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zoom RSS 外科医の6%以上が過去1年以内に自殺を考えた/米国医療事情

<<   作成日時 : 2011/01/19 20:10   >>

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画像 数千人のデータをもとにした調査によると、かなりの数の米国の外科医が燃え尽きや医療事故が原因で自殺思慮と格闘しているという。
 外科医の6%以上が過去1年以内に自殺を考えたというメイヨ・クリニックの研究結果が公表された。55〜64歳では全国平均の3倍にあたるという。若い外科医は6〜7%で一般人口と同程度だが45歳以上はリスクが高く、55〜64歳では7%と一般人の約2%に比べてかなり高い。過去3ヶ月に「大きな医療ミス」をおかしたと言う医師で高い割合だった。既婚であったり大学のメディカルセンターの医師はリスクが低かった。医師資格を失うのを恐れて、専門的な相談を受けたのは問題の多い医師の1/4にすぎなかった。その代わりに抗うつ剤の助けを借りていた。
 NIMH国立精神衛生研究所によると、2007年に米国人10万人あたり約11人の自殺死者が出た。
 
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高い自殺率は医師の職業病
http://kurie.at.webry.info/200805/article_21.html
医学生の悩みと医師の自殺リスク/米国医療事情
http://kurie.at.webry.info/201010/article_10.html
医学生の「燃え尽き」と治療への挑戦/米国
http://kurie.at.webry.info/200811/article_1.html
小児科医師の過労自殺、最高裁で和解/医師不足
http://kurie.at.webry.info/201007/article_9.html
麻酔科女医過労自殺 病院に賠償責任
http://kurie.at.webry.info/200705/article_55.html

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One in 16 U.S. surgeons consider suicide: survey
NEW YORK | Tue Jan 18, 2011 9:20pm EST
http://www.reuters.com/article/idUSTRE70H7N520110119

(Reuters) - A considerable number of U.S. surgeons struggle with thoughts of suicide, with burnout and past medical errors as possible reasons, according to a survey covering thousands of surgeons.

A team led by Tait Shanafelt of the Mayo Clinic in Rochester, Minnesota found that more than 6 percent of surgeons had thought about killing themselves within the past year.

Among those aged 55 to 64, the number was three times higher than national levels for that age group.

"What we are seeing through this work is that there is a high amount of burnout and stress among America's physicians, with potentially serious consequences for both physicians and their patients," Shanafelt said.

"It isn't necessarily that having thoughts of suicide endangers patient health, but some of the same root causes, particularly burnout, do appear to have a strong relationship with quality of care."

In a survey published last year, Shanafelt's team found that surgeons who reported high degrees of emotional exhaustion on the job also had higher odds of making major errors when they dealt with patients.

The same survey, based on responses from more than 7,900 physicians, for the current study, which appears in the Archives of Surgery.

While younger surgeons had rates of suicidal thinking that were similar to those in the general population, between 6 and 7 percent, those older than 45 were at increased risk.

Among those 55 to 64 years old, 7 percent of surgeons had considered suicide within the past year, compared to about 2 percent of the general population.

Doctors who felt burned out, or said they'd made a "major medical error" in the past 3 months, were more prone to suicidal thoughts.

Married surgeons, and those working in large university-based medical centers, were at lower risk for suicidal thoughts.

The survey also showed that only a fourth of the troubled surgeons had sought professional help, with most saying they hadn't out of fear of losing their medical license.

Instead, some chose to self-prescribe antidepressants or have friends do it for them.

"We've known for some time that physicians are at greater risk for suicide than other professions, although why that is has never really been understood," Shanafelt told Reuters Health.

According to the National Institutes of Mental Health, there were about 11 suicide deaths per 100,000 Americans in 2007.

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Suicidal Ideation Among American Surgeons

Tait D. Shanafelt, MD; Charles M. Balch, MD; Lotte Dyrbye, MD; Gerald Bechamps, MD; Tom Russell, MD; Daniel Satele, BA; Teresa Rummans, MD; Karen Swartz, MD; Paul J. Novotny, MS; Jeff Sloan, PhD; Michael R. Oreskovich, MD

Arch Surg. 2011;146(1):54-62. doi:10.1001/archsurg.2010.292

Background Suicide is a disproportionate cause of death for US physicians. The prevalence of suicidal ideation (SI) among surgeons and their use of mental health resources are unknown.

Study Design Members of the American College of Surgeons were sent an anonymous cross-sectional survey in June 2008. The survey included questions regarding SI and use of mental health resources, a validated depression screening tool, and standardized assessments of burnout and quality of life.

Results Of 7905 participating surgeons (response rate, 31.7%), 501 (6.3%) reported SI during the previous 12 months. Among individuals 45 years and older, SI was 1.5 to 3.0 times more common among surgeons than the general population (P < .02). Only 130 surgeons (26.0%) with recent SI had sought psychiatric or psychologic help, while 301 (60.1%) were reluctant to seek help due to concern that it could affect their medical license. Recent SI had a large, statistically significant adverse relationship with all 3 domains of burnout (emotional exhaustion, depersonalization, and low personal accomplishment) and symptoms of depression. Burnout (odds ratio, 1.910; P < .001) and depression (odds ratio, 7.012; P < .001) were independently associated with SI after controlling for personal and professional characteristics. Other personal and professional characteristics also related to the prevalence of SI.

Conclusions Although 1 of 16 surgeons reported SI in the previous year, few sought psychiatric or psychologic help. Recent SI among surgeons was strongly related to symptoms of depression and a surgeon's degree of burnout. Studies are needed to determine how to reduce SI among surgeons and how to eliminate barriers to their use of mental health resources.

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