Routine

Written a year and a half into the pandemic during a particularly difficult week, this poem explores the moral injury and emotional distress that emergency physicians encounter and must process daily. These repeated microtraumas throughout our day frequently contribute to depersonalization and it is important to recognize those factors that “break the routine” and help to improve physician well-being.     

工作家庭冲突与促进对警察工作倦怠影响

目的 了解警察工作倦怠的流行现状,探讨工作家庭冲突、家庭工作冲突和工作家庭促进对工作倦怠的影响。方法 采用分层整群抽样方法抽取新疆乌鲁木齐市某公安局2 212名在编警察进行工作倦怠、工作家庭冲突、家庭工作冲突和工作家庭促进问卷调查,运用层次多元回归分析工作倦怠与各因素的关系。结果 警察工作倦怠总分为（43.54±13.57）分,情感耗竭、人格解体和成就感降低分别为（17.46±7.54）、（9.98±5.62）、（16.09±7.26）分;工作倦怠总检出率为69.21%,轻度、中度和重度工作倦怠检出率分别为38.83%、24.77%和5.61%;情感耗竭、人格解体和成就感降低检出率分别为17.27%、28.84%和45.89%;在控制了人口学变量之后,工作家庭冲突、家庭工作冲突、工作家庭促进对情感耗竭、人格解体、成就感降低和工作倦怠的方差变异量分别增加了11.7%、14.1%、16.3%和23.8%;性别、年龄和警衔对情感耗竭呈正向作用;性别对人格解体呈负向作用;收入对成就感降低呈正向作用,学历对成就感降低呈负向作用;年龄和警衔对工作倦怠呈正向作用,学历对工作倦怠呈负向作用。结论 工作家庭冲突、家庭工作冲突和工作家庭促进对工作倦怠均做出了有效预测。     

The Effect of Ramadan and COVID-19 on the Relationship between Physical Activity and Burnout among Teachers

The objective of this study was to explore the effect of COVID-19 and Ramadan on physical activity (PA) and burnout in teachers and the relationship between them. A total of 57 secondary school teachers from public education centers participated in the present study. They were aged between 29 and 52 years. To determine the effect of Ramadan and COVID-19 on PA and burnout, participants completed the online questionnaires before COVID-19, one week before Ramadan and during the second week of Ramadan. The International Physical Activity Questionnaire-BREF and the Maslach Burnout Inventory-Human Services Survey were used to assess PA intensities and burnout, respectively. The data revealed that total PA (p < 0.001, p < 0.05, respectively) vigorous metabolic equivalent of task (MET) (p < 0.001, p < 0.05, respectively), moderate MET (p < 0.001, p < 0.01, respectively) were higher before COVID-19 and before Ramadan than during Ramadan. Regarding burnout subscales, emotional exhaustion (p < 0.001, p < 0.01, respectively) was higher before Ramadan than before COVID-19 and during Ramadan. A lower personal accomplishment was reported before Ramadan than before COVID-19 and during Ramadan (both p < 0.05). In addition, low to high correlations were observed between PA intensities and burnout subscales, except for the correlation between depersonalization and all PA intensities. In conclusion, Ramadan intermittent fasting along with PA was highly recommended for teachers and the general population to improve positive emotions and general health.     

小学教师心理健康与职业倦怠研究

目的:分析影响小学教师心理健康水平和职业倦怠的主要因素,评估小学教师心理健康以及职业倦怠现状,探讨提高小学教师心理素质的方法与途径,为小学教师心理健康和综合素质提高提供参考和科学依据.方法:采用心理测评和结构式访谈的方法对某小学114名教师作为样本进行研究,选用SCL-90症状自评量表(90题)、和教师职业倦怠量表MBI-ES(22题)施测.结果:小学教师SCL-90各因子与全国常模比较,在强迫、人际关系敏感、抑郁三个维度上高于全国常模,值得关注;根据MBI量表的计分和测量标准,小学教师职业倦怠问题有一定的普遍性;小学教师职业倦怠三个维度与心理健康9因子均呈正相关.结论:小学教师在强迫、人际、抑郁方面得分偏高,并可能是引起职业倦怠的影响因素之一,应提高心理健康水平以改善其职业倦怠现状.     

巴林特小组在改善肿瘤科护士职业倦怠感和工作-家庭冲突中的应用

目的:探讨巴林特小组在肿瘤科护士职业倦怠感和工作-家庭冲突中的应用。方法:将纳入本研究的护理人员分为对照组和试验组各23人,对照组实施常规心理干预,试验组在此基础上实施巴林特小组模式,应用职业倦怠感表和工作-家庭冲突表评价干预前后的效果。结果:干预后试验组职业倦怠感得分为(154.42±9.61)分,低于对照组的(160.43±9.73)分(P<0.05)。干预后试验组工作-家庭冲突得分为(24.47±2.98)分,低于对照组的(26.56±2.96)分,试验组家庭-工作冲突得分为(20.69±1.76)分,低于对照组的(22.78±2.02)分(P<0.05)。结论:巴林特小组能够有效改善肿瘤科护士职业倦怠感和工作-家庭冲突。     

