DOI QR코드

DOI QR Code

Impact of Coping and Communication Skills Program on Physician Burnout, Quality of Life, and Emotional Flooding

  • Penberthy, Jennifer K. (Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine) ;
  • Chhabra, Dinesh (Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine) ;
  • Ducar, Dallas M. (Department of Nursing, University of Virginia School of Nursing) ;
  • Avitabile, Nina (Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine) ;
  • Lynch, Morgan (Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine) ;
  • Khanna, Surbhi (Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine) ;
  • Xu, Yiqin (Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine) ;
  • Ait-Daoud, Nassima (Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine) ;
  • Schorling, John (Department of Internal Medicine, University of Virginia School of Medicine)
  • 투고 : 2017.04.20
  • 심사 : 2018.02.26
  • 발행 : 2018.12.30

초록

Background: Physician behaviors that undermine a culture of safety have gained increasing attention as health-care organizations strive to create a culture of safety and reduce medical errors. We developed, implemented, and assessed a course to teach physicians skills regarding effective coping and interpersonal communication skills and present our results regarding outcomes. Methods: We examined a professional development program specifically designed to address unprofessional or distressed behaviors of physicians, and we evaluated the impact on burnout, quality of life, and emotional flooding scores of the physicians. Assessments of burnout, quality of life, and emotional flooding were assessed preintervention and postintervention. Results: Results demonstrated statistically significant reductions over time in physicians' emotional flooding and emotional exhaustion (EE). Specifically, using a Wilcoxon Signed-Rank test, results revealed that flooding scores at follow-up were statistically significantly lower than at baseline, V = 590, p < 0.05, and EE and personal accomplishment distributions were found to significantly deviate from normal as indicated by Shapiroe-Wilks tests (p < 0.05). A Wilcoxon signed-rank test indicated that EE scores were significantly higher at baseline compared to follow-up 1, V = 285, p < 0.05. Conclusion: We conclude that the physician participants who enrolled in the educational skills training program improved scores on emotional flooding and EE and that this may be indicative of improved skills related to their experiences and learning in the program. These improved skills in physicians may have a positive impact on the overall culture of safety in the health system setting.

