| Autor: |
Dodek PM; Center for Health Evaluation and Outcome Sciences.; Division of Critical Care Medicine, and., Cheung EO; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois., Burns KEA; Department of Medicine.; Li Ka Shing Knowledge Institute., Martin CM; Division of Critical Care Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., Archambault PM; Department of Family Medicine and Emergency Medicine, and., Lauzier F; Department of Anesthesiology and Critical Care, Laval University, Quebec City, Quebec, Canada., Sarti AJ; Department of Critical Care, General Campus, The Ottawa Hospital, Ottawa, Ontario, Canada., Mehta S; Sinai Health System., Fox-Robichaud AE; Department of Medicine., Seely AJE; Division of Thoracic Surgery.; Department of Critical Care., Parshuram C; Department of Pediatrics.; Department of Critical Care Medicine, and., Garros D; Department of Pediatrics and., Withington DE; Department of Anesthesia., Cook DJ; Department of Medicine.; Department of Medicine, and.; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada., Piquette D; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada., Carnevale FA; Ingram School of Nursing, McGill University, Montreal, Quebec, Canada., Boyd JG; Department of Medicine, Queen's University, Kingston, Ontario, Canada., Downar J; Division of Palliative Care, and., Kutsogiannis DJ; Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada., Chassé M; Faculty of Medicine and.; School of Public Health, University of Montreal, Montreal, Quebec, Canada., Fontela P; Department of Pediatrics, Faculty of Medicine, and., Fowler RA; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada., Bagshaw S; Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada., Dhanani S; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada., Murthy S; Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Gehrke P; Niagara Health, St. Catharines, Ontario, Canada; and., Fujii T; School of Medicine, Jikei University, Tokyo, Japan. |
| Abstrakt: |
Rationale: Understanding the magnitude of moral distress and its associations may point to solutions. Objectives: To understand the magnitude of moral distress and other measures of wellness in Canadian critical care physicians, to determine any associations among these measures, and to identify potentially modifiable factors. Methods: This was an online survey of Canadian critical care physicians whose e-mail addresses were registered with either the Canadian Critical Care Society or the Canadian Critical Care Trials Group. We used validated measures of moral distress, burnout, compassion fatigue, compassion satisfaction, and resilience. We also measured selected individual, practice, and workload characteristics. Results: Of the 499 physicians surveyed, 239 (48%) responded and there were 225 usable surveys. Respondents reported moderate scores of moral distress (107 ± 59; mean ± standard deviation, maximum 432), one-third of respondents had considered leaving or had previously left a position because of moral distress, about one-third met criteria for burnout syndrome, and a similar proportion reported medium-high scores of compassion fatigue. In contrast, about one-half of respondents reported a high score of compassion satisfaction, and overall, respondents reported a moderate score of resilience. Each of the "negative" wellness measures (moral distress, burnout, and compassion fatigue) were associated directly with each of the other "negative" wellness measures, and inversely with each of the "positive" wellness measures (compassion satisfaction and resilience), but moral distress was not associated with resilience. Moral distress was lower in respondents who were married or partnered compared with those who were not, and the prevalence of burnout was lower in respondents who had been in practice for longer. There were no differences in any of the wellness measures between adult and pediatric critical care physicians. Conclusions: Canadian critical care physicians report moderate scores of moral distress, burnout, and compassionate fatigue, and moderate-high scores of compassion satisfaction and resilience. We found no modifiable factors associated with any wellness measures. Further quantitative and qualitative studies are needed to identify interventions to reduce moral distress, burnout, and compassion fatigue. |