Burnout and well‐being in otolaryngology trainees: A systematic review

ObjectiveTo comprehensively review the recent published literature to characterize current trends of burnout and well‐being among otolaryngology trainees.MethodsStudy design: systematic review and meta‐analysis. A comprehensive literature review from 2000 to 2021 of studies related to otolaryngology resident burnout and well‐being, as well as the general topic of well‐being among surgical residents was completed. All included studies were summarized qualitatively. For the quantitative analysis, only articles reporting a Maslach burnout inventory (MBI), modified MBI or Mini‐Z‐ Burnout assessment were included.ResultsTwenty‐five articles were included in the qualitative summary and nine articles in the quantitative analysis. In the qualitative summary, trainees were reported to have increased levels of distress and emotional hardening compared to attending otolaryngologists. Total hours worked per week and female gender were associated with worsened well‐being. Residency program strategies to improve trainee well‐being include program‐sponsored wellness activities, dedicated wellness champions, and assistance with clerical burden. Implementation of protected nonclinical time has been shown to decrease burnout and increase well‐being among trainees. Moreover, formal trainee mentorship programs have also been shown to reduce trainee burnout and stress. In the quantitative analysis, rates of trainee burnout ranged from 29.7% to 86% with an overall trend towards reduced rates of burnout from 2006 to 2021. Utilizing a weighted average, the overall burnout among otolaryngology residents was 58.6%.ConclusionsRates of burnout remain high among otolaryngology trainees. Implementing formal mentorship programs and providing protected time during regular work hours appear to be effective tools to improve resident well‐being.     

西安市三级乙等综合医院女护士职业倦怠状况调查

目的了解西安市三级乙等综合医院女护士职业倦怠的现状,为预防和降低护士的职业倦怠提供理论依据。方法采用Maslach工作倦怠量表于2015年4至6月对西安市3家三级乙等综合医院960名女护士进行一般情况和职业倦怠程度调查,并对调查资料进行统计学分析。结果西安市三级乙等综合医院女护士职业倦怠总得分为43.65±15.43分,其中情感衰竭(12.17±7.60)分;去人格化(6.53±5.85)分;个人成就感(24.90±8.68)分。在960名护士中,职业倦怠的发生率为88.4%,其中轻度65.9%,中度15.3%,重度7.2%。不同科室(F=4.55,P=0.00)、不同工作年限(F=7.91,P=0.00)、不同婚姻状况(F=7.88,P=0.00)的护士职业倦怠状况存在明显差异;其中,内科护士的职业情绪衰竭程度(13.32±7.69)及去人格化程度(7.08±5.81)较高,门诊科护士(27.63±8.77)和工作10年以上的护士(26.49±8.74)个人成就感较高。结论西安市三级乙等医院女护士职业倦怠的发生率处于高水平状态,倦怠程度处于轻中度水平,工作时间、工作科室、个人婚姻状况是影响护士职业倦怠的主要影响因素。     

疫情防控常态化背景下疫苗集中接种点医务人员职业倦怠现况调查

目的 本研究调查新冠疫苗全面接种时期相关医务人员的职业倦怠状况,探讨个体因素以及社会支持对倦怠水平的影响。方法 在南京市12个行政区中随机抽取4个辖区的新冠疫苗集中接种点,将全部医务人员共428名作为研究对象进行问卷调查,问卷包括人口学特征、中文版职业倦怠量表和社会支持量表。结果 医务人员情感耗竭、人格解体、个人成就感降低维度得分分别为(17.99±7.89)、(7.20±3.52)和(12.07±5.30)分。多元线性回归分析结果显示,上司支持(β=-0.180, P< 0.05)、同事支持(β=-0.180, P< 0.05)为情感耗竭的保护因素,已婚、问诊岗位为情感耗竭的危险因素(β=0.161、β=0.095,P值均< 0.05),女性是人格解体的保护因素(β=-0.096,P< 0.05),亲友支持(β=-0.235, P< 0.05)是人格解体的保护因素,已婚是人格解体的危险因素(β=0.142,P< 0.05),同事支持(β=-0.168, P< 0.05)、亲友支持(β=-0.210, P< 0.05)、工龄(β=-0.154, P< 0.05)为个人成就感降低的保护因素,硕士学历是个人成就感降低的危险因素(β=0.126,P < 0.05)。结论 重视提高全方面社会支持,重点关注已婚、男性、硕士学历以及较短工龄医务人员的心理健康。     

Exploring the effectiveness of a specialized therapy programme for burnout using subjective report and biomarkers of stress

The increasing prevalence of stress-related disorders such as burnout urges the need for specialized treatment approaches. Programmes combining psychotherapy and regenerative interventions emerge to be the most successful. However, evaluated therapy programmes are scarce and usually involve subjective symptom quantification without consideration of physiologic parameters. The aim of the present exploratory, single-group study was the multimodal investigation of the effectiveness of a specialized holistic therapy programme by assessing symptoms and biological markers of chronic stress. Seventy-one in-patients (39 men/32 women; age 46.8 ± 9.9 years) of a specialized burnout ward with the additional diagnosis of burnout (Z73.0) in conjunction with a main diagnosis of depressive disorder (F32 or F33) according to the International Classification of Diseases (ICD)-10 were included in the study. In addition to symptomatology, the stress-responsive biomarkers heart rate variability (HRV) and serum brain-derived neurotrophic factor (BDNF) were measured in patients at admittance to and discharge from the burnout ward applying a 6-week specialized treatment programme. At discharge, patients showed a significant reduction of symptom burden and a significant increase in serum BDNF, while HRV remained unchanged. The findings implicate that the therapy programme may have beneficial effects on symptomatology and neuroplasticity of patients with burnout. As therapy was often supplemented by psychopharmacological treatment, a relevant influence of antidepressant medication especially on BDNF has to be considered.