医師 の 中 の 燃え尽き た 状態 の 流行: 体系 的 な レビュー
Lisa S Rotenstein1,2,3, Matthew Torre1,4, Marco A Ramos5
1Harvard Medical School, Boston, Massachusetts.
JAMA
|October 17, 2018
まとめ
医者のバーンアウトの流行は,182件の研究における様々な定義と評価方法のために不明です. 労働ストレスの影響を理解するために,コンセンサスの定義と標準化されたツールの開発が不可欠です.
科学分野:
- 労働衛生について
- 精神科
- 医学教育
背景:
- 医者の倦怠感は 医療の質に影響を与える 既知の症状です
- 正確な流行データは健康政策にとって不可欠ですが,現在は不足しています.
- 研究方法の変動は,バーンアウトの範囲を明確に理解するのを妨げています.
研究 の 目的:
- 医師の疲労を評価するために使用される方法を体系的に検討し,特徴づけること.
- 医療従事者の 燃え尽き傾向を推定する
- 研究におけるバーンアウトの定義と測定の矛盾を特定する.
主な方法:
- 2018年6月1日以前に発表された研究に関する5つの主要なデータベース (EMBASE,ERIC,MEDLINE/PubMed,psycARTICLES,psycINFO) の体系的な文献検索
- 45か国から10万9,628人の医師を対象とした182件の研究が含まれています.
- メタアナリシスを排除した研究設計とバーンアウト評価の異質性による記述的および質的合成.
主要な成果:
- 総体的なバーンアウトは0%から80.5%と報告されています.
- 燃え尽きることとそのサブコンポーネント (感情的疲労,非個性化,個人的な業績の低さ) の 142以上の独特の定義が特定されました.
- Maslach Burnout Inventory (MBI) は 85. 7% の研究で用いられたが,MBIに基づく研究では少なくとも 47 件の総合的なバーンアウトの定義が認められた.
- 不一致は,バーンアウトと人口統計的,または臨床的要因との関連を確実に決定することを妨げました.
結論:
- 医者のバーンアウトの推定値,定義,評価方法には大きな違いがある.
- 標準化された測定ツールやコンセンサス定義の欠如は,決定的な結論を妨げています.
- 医療従事者の職業ストレスに対処するために 標準化されたバーンアウト評価ツールと 合意された定義の開発が不可欠です
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