实施以组织为基础的夫妻健康促进计划,以改善医生的福祉。

IF 10.5 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Jessica M Gold, Tait D Shanafelt, Hanhan Wang, Jo Townson, Sherilyn Stolz, Nikitha Menon, Mickey Trockel
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引用次数: 0

摘要

重要性:医生的工作时间很长,通常是不可预测的,并且经历多种与工作有关的压力,这可能会对他们的人际关系产生不利影响。目的:评估医师及其伴侣夫妻工作坊与职业倦怠、自我评价和工作对个人关系的影响(IWPR)的关系。设计、环境和参与者:在本队列研究中,参与者被分为立即干预组和延迟干预组,随后进行比较。干预组的参与者于2022年10月聚集在斯坦福大学附近的一个度假胜地,而对照组的参与者则被邀请参加2023年5月的研讨会。受邀的参与者包括斯坦福医学院的医生和他们的合作伙伴。符合条件的医生在COVID-19大流行期间在被认为是一线的部门或部门工作,或者在全机构调查中IWPR得分不高。数据分析时间为2024年6月14日至2024年10月1日。干预:干预组参加了为期2天的夫妻工作坊,并提供了3个晚上的会议。所有的课程都强调积极心理学的原则,并结合了教学、反思和非结构化的内容,重点是加强人际关系。主要结果和测量方法:主要结果为IWPR评分,分别在基线(干预组在研讨会开始前,对照组在登记时)和6个月后测量。IWPR是通过一项调查来衡量的,该调查询问了4个问题,涉及工作在过去一年中如何影响个人关系,回答包括完全不正确、有点正确、中等正确、非常正确和完全正确(得分分别为0、1、2、3和4)。其他结果测量包括倦怠和自我评价(较低的分数有利于倦怠,较高的分数有利于自我评价)。结果:干预组47例,对照组69例,女性22例(46.8%),对照组40例(57.9%),差异有统计学意义(P = 0.32)。干预组47名医生中的38名(80.9%)和对照组69名医生中的53名(76.8%)完成了配对评估(基线和6个月时)。在基线和6个月随访期间,干预组参与者的平均(SD)改善为1.59(2.66)点(Cohen d = 0.54 [95% CI, 0.23-0.85];结论和相关性:在这项由组织赞助的干预措施的队列研究中,包括旨在减轻医生不良IWPR的夫妻研讨会,参与与IWPR、倦怠和自我评价的统计学显著改善相关。进一步发展干预措施,以减轻医生的不良IWPR是必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Implementation of an Organization-Based Couples Health Promotion Program to Improve Physician Well-Being.

Importance: Physicians work long, often unpredictable hours and experience multiple work-related stressors, which may adversely affect their personal relationships.

Objective: To assess the associations of a couples' workshop for physicians and their partners with burnout, self-valuation, and impact of work on personal relationships (IWPR).

Design, setting, and participants: In this cohort study, participants were grouped into an immediate intervention group and a delayed intervention control group, which were later compared. The participants in the intervention group gathered at a resort near Stanford University in October 2022, whereas the participants in the control group were invited to participate in a May 2023 workshop. Invited participants included Stanford Medicine physicians and their partners. Eligible physicians worked in a department or division considered frontline during the COVID-19 pandemic or had unfavorable IWPR scores on an institution-wide survey. The data were analyzed from June 14, 2024, to October 1, 2024.

Intervention: The intervention group participated in a 2-day workshop for couples and were offered 3 evening sessions. All sessions emphasized positive psychology principles and incorporated didactic, reflection, and unstructured content focused on strengthening relationships.

Main outcomes and measures: The main outcome was IWPR score, measured at baseline (immediately preceding the workshop for the intervention group and at registration for the control group) and 6 months later. IWPR was measured with a survey asking 4 questions about how work had affected personal relationships during the past year, and the responses included not at all true, somewhat true, moderately true, very true, and completely true (with scores assigned as 0, 1, 2, 3, and 4, respectively). Other outcome measures included burnout and self-valuation (with a lower score being favorable for burnout and a higher score being favorable for self-valuation).

Results: Of 47 intervention group participants and 69 control group participants, 22 (46.8%) and 40 (57.9%), respectively, were women (P = .32). Paired assessments (at baseline and 6 months) were completed by 38 of 47 (80.9%) physicians in the intervention group and 53 of 69 (76.8%) in the control group. Between baseline and 6-month follow-up, participants in the intervention group showed a mean (SD) improvement of 1.59 (2.66) points (Cohen d = 0.54 [95% CI, 0.23-0.85]; P < .001) in IWPR, 1.22 (1.47) points (Cohen d = 0.68 [95% CI, 0.39-0.98]; P < .001) in burnout, and -1.25 points (2.09) (Cohen d = 0.68 [95% CI, -0.97 to -0.25]; P < .001) in self-valuation. Statistically significant changes in these measures were not observed in the control participants. In mixed-effects modeling comparing the intervention and control groups, being in the intervention group was associated with a 1.25-point improvement in IWPR (Glass d = -0.45 [95% CI, -0.12 to -0.79]; P = .01), a 1.24-point improvement in burnout (Glass d = -0.70 [95% CI, -0.37 to -1.03]; P < .001), and a 0.97-point improvement in self-valuation (Glass d = 0.47 [95% CI, 0.09-0.86]; P = .02).

Conclusions and relevance: In this cohort study of an organizationally sponsored intervention consisting of a couples' workshop designed to mitigate the adverse IWPR for physicians, participation was associated with statistically significant improvements in IWPR, burnout, and self-valuation. Further development of interventions to mitigate adverse IWPR among physicians is warranted.

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来源期刊
JAMA Network Open
JAMA Network Open Medicine-General Medicine
CiteScore
16.00
自引率
2.90%
发文量
2126
审稿时长
16 weeks
期刊介绍: JAMA Network Open, a member of the esteemed JAMA Network, stands as an international, peer-reviewed, open-access general medical journal.The publication is dedicated to disseminating research across various health disciplines and countries, encompassing clinical care, innovation in health care, health policy, and global health. JAMA Network Open caters to clinicians, investigators, and policymakers, providing a platform for valuable insights and advancements in the medical field. As part of the JAMA Network, a consortium of peer-reviewed general medical and specialty publications, JAMA Network Open contributes to the collective knowledge and understanding within the medical community.
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