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Asia Pac Fam Med:香港学者研究称,中国六至八成医生职业倦怠

2018-04-28 佚名 中国循环杂志

香港理工大学近期一项分析发现,中国医生的职业倦怠已成为普遍现象。有66.5%~87.8%的中国医生职业倦怠。

香港理工大学近期一项分析发现,中国医生的职业倦怠已成为普遍现象。有66.5%~87.8%的中国医生职业倦怠。

研究发现,有职业倦怠的医生更焦虑,工作满意度相下降,医疗差错风险高,更容易离职。每周工作时间超过40小时、在三级医院工作、30~40岁的医生的职业倦怠较高。

职业倦怠(Burnout)是翻译过来的,中文意思更接近“疲劳”和“过度劳累”。但实际包括身体、心理和精神三个层面。

作者也认为,中国人工作的态度,是不抱怨,或在疲惫的情况下忍受一切困难,虽然保证了医疗服务,但更倾向于倦怠。

而且,中国医疗的商业化,正在与中国传统医患关系背道而驰。医院成为“医疗服务提供者”,患者成了“客户”,传递的信息是“谁能负担得起更高的费用,就能得到更高质量的医疗服务”。

中国40岁以下的年轻医生职业倦怠感重,可能的原因是年轻医生的工作量更大,工作经验少,但同时也是月薪最低的群体。

一位来自西安的年轻医生表示,在被“病人”提醒,自己的家庭非常富有,并要求获得最好的医疗服务时,他很绝望。

另一位来自上海的年轻医生悲伤地表示,为了避免投诉而,即使被“患者”殴打或指责,也不能有身体或语言上的反击。她对目前中国医生的低社会地位感到非常沮丧。

但在工作和社会生活之间怎样实现良好平衡的艺术,在中国文化和医学教育中都没有涉及。尤其是中国文化鼓励在没有抱怨的情况下承受所有困难,这可能会导致中国医生不愿意寻求帮助。

作者呼吁,医生既要弥合传统的高道德标准和当今病人的需求,也要努力争取工作与生活平衡的艺术,需要将医学人文学科正式纳入中国医学院的医学课程,主张“医学人文学复兴”。

2016年,一项对黑龙江省多专业1274名医生进行的研究发现,倦怠与焦虑正相关,研究中有31%的医生焦虑。

一项中国10省份的多中心研究显示,报告严重倦怠的医生在过去一年发生医疗差错的比例高,包括病历记录不完整或不正确、用药物错误和治疗延误。

该研究发现,每周工作时间和每日服务患者人数与倦怠正相关。研究中医生平均每周工作时间为54±11小时,平均每日看病人数为27人。医生每周工作时间超过60小时的人,容易发生医疗差错。

本次评估纳入了11篇论文,其中包括9302名参与者。

原始出处:
Lo D, Wu F, Chan M,et al. A systematic review of burnout among doctors in China: a cultural perspective. Asia Pac Fam Med. 2018; 17: 3.

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