Associations Between Job Demands, Job Resources And Patient-Related Burnout Among Physicians: Results From A Multicentre Observational Study

BMJ OPEN(2020)

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摘要
Objectives To investigate associations of job demands and resources with patient-related burnout among physicians. Design Multicentre observational study. Setting Fifty medical departments at 14 (academic and non-academic) hospitals in the Netherlands. Participants Four hundred sixty-five physicians (71.6% response rate), comprising 385 (82.8%) medical specialists and 80 (17.2%) residents. Main outcome measures Job demands (workload and bureaucratic demands), job resources (participation in decision making, development opportunities, leader's inspiration, relationships with colleagues and patients)-measured with the validated Questionnaire of Experience and Evaluation of Work and Physician Worklife Survey-and patient-related burnout, measured using the validated Copenhagen Burnout Inventory. Results Patient-related burnout was positively associated with workload (b=0.36; 95% CI, 0.25 to 0.48; p<0.001) and negatively associated with development opportunities (b=-0.18; 95% CI, -0.27 to -0.08; p<0.001) and relationships with patients (b=-0.12; 95% CI, -0.22 to -0.03; p=0.01). Relationships with patients moderated the association between bureaucratic demands and patient-related burnout (b=-0.15; 95% CI, -0.27 to -0.04; p=0.01). Conclusions Physicians with high workloads and few development opportunities reported higher levels of patient-related burnout. Those with positive patient relationships were less likely to experience patient-related burnout, even in the presence of excessive bureaucracy. Therefore, positive physician-patient relationships may be supported to reduce the likelihood of physicians' patient-related burnout. However, the specific support needed to effectively reduce patient-related burnout may vary per healthcare context and thus requires intensified research across healthcare systems and settings.
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关键词
health policy, human resource management, quality in health care, medical education & training
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