Abstract：
BACKGROUND: Obstetrics and gynecology surgery is becoming increasingly complex because of an aging population with increasing rates of medical comorbidities and obesity. Complications are therefore common, and not only impact the patient but can also cause distress to the obstetrics and gynecology surgeon as a \"second victim.\"
OBJECTIVE: This study aimed to describe and quantify the range of effects of complications on obstetrics and gynecology surgeons, and assess sociodemographic, clinician, and practice factors associated with such impact.
METHODS: A cross-sectional survey was developed on the basis of interviews with obstetrics and gynecology surgeons and a review of the literature. The survey assessed obstetrics and gynecology surgeons\' demographic, clinical, and practice characteristics; estimated the number of complications per year and the impact of complications on distress, physical and mental health, sleep, and relationships; and explored strategies that obstetrics and gynecology surgeons used to cope with complications. Univariate logistic regression analyses were used to determine the association between obstetrics and gynecology surgeons\' characteristics and complication consequences.
RESULTS: Overall, of 727 survey respondents, 431 (61%) were female, 384 (55%) were aged ≥50 years, almost half had worked as obstetrics and gynecology surgeons for ≥15 years (329 [45%]), and 527 (73%) reported completing <10 surgical procedures per week. Most (568 [78%]) reported <3 surgical complications per year, and most (472 [66%]) thought this was similar or less frequent compared with their colleagues. Complications caused most stress when they resulted in poor patient outcomes (653 [90%]), had severe patient consequences (630 [87%]), or were a result of surgeon error (627 [86%]). Complications impacted most obstetrics and gynecology surgeons\' well-being and sleep. A greater proportion of those aged <50 years reported that their mental well-being (32 [10%]; P=.002) and sleep (130 [42%]; P=.03) were affected when a complication occurred. Female participants were also more likely to report that their physical health (14 [3%]; P≤.001), mental health (39 [9%]; P=.01), and sleep (183 [43%]; P≤.001) were affected. Current trainees (11 [10%]) and surgeons with <15 years of experience (25 [9%]) were more likely to experience mental well-being consequences compared with surgeons with ≥15 years of experience (12 [4%]; P=.01). Female participants reported less willingness to interact with colleagues when complications occurred (323 [75%]; P=.006), and surgeons with <15 years of training were less likely to report comfort in talking (221 [74%]; P=.03) and interacting with others (212 [74%]; P=.02).
CONCLUSIONS: The vast majority of obstetrics and gynecology surgeons experience a major impact on their health and well-being when one of their patients develops a complication. The degree and type of impact reported are similar to those observed in other surgical specialties. Future studies are needed to test interventions that alleviate the substantial impact and to follow obstetrics and gynecology surgeons longitudinally to understand the duration of the impact of complications.
OBJECTIVE: This study aimed to describe and quantify the range of effects of complications on obstetrics and gynecology surgeons, and assess sociodemographic, clinician, and practice factors associated with such impact.
METHODS: A cross-sectional survey was developed on the basis of interviews with obstetrics and gynecology surgeons and a review of the literature. The survey assessed obstetrics and gynecology surgeons\' demographic, clinical, and practice characteristics; estimated the number of complications per year and the impact of complications on distress, physical and mental health, sleep, and relationships; and explored strategies that obstetrics and gynecology surgeons used to cope with complications. Univariate logistic regression analyses were used to determine the association between obstetrics and gynecology surgeons\' characteristics and complication consequences.
RESULTS: Overall, of 727 survey respondents, 431 (61%) were female, 384 (55%) were aged ≥50 years, almost half had worked as obstetrics and gynecology surgeons for ≥15 years (329 [45%]), and 527 (73%) reported completing <10 surgical procedures per week. Most (568 [78%]) reported <3 surgical complications per year, and most (472 [66%]) thought this was similar or less frequent compared with their colleagues. Complications caused most stress when they resulted in poor patient outcomes (653 [90%]), had severe patient consequences (630 [87%]), or were a result of surgeon error (627 [86%]). Complications impacted most obstetrics and gynecology surgeons\' well-being and sleep. A greater proportion of those aged <50 years reported that their mental well-being (32 [10%]; P=.002) and sleep (130 [42%]; P=.03) were affected when a complication occurred. Female participants were also more likely to report that their physical health (14 [3%]; P≤.001), mental health (39 [9%]; P=.01), and sleep (183 [43%]; P≤.001) were affected. Current trainees (11 [10%]) and surgeons with <15 years of experience (25 [9%]) were more likely to experience mental well-being consequences compared with surgeons with ≥15 years of experience (12 [4%]; P=.01). Female participants reported less willingness to interact with colleagues when complications occurred (323 [75%]; P=.006), and surgeons with <15 years of training were less likely to report comfort in talking (221 [74%]; P=.03) and interacting with others (212 [74%]; P=.02).
