Research On Objective Evaluation Of Job Burnout Among Young Anesthesiologists By Heart Rate Variability Analysis

Objective: Job burnout is the consequence of long-term high stress of body.It was hoped that the burnout of young anesthesiologists was quantitatively evaluated by heart rate variability(HRV)in terms of autonomic nervous system,so as to explore their objective evaluation method.Methods: A total of 27 young anesthesiologists in Department of Anesthesiology in Tianjin Medical University General Hospital,27 young dentists in Stomatological Hospital of Tianjing Medical University,and another 27 patients with elective surgery in General Surgery Department of General Hospital of Tianjin Medical University were selected as study objects,who were between 23 to 36 years of age.The doctors in doctor group had at least one-year work experience,and patient group had Ⅰ or Ⅱ grading in ASA classification.The copies of Maslach Burnout Inventory-Human Services Survey(MBI-HSS)were distributed by researchers to all the doctors in the study,and were submitted on the same day.At the same time,single HRV signals collection for 5 min as well as blood pressure measurement were performed for them,and they were required to be seated calmly,quiet and relaxed during the collection.The collections were implemented at the following time points: workday morning(basic status),morning of 24 h duty(before beginning of duty),the afternoon of 24 h duty,morning of the completion of 24 h duty of anesthesiologists,and workday morning of dentists(basic status).Hamilton Anxiety Scale(HAMA)was performed for the patients who were going to undergo elective surgery by researchers in the operation preparation room,and they were collected HRV signals for 5 min and measured blood pressure in 10 min after entry to the operating room,keeping quiet in supine position during the collection.Results: The proportions of anesthesiologists with advanced emotional exhaustion,advanced depersonalization and reduced personal accomplishment in MBI-HSS were 29.63%,3.70% and 62.96%,respectively.No significant differences were found in blood pressure variation during 24 h duty,and in HRV at basic status compared with the morning of 24 h duty for anesthesiologists.HFn in the morning of 24 h duty completion was significantly decreased compared with the basic status(P<0.05),SD2,Log TP,LFn and LF/HF were increased(P<0.05),which indicated that the activity of vagus system was inhibited,and that of sympathetic nervous system was increased.Positive rate of MBI burnout was 33% in anesthesiologists,and 37% in the dentists.No significant differences in positive rate of MBI burnout as well as hemodynamic indicators at basic status were found between anesthesiologists and dentists.The anesthesiologists at basic status had significantly lower HFn(P<0.05),slightly lower RMSSD,SD1 and Log HF,and significantly higher Log LF,LFn as well as LF/HF than the dentists(P < 0.05).Besides,the SDNN and SD2 of anesthesiologists were slightly higher,revealing that vagus nerve activity at basic status was slightly lower,and sympathetic nervous system was higher than the dentists.Compared with the patients who were going to undergo elective surgery,the HFn of anesthesiologists at basic status was significantly lower(P<0.05),RMSSD,SD1 and Log HF were slightly lower,and Log LF,LFn as well as LF/HF were significantly higher(P<0.05).In addition,the anesthesiologists had slightly higher Log TP,demonstrating that they had lower vagus nerve activity and higher sympathetic nerve activity than patients who were going to undergo elective surgery.Conclusions: Young anesthesiologists present job burnout in daily work,manifesting as altered autonomic nervous system activity dominated by sympathetic nervous excitation.Job burnout can be objectively and quantitatively evaluated by HRV analysis that has obvious advantages compared with conventional MBI-HSS assessment and hemodynamic indicators.