卢旺达围手术期医护人员职业倦怠和疲劳的生活体验：一项定性研究。

IF 9.1 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia Pub Date : 2024-09-20 DOI:10.1016/j.bja.2024.07.018

M. Dylan Bould , Eugene Tuyishime , Charles Nkurunziza , Christophe Mpirimbanyi , Gedeon Mutabezi , Logan Wiwchar , Lydia Yilma , Christopher Charles , Christian Rangel

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引用次数: 0

摘要

背景缺乏有关工作场所压力对非洲医院医护人员福祉的负面影响的定性数据。我们开展了一项基于访谈的定性研究，研究对象包括卢旺达所有省份的 64 名围手术期医护专业人员。我们采用了迭代主题分析法，旨在探索卢旺达医护专业人员的生活经验，并考虑马斯拉赫模型在多大程度上与这些经验相吻合。结果我们发现对个人所受影响的反应不一，包括否认职业倦怠和疲劳以至于身体疲惫。他们的反应与马斯拉赫的三因素模型一致，即情绪衰竭、个人成就感下降和人格解体，并对医疗保健系统产生了下游影响。其他因素包括强烈的爱国主义文化、以卢旺达种族屠杀后的恢复为叙事框架的目标，以及个人和集体对发展卢旺达医疗保健系统的投资。考虑到个人和集体成就感的降低、精神伤害及其对整个医疗系统的各种下游影响，可能更能体现卢旺达职业倦怠的代价。要改善工作压力的成因，可能需要在改善人员配备和工作条件方面投入大量资金。

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Lived experience of burnout and fatigue in perioperative healthcare professionals in Rwanda: a qualitative study

Background

There is a lack of qualitative data on the negative effects of workplace stressors on the well-being of healthcare professionals in hospitals in Africa. It is unclear how well research methods developed for high-income country contexts apply to different cultural, social, and economic contexts in the global south.

Methods

We conducted a qualitative interview-based study including 64 perioperative healthcare professionals across all provinces of Rwanda. We used an iterative thematic analysis and aimed to explore the lived experience of Rwandan healthcare professionals and to consider to what extent the Maslach model aligns with these experiences.

Results

We found mixed responses of the effects on individuals, including the denial of burnout and fatigue to the points of physical exhaustion. Responses aligned with Maslach's three-factor model of emotional exhaustion, decreased personal accomplishment, and depersonalisation, with downstream effects on the healthcare system. Other factors included strongly patriotic culture, goals framed by narratives of Rwanda's recovery after the genocide, and personal and collective investment in developing the Rwandan healthcare system.

Conclusions

The Rwandan healthcare system presents many challenges which can become profoundly stressful for the workforce. Consideration of reduced personal and collective accomplishment, of moral injury, and its diverse downstream effects on the whole healthcare system may better represent the costs of burnout Rwanda. It is likely that improving the causes of work-based stress will require a significant investment in improving staffing and working conditions.

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来源期刊

British journal of anaesthesia 医学-麻醉学

CiteScore

13.50

自引率

7.10%

发文量

488

审稿时长

27 days

期刊介绍： The British Journal of Anaesthesia (BJA) is a prestigious publication that covers a wide range of topics in anaesthesia, critical care medicine, pain medicine, and perioperative medicine. It aims to disseminate high-impact original research, spanning fundamental, translational, and clinical sciences, as well as clinical practice, technology, education, and training. Additionally, the journal features review articles, notable case reports, correspondence, and special articles that appeal to a broader audience. The BJA is proudly associated with The Royal College of Anaesthetists, The College of Anaesthesiologists of Ireland, and The Hong Kong College of Anaesthesiologists. This partnership provides members of these esteemed institutions with access to not only the BJA but also its sister publication, BJA Education. It is essential to note that both journals maintain their editorial independence. Overall, the BJA offers a diverse and comprehensive platform for anaesthetists, critical care physicians, pain specialists, and perioperative medicine practitioners to contribute and stay updated with the latest advancements in their respective fields.