的职业倦怠负担。我们提供预防和缓解策略。此外,为了在个人和组织所做的工作的基础上,我们敦促国家机构从监管的角度解决倦怠问题。
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引用次数: 0
Addressing Surgeon Burnout Through a Multi-level Approach: A National Call to Action. 通过多层次的方法解决外科医生的职业倦怠:全国行动呼吁。
IF 0.7 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.1007/s40719-022-00249-x
Kimberly B Golisch, Jes M Sanders, Anna Rzhetsky, Leah C Tatebe

Purpose of review: Physician burnout is an epidemic and there are unique aspects of surgery that dictate rates of burnout among general surgeons and surgical trainees. This review characterizes the scope of burnout and its drivers within the field of surgery and advocates for strategies to address burnout at the individual, institutional, and national levels.

Recent findings: Rates of burnout in surgery are increasing with higher numbers of young and female surgeons affected. Contributing factors are generally related to work-life balance, longer hours, and mistreatment in the workplace. Attempts have been made at implementing structured initiatives in an effort to combat work dissatisfaction and emotional exhaustion. Still, rates of burnout continue to increase.

Summary: General surgeons and trainees are at high risk for burnout with resulting attrition, depression, and suicidal ideation. The solution to burnout must be addressed at individual, institutional, and national levels. Further research into the factors leading to surgeon burnout and enactment of effective strategies to mitigate burnout must be pursued.

综述目的:医生职业倦怠是一种流行病,外科手术中有一些独特的方面决定了普通外科医生和外科实习生的职业倦怠率。本综述概述了外科领域中职业倦怠的范围及其驱动因素,并倡导在个人、机构和国家层面上解决职业倦怠的策略。最近的研究发现:手术倦怠率正在上升,受影响的年轻和女性外科医生的数量越来越多。造成这种情况的因素通常与工作与生活的平衡、较长的工作时间和工作场所的虐待有关。为了消除对工作的不满和情绪上的疲惫,已经尝试实施有组织的举措。尽管如此,职业倦怠率仍在持续上升。总结:普通外科医生和实习医生有很高的职业倦怠风险,由此导致的减员、抑郁和自杀意念。职业倦怠的解决方案必须从个人、机构和国家层面着手。必须进一步研究导致外科医生职业倦怠的因素,并制定有效的策略来减轻职业倦怠。
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引用次数: 3
Environmental Factors Impacting Wellness in the Trauma Provider. 影响创伤提供者健康的环境因素。
IF 0.7 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.1007/s40719-022-00246-0
Alexis Hess, Maddison Porter, Saskya Byerly

Purpose of review: The purpose of this review is to evaluate the recent literature on environmental factors impacting wellness for the acute care surgeon. This includes factors influencing physical, mental, and emotional well-being.

Recent findings: Recent studies have identified challenges to surgeon wellness including increased incidence of sleep deprivation, musculoskeletal pain and injuries, pregnancy complications, moral injury, posttraumatic stress disorder (PTSD), and burnout. Qualitative studies have characterized the surgeon's emotional response to occupational stress, adverse events, and surgical complications. Further descriptive studies offer interventions to prevent moral injury after adverse events and to improve surgeon work environment.

Summary: Acute care surgeons are at increased risk of sleep deprivation, musculoskeletal pain and injury, pregnancy complications, moral injury, PTSD, and burnout. Surgeons experience feelings of isolation and personal devaluation after adverse events or complications, and this may lead to practice limitation and progression to PTSD and/or burnout. Interventions to provide mentorship, peer support, and education may help surgeons recover after adverse events. Further study is necessary to evaluate institution-driven interventional opportunities to improve surgeon well-being and to foster an inclusive and supportive environment.

综述目的:本综述的目的是评价最近关于环境因素影响急症外科医生健康的文献。这包括影响身体、精神和情感健康的因素。最近的发现:最近的研究已经确定了外科医生健康面临的挑战,包括睡眠剥夺、肌肉骨骼疼痛和损伤、妊娠并发症、道德伤害、创伤后应激障碍(PTSD)和倦怠的发生率增加。定性研究描述了外科医生对职业压力、不良事件和手术并发症的情绪反应。进一步的描述性研究提供干预措施,以防止不良事件后的道德伤害和改善外科医生的工作环境。总结:急诊外科医生面临睡眠剥夺、肌肉骨骼疼痛和损伤、妊娠并发症、精神创伤、创伤后应激障碍和倦怠的风险增加。在不良事件或并发症后,外科医生会感到孤立和自我贬值,这可能导致实践限制和发展为创伤后应激障碍和/或倦怠。提供指导、同伴支持和教育的干预措施可能有助于外科医生在不良事件后恢复。进一步的研究是必要的,以评估机构驱动的介入机会,以提高外科医生的福祉,并促进包容性和支持性的环境。
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引用次数: 2
Sleep Deprivation, Burnout, and Acute Care Surgery. 睡眠剥夺,倦怠和急症护理外科。
IF 0.7 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.1007/s40719-023-00253-9
Hermona Abera, Maya Hunt, Jeremy H Levin

Purpose of review: To define what sleep deprivation is, how it relates to the growing problem of burnout within surgeons, and what can be done to mitigate its effects.

