规范化培训住院医师倦怠焦虑抑郁发生率meta分析

A META-ANALYSIS OF INCIDENCE OF BURNOUT, ANXIETY, AND DEPRESSION AMONG PHYSICIANS DURING STANDARDIZED RESIDENCY TRAINING

目的对已经发表的有关住院医师规范化培训(住培)期间医师倦怠、焦虑和抑郁发生率的文献进行meta分析。方法系统检索中国知网(CNKI)、维普、中国生物医学文献数据库(CBM)、PubMed和Embase数据库。2名研究者严格按照纳入和排除标准独立筛选文献和提取资料,采用R软件进行分析。结果共纳入29项研究(12364人),其中12项、11项和15项研究分别报道了倦怠、焦虑和抑郁的发生率,漏斗图和Egger’s检验提示各研究均无明显的发表偏倚。meta分析结果显示,倦怠、焦虑和抑郁的发生率分别为62%(95%CI=46%~77%)、37%(95%CI=21%~55%)和44%(95%CI=33%~55%)。敏感性分析提示研究结果较稳定。结论住培医师倦怠、焦虑和抑郁的总体发生率略高于国外同类报道。今后的研究需要进一步探索降低倦怠、焦虑和抑郁发生率的有效策略。

Objective To conduct a meta-analysis of published literature on the incidence of burnout,anxiety,and depression among physicians during standardized residency training.Methods Through Chinese National Knowledge Infrastructure,Chinese Biomedical Literature Database,VIP,PubMed,and Embase,two researchers independently selected literature and extracted data according to the inclusion and exclusion criteria.R software was used for analysis.Results A total of 29 studies involving 12364 residents were included.Twelve,11,and 15 studies reported the incidence rates of burnout,anxiety,and depression,respectively.No significant publication bias was found through the funnel plot and Egger’s test.The meta-analysis results showed that the incidence rates of burnout,anxiety,and depression were 62%(95%CI=46%-77%),37%(95%CI=21%-55%),and 44%(95%CI=33%-55%),respectively.The sensitivity analysis indicated that the research results were stable.[WTHX]Conclusion The overall incidence rates of burnout,anxiety,and depression of residents in standardized training are slightly higher than the levels reported abroad.Future research should explore effective strategies for reducing burnout,anxiety,and depression for them.