Abstract:
OBJECTIVE:The purpose of this study was to determine the prevalence of burnout in chairs of academic departments of obstetrics and gynecology, identify important stressors, and develop strategies to treat and prevent burnout. STUDY DESIGN:We performed a cross-sectional study of 131 chairs in the United States and Puerto Rico. We used a 6-part questionnaire focusing on demographics, potential stressors, satisfaction with personal and professional life, self-efficacy, burnout as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and support from the spouse/partner and family. Statistical analyses were performed with the chi(2) test for categorical variables and t test or analysis of variance for continuous variables. RESULTS:Questionnaires were returned from 119 chairs, 110 men and 9 women, a response rate of 91%. Chairs had served an average of 7.2 years. They worked an average of 67.4 hours each week, spending 45% of their time in administrative duties, 31% in patient care, 15% in teaching, and 8% in research. Female chairs worked significantly more hours per week than male chairs, 76.9 versus 66.7 hours (P =.005). Chairs who had served >10 years worked significantly fewer hours each week than did those who had been chairs <5 years, 63.2 versus 69.2 hours (P =.04). The most significant stressors were hospital/departmental budget deficits, Medicare/Medicaid billing audits, loss of key faculty, union disputes, and faculty, resident, and staff dismissals. To deal with stress, chairs most often spent time with family and friends. Twenty-two percent of chairs were somewhat-very dissatisfied with their positions. The MBI-HSS revealed a high subscale score for emotional exhaustion, moderate-high for depersonalization, and high for personal accomplishment. High emotional exhaustion was observed in younger chairs, those who worked nearly 70 hours each week, and those with less spouse/partner support. Burnout was more common in new chairs. CONCLUSION:Burnout in chairs of obstetrics and gynecology is characterized by a high level of emotional exhaustion, moderate-high depersonalization, and high personal accomplishment. These findings should be used to develop programs to improve the psychologic well-being of our academic leaders.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Gabbe SG,Melville J,Mandel L,Walker Edoi
10.1067/mob.2002.122391subject
Has Abstractpub_date
2002-04-01 00:00:00pages
601-12issue
4eissn
0002-9378issn
1097-6868pii
S0002937802849857journal_volume
186pub_type
杂志文章abstract::Ocular malignant melanoma, similar to the cutaneous variety, may metastasize to the placenta, almost always in the presence of widespread disease. The prognosis is poor, and there is a 25% risk of spread to the fetus. All women with a history of this disease should be informed of the risks when they are contemplating ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70626-9
更新日期:1996-05-01 00:00:00
abstract::The efficacy and acceptability of PGF2alpha (prostaglandin F2alpha) as an abortifacient has been examined during intravenous infusion in 15 obstetrically normal midtrimester patients. Infusions of up to 200 mcg/minute of PGF2alpha induced complete abortions in 3 and incomplete abortions in an additional 3 patients. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(71)90104-9
更新日期:1971-12-15 00:00:00
abstract::As the American physician workforce matures in age, senior physicians on the active clinical staff may become vulnerable to diminished professional performance. Many physicians compensate by using experiential rather than analytic methods to effectively solve clinical problems. Surgical expertise also may be at risk i...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2011.07.043
更新日期:2012-03-01 00:00:00
abstract::Chronic pelvic pain is common among women of reproductive age and is associated with significant morbidity and comorbidities. In this Viewpoint, we explore the evolutionary cause of pelvic pain and summarize evidence that supports a menstruation-related evolutionary cause of chronic visceral pelvic pain: (1) lifetime ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.05.019
更新日期:2016-08-01 00:00:00
abstract::We provide a justification for preventive ethics in obstetric practice. Four clinical guides to resolving ethical conflicts between pregnant women and their physicians can be identified: (1) informed consent as an ongoing dialogue between the pregnant woman and her physician, (2) negotiation as a clinical strategy, (3...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90374-g
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether quantification of cervicovaginal fluid fetal fibronectin (fFN) improves diagnostic accuracy of spontaneous preterm birth (sPTB) in symptomatic women. STUDY DESIGN:A prospective blinded predefined secondary analysis of a larger study of cervicovaginal fluid f...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.10.890
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:Both oxidative stress and endoplasmic reticulum stress (ER stress) are causal events in diabetic embryopathy. We tested whether oxidative stress causes ER stress. STUDY DESIGN:Wild-type (WT) and superoxide dismutase 1 (SOD1)-overexpressing day 8.75 embryos from nondiabetic WT control with SOD1 transgenic mal...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.06.037
更新日期:2013-10-01 00:00:00
abstract::Repeated use of a long-acting sympathomimetic amine in the form of a nasal spray was associated with a nonreactive nonstress test and late decelerations in a patient at 41 weeks of gestation. Six hours after the last dose, these changes gradually disappeared. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90351-5
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine whether elevated second-trimester human chorionic gonadotropin levels identify women likely to benefit from low-dose aspirin therapy. STUDY DESIGN:We evaluated second-trimester human chorionic gonadotropin levels obtained from healthy nulliparous women before screening for partic...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9378(95)91373-4
更新日期:1995-10-01 00:00:00
abstract::Thirty-one patients with clinical features of polycystic ovary syndrome (PCO) were studied to determine the correlation between biochemical and histologic findings. The biochemical features investigated were the effects of adrenocortical and ovarian suppression by dexamethasone and oral contraceptives (Ovulen) on plas...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33087-3
更新日期:1979-06-15 00:00:00