키워드

참고문헌

  1. Privitera MR, Rosenstein AH, Plessow F, LoCastro TM. Physician burnout and occupational stress: an inconvenient truth with unintended consequences. J Hosp Adm 2015;4:27-35.
  2. Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, West CP. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc 2015;90:1600-13. https://doi.org/10.1016/j.mayocp.2015.08.023
  3. Rosen IM, Gimotty PA, Shea JA, Bellini LM. Evolution of sleep quantity, sleep deprivation, mood disturbances, empathy, and burnout among interns. Acad Med 2006;81:82-5. https://doi.org/10.1097/00001888-200601000-00020
  4. Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, Shanafelt TD. Burnout among US medical students, residents, and early career physicians relative to the general US population. Acad Med 2014;89:443-51. https://doi.org/10.1097/ACM.0000000000000134
  5. Gabbe SG, Melville J, Mandel L, Walker E. Burnout in chairs of obstetrics and gynecology: diagnosis, treatment, and prevention. Am J Obstet Gynecol 2002;186:601-12. https://doi.org/10.1067/mob.2002.122391
  6. Schernhammer E. Taking their own lives - the high rate of physician suicide. N Engl J Med 2005;352:2473-6. https://doi.org/10.1056/NEJMp058014
  7. Fridner A, Belkic K, Marini M, Gustafsson SM, Schenck-Gustafsson K. Why don't academic physicians seek needed professional help for psychological distress? Swiss Med Wkly 2012;142:13626.
  8. Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, West CP, Sloan J, Oreskovich MR. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med 2012;172:1377-85. https://doi.org/10.1001/archinternmed.2012.3199
  9. Peckham C. Physician burnout: it just keeps getting worse. Medscape 2015 Jan 26, 2015.
  10. Weber DO. Poll results: doctors' unprofessional behavior disturbs physician leaders. Physician Exec 2004;30:6-14.
  11. Rosenstein AH, O'Daniel M. A survey of the impact of unprofessional behaviors and communication defects on patient safety. Jt Comm J Qual Patient Saf 2008;34:464-71. https://doi.org/10.1016/S1553-7250(08)34058-6
  12. Salyers MP, Bonfils KA, Luther L, Firmin RL, White DA, Adams EL, Rollins AL. The relationship between professional burnout and quality and safety in healthcare: a meta-analysis. J Gen Intern Med 2017;32:475-82. https://doi.org/10.1007/s11606-016-3886-9
  13. Rosenstein AH. Nurse-physician relationships: impact on nurse satisfaction and retention. Am J Nurs 2002;102:26-34.
  14. Rosenstein AH, O'Daniel M. Impact and implications of unprofessional behavior in the perioperative arena. J Am Coll Surg 2006;203:96-105. https://doi.org/10.1016/j.jamcollsurg.2006.03.027
  15. Leape LL, Fromson JA. Problem doctors: is there a system-level solution? Ann Intern Med 2006;144:107-15. https://doi.org/10.7326/0003-4819-144-2-200601170-00008
  16. Pfifferling JH. Physicians' "unprofessional" behavior: consequences for medical quality and safety. Am J Med Qual 2008;23:165-7. https://doi.org/10.1177/1062860608315338
  17. Roback HB, Strassberg D, Iannelli RJ, Finlayson AJ, Blanco M, Neufeld R. Problematic physicians: a comparison of personality profiles by offence type. Can J Psychiatry 2007;52:315-22. https://doi.org/10.1177/070674370705200506
  18. Spickard Jr A, Gabbe SG, Christensen JF. Mid-career burnout in generalist and specialist physicians. JAMA 2002;288:1447-50. https://doi.org/10.1001/jama.288.12.1447
  19. Goleman D, Boyatzis R, McKee A. Primal leadership: realizing the power of emotional intelligence. Boston: Harvard Business School Press; 2002.
  20. Goodman MJ, Schorling JB. A mindfulness course decreases burnout and improves well-being among healthcare providers. Int J Psychiatry Med 2012;43:119-28. https://doi.org/10.2190/PM.43.2.b
  21. Samenow CP, Swiggart W, Spickard Jr A. A CME course aimed at addressing unprofessional physician behavior. Physician Exec 2008;34:32-40.
  22. Nigg CR, Burbank P, Padula C, Dufresne R, Rossi JS, Velicer WF, Laforge RG, Prochaska JO. Stages of change across ten health risk behaviors for older adults. Gerontologist 1999;39:473-82. https://doi.org/10.1093/geront/39.4.473
  23. Gottman JM. The roles of conflict engagement, escalation, and avoidance in marital interaction: a longitudinal view of five types of couples. J Consult Clin Psychol 1993;61:6-15. https://doi.org/10.1037/0022-006X.61.1.6
  24. Stamm BH. Professional quality of life: compassion satisfaction and fatigue version 5 (ProQOL); 2009. www.isu.edu/-bhstamm. www.proqol.org.
  25. Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory manual. Palo Alto: Consulting Psychologists Press; 1996.
  26. Beck AT, Steer RA, Brown GK. Manual for the Beck depression inventory-II. San Antonio, TX: Psychological Corporation; 1996.
  27. Heather N, Gold R, Rollnick S. Readiness to change questionnaire user's manual: technical report 15. Kensington, Australia: National Drug and Alcohol Research Centre, University of New South Wales; 1991.
  28. R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2015.
  29. Warnes GR, Bolker B, Gorjanc G, Grothendieck G, Korosec A, Lumley T, MacQueen D, Magnusson A, Rogers J. gdata: various R programming tools for data manipulation; 2015. R package version 2.17.0, http://CRAN.R-project.org/package-gdata.
  30. Steenkamp MM, Suvak MK, Dickstein BD, Shea MT, Litz BT. Emotional functioning in obsessive-compulsive personality disorder: comparison to borderline personality disorder and healthy controls. J Pers Disord 2015;26:794-808.
  31. Maslach C. Burnout: the cost of caring. Los Altos: ISHK; 2003.
  32. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol 2001;52:397-422. https://doi.org/10.1146/annurev.psych.52.1.397
  33. D'Amato A, Zijlstra FR. Psychological climate and individual factors as antecedents of work outcomes. Eur J Work Organ Psychol 2008;17:33-54. https://doi.org/10.1080/13594320701307420
  34. Parker CP, Baltes BB, Young SA, Huff JW, Altmann RA, Lacost HA, Roberts JE. Relationships between psychological climate perceptions and work outcomes: a meta-analytic review. J Organ Behav 2003;24:389-416. https://doi.org/10.1002/job.198
  35. Bedi A, Courcy F, Paquet M, Harvey S. Interpersonal aggression and burnout: the mediating role of psychological climate. Stress Health 2013;29:350-9. https://doi.org/10.1002/smi.2476

피인용 문헌

  1. Mental Health Problems of HIV Healthcare Providers During the COVID-19 Pandemic: The Interactive Effects of Stressors and Coping vol.25, pp.1, 2018, https://doi.org/10.1007/s10461-020-03073-z
  2. Burnout Prevalence and Its Associated Factors among Malaysian Healthcare Workers during COVID-19 Pandemic: An Embedded Mixed-Method Study vol.9, pp.1, 2021, https://doi.org/10.3390/healthcare9010090