共生干预对医师职业倦怠的影响。

Jason C Seto, Jennifer Beals, Todd B Seto, Holly Olson, Kuo-Chiang Lian, Malia Ramirez, Susan Steinemann
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引用次数: 0

摘要

共食性,即在一起吃饭的行为,如果组织起来进行便利的讨论,是一种基于证据的干预措施,可以促进参与,减少医生的倦怠。本初步研究的目的是评估医师共通干预的可行性、可接受性和影响。共生干预是基于梅奥诊所的模式,该模式包括6个月在当地餐馆举行的6个2小时的晚餐会议,并进行促进讨论。7名医生参与其中,对照组根据专业和职业阶段进行匹配。所有参与者在基线、6个月和12个月时完成了Maslach职业倦怠量表和工作生活领域调查(MBI/AWS)。结果采用曼-惠特尼检验进行分析,比较干预组成员与对照组。基线时,干预组7人中有4人符合倦怠标准,对照组7人中有3人符合倦怠标准。6个月时,MBI在各方面均有改善:情绪耗竭(EE) 24.3至17.2;人格解体(DP) 7.1 - 5.1;个人成就(PA) 40.0 - 43.3。干预组成员情感表达的改善明显大于对照组(P= 0.015)。同样,干预组的AWS各维度(奖励除外)均有所改善,工作量(P= 0.012)、控制(P= 0.027)和社区(P= 0.039)均有显著改善。在12个月时,EE(21.6)、DP(5.3)和PA(42.7)的改善持续存在,但有所减弱,MBI/AWS与基线相比没有统计学意义上的变化。研究结果表明,在干预后,医生的职业倦怠有了显著改善,在12个月时有所减弱。结果将用于支持在小组实践中更广泛地实施共栖性。
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The Impact of a Commensality Intervention on Physician Burnout.

Commensality, the act of eating together, when organized around facilitated discussion is an evidence-based intervention that can promote engagement and reduce physician burnout. The purpose of this pilot study is to evaluate the feasibility, acceptance, and impact of a commensality intervention for physicians. The Commensality Intervention was based on a Mayo Clinic model that consisted of 6, 2-hour dinner meetings at local restaurants over 6 months with facilitated discussion. Seven physicians participated, with controls matched by specialty and career stage. All completed the Maslach Burnout Inventory and Areas of Worklife Survey (MBI/AWS) at baseline, 6 months, and 12 months. Results were analyzed using Mann-Whitney tests for comparison of intervention group members to controls. At baseline, 4 of 7 in the intervention group and 3 of 7 controls met criteria for burnout. At 6 months, MBI improved in all dimensions: emotional exhaustion (EE) 24.3 to 17.2; depersonalization (DP) 7.1 to 5.1; personal accomplishment (PA) 40.0 to 43.3. Improvement in EE was significantly greater for intervention group members vs. controls (P=.015). Similarly, every AWS dimension (except reward) improved in the intervention group, with significant improvements in Workload (P=.012), Control (P=.027), and Community (P=.039). At 12 months, improvements in EE (21.6), DP (5.3) and PA (42.7) persisted but were attenuated, with none of the MBI/AWS changes from baseline statistically significant. Findings suggest significant improvements in physician burnout following the intervention, with attenuation at 12-months. Results will be used to support the broader implementation of commensality within the group practice.

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