SP4.1.16 V is for vicious: a COVID burnout vector perspective

British Journal of Surgery(2021)

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摘要
Abstract Aims No employment sector has been more heavily pressed by COVID-19 than healthcare. This study aimed to characterise surgical trainee burnout related to the pandemic, following a previous observational cohort study reporting 59% burnout. Methods A 36-point survey, including the 22-point Maslach Burnout Inventory evaluated emotional exhaustion, depersonalisation, and personal accomplishment amongst all surgical trainees within a UK Statutory Education Body, with responses received from 121 (75 Core (CST), 46 Higher Surgical Trainees (HST)). Results High burnout levels were evident across one, two, or all three domains in 60.3% (n = 73), 32.2% (n = 39) and 13.2% (n = 16), respectively. Median emotional exhaustion, depersonalisation and personal accomplishment scores were 19 (range 0-48), 7 (0-25) and 36 (6-48), respectively. Median emotional exhaustion score was related to age (25-29yr 25 vs. >40yr 4; p = 0.016), trainee grade (CST 23 vs. HST 13; p = 0.001) and parenthood (parents 13 vs. not parents 21; p = 0.011), as was depersonalisation: 9 (25-29yr) vs. 1 (>40yr; p = 0.001), 8 (CST) vs. 6 (HST; p = 0.006) and 5 (parents) vs. 8 (not parents; p < 0.001), respectively. COVID-19 induced curriculum working pattern disruption was observed in 82.6% (n = 100), with 31.4% (n = 38) redeployed away from surgery. Barriers to training and career development were the commonest stressors (71.9%) and more prevalent among younger trainees (25-29yr. 76.8% vs. >40yr. 28.6%; p = 0.045) and CST (80.0% vs. HST 58.7%; p = 0.011). Clinical workload concerns were associated with emotional exhaustion (OR 3.12; p = 0.008). Conclusions Burnout endures, though unique adverse clinical work environments may have boosted resilience. Countermeasures including Enhanced Stress Resilience Training remain a priority.
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