巴林特小组活动对初级保健医生职业倦怠的干预效果

Effects of Balint group intervention on occupational burnout of primary care physicians

目的探讨参加巴林特小组活动改善初级保健医生职业倦怠的干预效果。方法将在社区初级保健中心工作的210名医生按照1∶2随机分入巴林特活动干预小组(n=70)和无巴林特小组干预的对照组(n=140),干预组对象接受了为期一年的巴林特小组活动干预,对照组仅接受自然观察。研究采用Maslash职业倦怠量表(MBI)分别于基线和一年时评估两组医生的职业倦怠程度。结果基线时干预组和对照组的MBI三个分量表评分差异均无统计学意义(均P>0.05);干预后干预组的MBI情绪疲惫感[(20.1±8.3)分]和对服务对象冷漠[(6.8±4.9)分]分量表评分低于对照组[(22.6±8.7)分,(10.8±5.2)分],而MBI无工作成就感[(38.3±7.5)分]分量表评分高于对照组[(34.6±7.7)分],均差异有统计学意义(t=1.993,5.355,3.311,均P<0.05)。与基线相比,干预组情绪疲惫感、工作冷漠感和无工作成就感3个维度的评分变化[(-2.2±0.9)分,(-3.4±1.1)分,(5.5±1.3)分]均差异有统计学意义(t=2.054,4.258,9.875,P<0.05),而对照组各维度评分变化差异无统计学意义(P>0.05)。结论巴林特小组活动可显著减轻初级保健医生的职业倦怠。

Objective To examine the effects of participating in Balint group (PBG) for reducing occupational burnout among primary care physicians (PCPs). Methods In this randomized controlled trial, 240 PCPs were randomly assigned to PBG (n=70) and control group (n=240) in propotion of 1∶2.Subjects of PBG received Balint group intervention for one year, while control group received natural observation.Maslach Burnout Inventory (MBI) was used to assess the severity of occupational burnout. Results At baseline all three subscales of MBI had no significant difference between PBG and cotrol group(P>0.05). After the intervention, PBG had statistically lower subscale scores in emotional exhaustion ((20.1±8.3) vs (22.6±8.7), t=1.993, P=0.048) and depersonalization ((6.8±4.9) vs (10.8±5.2), t=5.355, P<0.001) than the control group, while had statistically higher score in personal accomplishment subscale((38.3±7.5) vs (34.6±7.7), t=3.311, P=0.001) than the control group. Conclusions PBG is effective in reducing occupational burnout among PCPs.