CONCLUSIONS: The vast majority of obstetrics and gynecology surgeons experience a major impact on their health and well-being when one of their patients develops a complication. The degree and type of impact reported are similar to those observed in other surgical specialties. Future studies are needed to test interventions that alleviate the substantial impact and to follow obstetrics and gynecology surgeons longitudinally to understand the duration of the impact of complications.
摘要：
背景：由于人口老龄化，医学合并症和肥胖症的发生率不断增加，妇产科（OBGYN）手术变得越来越复杂。因此并发症很常见，不仅影响患者，而且还可能给作为“第二受害者”的OBGYN外科医生带来痛苦。
目的：我们研究的目的是描述和量化并发症对OBGYN外科医生的影响范围，并评估社会人口统计学，与这种影响相关的临床医生和实践因素。
方法：根据对OBGYNs的访谈和文献综述进行了横断面调查。调查评估了OBGYN的人口统计，临床和实践特点，估计每年的并发症数量，苦恼,身心健康,睡眠,由并发症引起的关系影响，并探讨了OBGYNs用于应对并发症的策略。单变量逻辑回归分析用于确定OBGYNs特征之间的关联，和并发症的后果。
结果：总体而言，在727名受访者中，431（61%）为女性，384人（55%）50岁或以上，近一半的人在OBGYN工作了15年或更长时间(329(45%))，和527（73％）通常每周完成少于10次外科手术。大多数（568（78％））报告每年少于3次手术并发症，大多数（472（66％））认为这与他们的同事相似或更少。并发症在导致患者预后不良时引起的压力最大（653（90％）），有严重的患者后果（630（87％））或外科医生错误的结果（627（86％））。并发症影响了大多数OBGYN的健康和睡眠。50岁以下的人中有更多的人报告说他们的心理健康(32(10%)，p=0.002)和睡眠(130(42%)，发生并发症时，p=0.03）受到影响。女性也更有可能报告自己的身体健康(14(3%)，p=<0.001)，心理健康（39（9%），p=0.01）和睡眠（183（43%），p=<0.001)受到影响。与≥15年经验的外科医生（12（4％））相比，当前的受训者（11（10％））和经验少于15年的外科医生（25（9％））更有可能经历心理健康后果（p=0.01）。女性报告并发症发生时与同事互动的意愿较低（323（75％），p=0.006），受过不到15年培训的外科医生不太可能报告说话舒适（221（74％），p=0.03)和与他人互动(212(74%)，p=0.02)。
结论：当其中一名患者出现并发症时，绝大多数OBGYN患者会对他们的健康和福祉产生重大影响。报告的影响程度和类型与其他外科专业所经历的相似。未来的研究需要测试干预措施以减轻重大影响，并纵向跟踪OBGYN，以了解并发症的影响持续多长时间。
目的：我们研究的目的是描述和量化并发症对OBGYN外科医生的影响范围，并评估社会人口统计学，与这种影响相关的临床医生和实践因素。
方法：根据对OBGYNs的访谈和文献综述进行了横断面调查。调查评估了OBGYN的人口统计，临床和实践特点，估计每年的并发症数量，苦恼,身心健康,睡眠,由并发症引起的关系影响，并探讨了OBGYNs用于应对并发症的策略。单变量逻辑回归分析用于确定OBGYNs特征之间的关联，和并发症的后果。
结果：总体而言，在727名受访者中，431（61%）为女性，384人（55%）50岁或以上，近一半的人在OBGYN工作了15年或更长时间(329(45%))，和527（73％）通常每周完成少于10次外科手术。大多数（568（78％））报告每年少于3次手术并发症，大多数（472（66％））认为这与他们的同事相似或更少。并发症在导致患者预后不良时引起的压力最大（653（90％）），有严重的患者后果（630（87％））或外科医生错误的结果（627（86％））。并发症影响了大多数OBGYN的健康和睡眠。50岁以下的人中有更多的人报告说他们的心理健康(32(10%)，p=0.002)和睡眠(130(42%)，发生并发症时，p=0.03）受到影响。女性也更有可能报告自己的身体健康(14(3%)，p=<0.001)，心理健康（39（9%），p=0.01）和睡眠（183（43%），p=<0.001)受到影响。与≥15年经验的外科医生（12（4％））相比，当前的受训者（11（10％））和经验少于15年的外科医生（25（9％））更有可能经历心理健康后果（p=0.01）。女性报告并发症发生时与同事互动的意愿较低（323（75％），p=0.006），受过不到15年培训的外科医生不太可能报告说话舒适（221（74％），p=0.03)和与他人互动(212(74%)，p=0.02)。
结论：当其中一名患者出现并发症时，绝大多数OBGYN患者会对他们的健康和福祉产生重大影响。报告的影响程度和类型与其他外科专业所经历的相似。未来的研究需要测试干预措施以减轻重大影响，并纵向跟踪OBGYN，以了解并发症的影响持续多长时间。
