{"id":18002,"date":"2019-12-12T05:52:10","date_gmt":"2019-12-11T21:52:10","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=18002"},"modified":"2019-12-24T05:45:49","modified_gmt":"2019-12-23T21:45:49","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%a4%96%e7%a7%91%e4%bd%8f%e9%99%a2%e5%8c%bb%e7%94%9f%e5%9f%b9%e8%ae%ad%e6%9c%9f%e9%97%b4%e7%9a%84%e6%ad%a7%e8%a7%86%e3%80%81%e8%99%90%e5%be%85","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=18002","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u5916\u79d1\u4f4f\u9662\u533b\u751f\u57f9\u8bad\u671f\u95f4\u7684\u6b67\u89c6\u3001\u8650\u5f85\u3001\u9a9a\u6270\u53ca\u5026\u6020"},"content":{"rendered":"\n<p><a class=\"\" href=\"https:\/\/www.nejm.org\/medical-articles\/special-article\">SPECIAL ARTICLE<\/a><strong> <\/strong><strong>FREE PREVIEW<\/strong><\/p>\n\n\n\n<h1 class=\"wp-block-heading\">Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Yue-Yung Hu, Ryan J. Ellis, D. Brock Hewitt, et al.<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">N Engl J Med 2019; 381:1741-1752<br \/>DOI: 10.1056\/NEJMsa1903759<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">BACKGROUND<\/h3>\n\n\n\n<p>Physicians, particularly trainees and those in surgical subspecialties, are at risk for burnout. Mistreatment (i.e., discrimination, verbal or physical abuse, and sexual harassment) may contribute to burnout and suicidal thoughts.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">METHODS<\/h3>\n\n\n\n<p>A cross-sectional national survey of general surgery residents administered with the 2018 American Board of Surgery In-Training Examination assessed mistreatment, burnout (evaluated with the use of the modified Maslach Burnout Inventory), and suicidal thoughts during the past year. We used multivariable logistic-regression models to assess the association of mistreatment with burnout and suicidal thoughts. The survey asked residents to report their gender.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">RESULTS<\/h3>\n\n\n\n<p>Among 7409 residents (99.3% of the eligible residents) from all 262 surgical residency programs, 31.9% reported discrimination based on their self-identified gender, 16.6% reported racial discrimination, 30.3% reported verbal or physical abuse (or both), and 10.3% reported sexual harassment. Rates of all mistreatment measures were higher among women; 65.1% of the women reported gender discrimination and 19.9% reported sexual harassment. Patients and patients\u2019 families were the most frequent sources of gender discrimination (as reported by 43.6% of residents) and racial discrimination (47.4%), whereas attending surgeons were the most frequent sources of sexual harassment (27.2%) and abuse (51.9%). Proportion of residents reporting mistreatment varied considerably among residency programs (e.g., ranging from 0 to 66.7% for verbal abuse). Weekly burnout symptoms were reported by 38.5% of residents, and 4.5% reported having had suicidal thoughts during the past year. Residents who reported exposure to discrimination, abuse, or harassment at least a few times per month were more likely than residents with no reported mistreatment exposures to have symptoms of burnout (odds ratio, 2.94; 95% confidence interval [CI], 2.58 to 3.36) and suicidal thoughts (odds ratio, 3.07; 95% CI, 2.25 to 4.19). Although models that were not adjusted for mistreatment showed that women were more likely than men to report burnout symptoms (42.4% vs. 35.9%; odds ratio, 1.33; 95% CI, 1.20 to 1.48), the difference was no longer evident after the models were adjusted for mistreatment (odds ratio, 0.90; 95% CI, 0.80 to 1.00).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">CONCLUSIONS<\/h3>\n\n\n\n<p>Mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>SPECIAL ARTICLE FREE PREVIEW Discrimination, Abuse, Har [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/18002"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=18002"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/18002\/revisions"}],"predecessor-version":[{"id":18003,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/18002\/revisions\/18003"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=18002"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=18002"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=18002"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}