住院醫師工作疲勞與個人性格及因應型態的關連

The Association of Resident Burnout with Personal Characteristics and Coping Styles

10.6145/jme.201103_15(1).0003

呂碧鴻(Bee-Horng Lue)；高美英(Meei-Ying Kao)；陳秀蓉(Hsiu-Jung Chen)；王長偉(Chang-Wei Wang)

住院醫師工作疲勞 ； 性格 ； 因應型態 ； resident burnout ； personality ； coping style

Journal of Medical Education

15卷1期（2011 / 03 / 01）

21 - 30

繁體中文

目的：住院醫師的工作內涵與患者的要求以及自我的挑戰，不論是質與量都比其他時期的醫師多，本研究目的欲探討住院醫師容易出現工作疲勞(burnout)，是否與其性格和因應型態有闕，研究假設低疲勞組將比高疲勞組顯示出正向性格與積極因應方式，而此性格及因應型態將是疲勞的重要保護因子，預期此結果將可提供教育訓練者與醫師預防與調節疲勞之重要方向。方法：554位住院醫師，男性佔67.7%，女性佔32.3%，填寫三份測量工具：哥本哈根疲勞量表、因應策略查表及五大性格量表，依其在疲勞量表上之分數，分成高、中、低疲勞組。進行單因子變異數分析與事後檢定法分析疲勞與性格及因應之關係。結果：1.與高疲勞組住院醫師比較，低疲勞組住院醫師在性格表現上，有比較低的神經質傾向，較高外向性、較高嚴謹性以及高宜人性性格，開放性在三組間則無顯著差異。2.低疲勞組採用投入因應傾向顯著高於中等疲勞組與高疲勞組，而高疲勞組則傾向採取較多逃離式因應。討論：從低疲勞組與中、高疲勞組醫師間性格的差異，反映醫師自身性格可能與疲勞有關，若醫師能覺察自身的性格特性做適切的自我調節，則可能較易抗衡醫學生涯中各種挑戰。又低疲勞組之住院醫師顯著地呈現健康的性格與積極因應傾向，推論性格與因應相互影響可能具有對抗疲勞的保護作用，未來可更近一步研究驗證此保護因子之角色。

Objectives: During the residency training years, compared to other periods of professional development, physicians must adjust to tougher workloads, higher professional self-expectations, and increased demands from patients, The objective of this study is to explore how the development of burnout among resident physicians is related to their personal characteristics or coping styles. Knowing how burnout develops in relation to these two factors may provide healthcare educators and physicians with an important approach to preventing physician burnout. This study proposes that physicians with lower occurrence of burnout may possess more positive personal characteristics, such as extroversion, conscientiousness, and agreeability which may then increase their ability to develop more active adaptation skills and coping styles. Methods: A total of 554 resident physicians, (67.7% male and 32.3% female), were enrolled in this study. All of them completed three measures: Copenhagen Burnout Inventory, Coping Strategies Inventory, and Five-factor Inventory. They were then divided into three groups according to the scores obtained from these indices: high, moderate, and low burnout. Analysis of variance and Scheffé tests were used to assess the relationship between burnout, personal characteristics, and coping styles. Results: 1. Compared with the high burnout group, the residents in the low burnout group exhibited less neuroticism, more extroversion, more conscientiousness and more agreeability. There was no significant difference in the dimension of openness amongst the three groups. 2. The low burnout group tended to use engagement coping styles more so than the moderate or high burnout groups. The high burnout group tended to use disengagement coping styles. Discussion: The presence of positive or negative personal characteristics of those in the low, moderate, and high burnout groups correlates with the occurrence of physician burnout. The low burnout residents exhibited more positive characteristics and active coping styles than those in the other groups. If physicians are made aware of potentially detrimental personal characteristics, and adjust their behavior and coping styles accordingly, they may better meet the various challenges in their medical career. We therefore conclude that certain personal characteristics and coping styles may protect physicians from burnout. Further study is suggested to explore these protective factors and how best to employ them.

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