目标:急诊医学(EM)设置非常紧张,鉴于工作量大,紧张的工作环境,和延长的工作时间。反过来,越来越多的医疗工作者(HCWs)报告了倦怠率及其三个领域.因此,我们进行了这项荟萃分析,以确定EMHCWs中职业倦怠的患病率和危险因素.
方法:在2023年2月搜索了六个数据库,产生了29篇文章(16,619EMHCWs)报告了倦怠或其三个领域(情绪疲惫\“EE\”,去个性化\"DP\",和个人成就“PA”)。主要结果是倦怠及其领域的患病率,次要结局包括高倦怠的危险因素,EE,DP,或低PA。使用STATA软件汇总研究中的倦怠率。患病率使用合并效应大小(ES)进行测量,当遇到异质性时,使用随机效应模型;否则,采用固定效应模型。
结果:总体倦怠的患病率很高(43%),35%的EMHCW有很高的倦怠风险。同时,39%,43%,36%的EM工人报告有高水平的EE和DP和低水平的PA,分别。观察到特定国家/地区的倦怠率变化。高倦怠率,高EE,高DP,与大流行前相比,COVID-19大流行期间的低PA更高。职业的类型(护士,医师,居民,等。)在修改倦怠率及其领域方面发挥了重要作用。然而,性别不是EM工人中高倦怠或其领域的重要决定因素。
结论:倦怠是急诊医学实践中普遍存在的问题,影响所有工人。随着居民培训年限的进步,他们经历倦怠的可能性加剧。护士受这个问题影响最大,其次是医生。与国家相关的倦怠及其领域的差异是显而易见的。
OBJECTIVE: Emergency medicine (EM) settings are very stressful, given the high workload, intense working environment, and prolonged working time. In turn, the rate of burnout and its three domains have been increasingly reported among healthcare workers (HCWs). Therefore, we conducted this meta-analysis to determine the prevalence and risk factors of burnout among EM HCWs.
METHODS: Six databases were searched in February 2023, yielding 29 articles (16,619 EM HCWs) reporting burnout or its three domains (emotional exhaustion \"EE\",
depersonalization \"DP\", and personal accomplishment \"PA\"). The primary outcome was the prevalence of burnout and its domains, while secondary outcomes included the risk factors of high burnout, EE, DP, or low PA. Burnout rates were pooled across studies using STATA software. The prevalence was measured using the pooled effect size (ES), and the random-effects model was used when heterogeneity was encountered; otherwise, the fixed-effects model was used.
RESULTS: The prevalence of overall burnout was high (43%), with 35% of EM HCWs having a high risk of burnout. Meanwhile, 39%, 43%, and 36% of EM workers reported having high levels of EE and DP and low levels of PA, respectively. Country-specific changes in the rate of burnout were observed. The rate of high burnout, high EE, high DP, and low PA was higher during the COVID-19 pandemic as compared to the pre-pandemic period. The type of profession (nurses, physicians, residents, etc.) played a significant role in modifying the rate of burnout and its domains. However, gender was not a significant determinant of high burnout or its domains among EM workers.
CONCLUSIONS: Burnout is a prevalent problem in emergency medicine practice, affecting all workers. As residents progress through their training years, their likelihood of experiencing burnout intensifies. Nurses are most affected by this problem, followed by physicians. Country-associated differences in burnout and its domains are evident.