退伍军人健康管理局精神科医生的职业倦怠

Hector A. Garcia , Cindy A. McGeary , Erin P. Finley , Norma S. Ketchum , Donald D. McGeary , Alan L. Peterson
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引用次数: 35

摘要

研究表明,精神卫生工作者有很高的倦怠风险,而倦怠会增加员工流动率,降低护理质量。退伍军人管理局(VA)在美国各地雇佣了3000多名精神科医生,但对这一人群的职业倦怠知之甚少。本研究的目的是在全国退伍军人精神科医生样本中检验倦怠和离开退伍军人的意向的预测因素。参与者(N = 125)回答了一项匿名在线调查。研究人员使用回归分析来检验工作场所变量、患者特征和倦怠之间的关系,该调查由马斯拉奇倦怠调查(Maslach burnout inventory - generalsurvey)测量,包括愤世嫉俗、精疲力竭和职业效能的子量表,以及离开退伍军人事务部的意图。基于既定的分值,90%的样本报告高度愤世嫉俗,86%报告高度精疲力竭,74%报告高度职业效能。高度愤世嫉俗预示着离开退伍军人管理局的意图(p = 0.004)。不觉得自己是团队的一部分预示着更大的玩世不恭(p = 0.01),而病人的特征,如疑似装病,则显示出玩世不恭的积极趋势(p = 0.05)。工作场所的特征,如主管的不公平待遇(p = .03)和资源不足(p = .001)预示着更大的疲惫。目前的研究结果表明,职业倦怠在退伍军人事务部精神科工作人员中很普遍。减少倦怠的具体行政措施可能有可能改善该工作人员的情绪健康,并确保为其服务的退伍军人提供高质量的护理。退伍军人事务部精神病学工作人员和患者人数的规模都强调了对退伍军人事务部发生的职业倦怠有更深入了解的重要性。
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Burnout among psychiatrists in the Veterans Health Administration

Research suggests that mental health workers are at high risk for burnout, and that burnout can increase staff turnover and reduce quality of care. The Veterans Administration (VA) employs over 3000 psychiatrists across the United States, but little is known about burnout in this population. This study was conducted to examine predictors of burnout and intent to leave the VA among a national sample of VA psychiatrists. Participants (N = 125) responded to an anonymous online survey. Regression analyses were used to examine relationships between workplace variables, patient characteristics, and burnout as measured by the Maslach Burnout Inventory-General Survey – which includes sub-scales for cynicism, exhaustion, and professional efficacy – as well as intent to leave the VA. Based on established cut-off scores, 90% of the sample reported high cynicism, 86% reported high exhaustion, and 74% reported high professional efficacy. High cynicism predicted the intent to leave the VA (p = .004). Not feeling part of a coherent team predicted greater cynicism (p = .01), and patient characteristics such as suspected malingering showed a positive trend with cynicism (p = .05). Workplace characteristics such as unfair treatment by supervisors (p = .03) and insufficient resources (p = .001) predicted greater exhaustion. The current findings suggest that burnout is prevalent in the VA psychiatry workforce. Specific administrative measures to reduce burnout may have potential to improve the emotional health of that workforce and ensure high quality of care for the veteran population it serves. The size of both the VA psychiatry workforce and patient population underscores the importance of greater understanding of burnout as it occurs in the VA.

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