Recent findings: There is a growing awareness that sleep deprivation, in both its acute and chronic manifestations, plays an immense role in burnout. The physical and mental manifestations of sleep deprivation are manifold, effecting nearly every physiologic system. Studies evaluating strategies at mitigating the effects of sleep deprivation are promising, including work done with napping, stimulant use, and service restructuring, but are fundamentally limited by generalizability, scale, and scope.

Summary: The overwhelming majority of data published on sleep deprivation is limited by size, scope, and generalizability. Within acute care surgery, there is a dearth of studies that adequately define and describe sleep deprivation as it pertains to high-performance professions. Given the growing issue of burnout amongst surgeons paired with a growing patient population that is older and more complex, strategies to combat sleep deprivation are paramount for surgeon retention and wellbeing.

综述目的:定义睡眠剥夺是什么,它与外科医生日益严重的职业倦怠问题有何关系,以及如何减轻其影响。最近的研究发现:越来越多的人意识到,无论是急性还是慢性的睡眠剥夺,都会在职业倦怠中扮演重要角色。睡眠剥夺的生理和心理表现是多方面的,几乎影响到每一个生理系统。评估减轻睡眠剥夺影响的策略的研究是有希望的,包括关于午睡、兴奋剂使用和服务重组的工作,但从根本上受到普遍性、规模和范围的限制。总结:绝大多数发表的关于睡眠剥夺的数据受到规模、范围和概括性的限制。在急症护理外科中,缺乏充分定义和描述与高性能专业相关的睡眠剥夺的研究。鉴于外科医生的职业倦怠问题日益严重,加上患者年龄越来越大、情况越来越复杂,对抗睡眠不足的策略对外科医生的留任和健康至关重要。
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引用次数: 0
Socioeconomic Factors and Pediatric Injury. 社会经济因素与儿童伤害。
IF 0.7 Q3 Medicine Pub Date : 2023-01-01 Epub Date: 2023-01-23 DOI: 10.1007/s40719-023-00251-x
Stephen Trinidad, Meera Kotagal

Purpose of review: The goal of this review is to describe how socioeconomic status (SES) is evaluated in the pediatric trauma literature and further consider how differences in SES can lead to inequities in pediatric injury.

Recent findings: Insurance status, area-level income, and indices of socioeconomic deprivation are the most common assessments of socioeconomic status. Children from socioeconomically disadvantaged backgrounds experience higher rates of firearm-related injuries, motor vehicle-related injuries, and violence-related injuries, contributing to inequities in morbidity and mortality after pediatric injury. Differences in SES may also lead to inequities in post-injury care and recovery, with higher rates of readmission, recidivism, and PTSD for children from socioeconomically disadvantaged backgrounds.

Summary: Additional research looking at family-level measures of SES and more granular measures of neighborhood deprivation are needed. SES can serve as an upstream target for interventions to reduce pediatric injury and narrow the equity gap.

综述目的:本综述的目的是描述儿童创伤文献中如何评估社会经济地位,并进一步考虑社会经济地位的差异如何导致儿童损伤的不公平。最近的研究结果:保险状况、地区收入和社会经济贫困指数是对社会经济状况最常见的评估。来自社会经济弱势背景的儿童遭受枪支相关伤害、机动车相关伤害和暴力相关伤害的比率更高,这导致了儿童受伤后发病率和死亡率的不平等。社会经济地位的差异也可能导致受伤后护理和康复方面的不平等,来自社会经济弱势背景的儿童的再入院率、累犯率和创伤后应激障碍率更高。总结:还需要对家庭层面的社会经济地位指标和更精细的社区剥夺指标进行更多的研究。SES可以作为干预措施的上游目标,以减少儿科损伤并缩小公平差距。
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引用次数: 5
Adult ECMO in the En Route Care Environment: Overview and Practical Considerations of Managing ECMO Patients During Transport 途中护理环境中的成人ECMO:运输过程中管理ECMO患者的概述和实践考虑
IF 0.7 Q3 Medicine Pub Date : 2022-10-20 DOI: 10.1007/s40719-022-00245-1
V. Sams, Jess T Anderson, J. Hunninghake, Michael Gonzales
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引用次数: 1
Department of Surgery Leadership Towards Diversity, Equity, and Inclusion 外科领导走向多样性、公平性和包容性
IF 0.7 Q3 Medicine Pub Date : 2022-10-10 DOI: 10.1007/s40719-022-00244-2
J. Dimick, J. Matthews, D. Wood
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引用次数: 0
The Recognition of Shock in Pediatric Trauma Patients 儿童创伤患者对休克的认识
IF 0.7 Q3 Medicine Pub Date : 2022-09-20 DOI: 10.1007/s40719-022-00239-z
M. Reppucci, J. Stevens, S. Moulton, S. Acker
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引用次数: 1
Frailty in the Geriatric Trauma Patient: a Review on Assessments, Interventions, and Lessons from Other Surgical Subspecialties 老年创伤患者的虚弱:评估、干预和其他外科专科的经验教训综述
IF 0.7 Q3 Medicine Pub Date : 2022-09-12 DOI: 10.1007/s40719-022-00241-5
H. Kregel, T. Puzio, Sasha D. Adams
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引用次数: 0
Pediatric Firearm Injury Advocacy 儿童火器伤宣传
IF 0.7 Q3 Medicine Pub Date : 2022-09-03 DOI: 10.1007/s40719-022-00243-3
B. Naik-Mathuria, S. McKay
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引用次数: 1
期刊
Current Trauma Reports
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