abstract:OBJECTIVE:The studies presented in this report were undertaken to evaluate whether Fusobacterium nucleatum, a common anaerobic isolate in intrauterine infection, stimulates arachidonic acid metabolism, a rate-limiting step for prostaglandin synthesis, in the human uterine endometrium. STUDY DESIGN:Effects of F nucleat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70028-6
更新日期:1998-12-01 00:00:00
abstract::Bleeding from the site of cordocentesis can be detected by ultrasound examination, but significant hemorrhage into the amniotic fluid rarely occurs. To evaluate the relative contribution of amniotic fluid thromboplastins and the quantity of Wharton's jelly in facilitating coagulation at the puncture site, amniotic flu...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90464-x
更新日期:1989-02-01 00:00:00
abstract::Large ovarian cysts are conventionally treated by laparotomy. We describe a technique of transabdominal drainage under ultrasonographic control followed by laparoscopic excision of an ovarian cyst that was 24 x 10 x 20 cm. This approach has the benefits of minimal-access surgery and is suitable for unilocular benign c...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70060-1
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:Placental insufficiency is a primary cause of intrauterine growth restriction (IUGR). In our study, microarray technology was used to identify genes, which may impair placentation resulting in IUGR. STUDY DESIGN:The RNA was isolated from both IUGR term placentas and normal term placentas. Microarray experime...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.08.027
更新日期:2007-01-01 00:00:00
abstract::Pelvic floor disorders are common, with 1 in 4 US women reporting moderate to severe symptoms of urinary incontinence, pelvic organ prolapse, or fecal incontinence. Given the high societal burden of these disorders, identifying potentially modifiable risk factors is crucial. Physical activity is one such potentially m...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2015.08.067
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:Recent developments permit the use of pulse oximetry to evaluate fetal oxygenation in labor. We tested the hypothesis that the addition of fetal pulse oximetry in the evaluation of abnormal fetal heart rate patterns in labor improves the accuracy of fetal assessment and allows safe reduction of cesarean deliv...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mob.2000.110632
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:Closure of the fetal ductus arteriosus, which is usually due to nonsteroidal antiinflammatory agents, may be detrimental. Therefore prenatal and postnatal clinical and echocardiographic findings in four human fetuses with spontaneous ductus arteriosus occlusion are reported. STUDY DESIGN:Echocardiographic an...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70317-4
更新日期:1996-03-01 00:00:00
abstract::We examined the effect of sustained hypoxemia with progressive acidemia on pituitary-adrenal endocrine function (adrenocorticotropic hormone, cortisol) and on adrenal blood flow in fetal sheep. Hypoxemia was induced by the maternal sheep breathing a gas mixture containing 9% oxygen, with 3% carbon dioxide added. Induc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90169-9
更新日期:1986-12-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine whether indomethacin is associated with an increased incidence of constriction of the human fetal ductus arteriosus with advancing gestational age. STUDY DESIGN:A retrospective analysis of fetal echocardiograms performed in 44 patients with premature labor or hydr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)90763-7
更新日期:1993-05-01 00:00:00
abstract::Percutaneous umbilical blood sampling (cordocentesis) provides direct access to the fetal circulation in the second and third trimesters of pregnancy. Seventeen patients underwent this procedure between December 1985 and December 1986 for evaluation of a variety of clinical situations, including nonlethal fetal abnorm...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90795-8
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Although consensus guidelines on the management of cardiovascular disease in pregnancy reserve cesarean delivery for obstetric indications, there is a paucity of data to support this approach. OBJECTIVE:The objective of the study was to compare cardiovascular and obstetric morbidity in women with cardiovasc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2019.07.019
更新日期:2020-01-01 00:00:00
abstract::Primary immature (malignant) teratoma of the fallopian tube is an extremely rare occurrence. We report such a case, which appears to be the third reported in the literature. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(89)80055-9
更新日期:1989-03-01 00:00:00
abstract::We report a case of splenic rupture after cesarean delivery for abruptio placentae. The diagnosis was not suspected until a laparotomy was performed. Diagnosis and management were complicated by disseminated intravascular coagulation and renal failure. The importance of early diagnosis and management modalities are di...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90199-x
更新日期:1995-07-01 00:00:00
abstract::Healthy pregnant women underwent a mild exercise study to evaluate the effects of this amount of work on their fetuses. The results indicated that there were no direct correlations between exercise and fetal body or breathing movements at this particular work intensity (2.33 m). We found a relationship between the mat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90003-0
更新日期:1983-11-01 00:00:00
abstract::Each year, nearly 4 million pregnant patients in the United States receive prenatal care-a crucial preventive service that improves pregnancy outcomes for mothers and their children. National guidelines currently recommend 12-14 in-person prenatal visits, a schedule that has remained unchanged since 1930. When scrutin...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.05.029
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:Gastroschisis is increasing in many countries, especially among young women. Because young women may have inadequate nutrition, we assessed the relationship between individual nutrients and the risk for gastroschisis. STUDY DESIGN:We analyzed data from the National Birth Defects Prevention Study, a populatio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.12.053
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to clone and express a recombinant human zona pellucida protein 3 and to characterize its biologic activities as a sperm ligand and an inducer of the acrosome reaction. STUDY DESIGN:Human ovarian teratocarcinoma (PA-1) cells were transfected with an expression vector containing huma...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.113849
更新日期:2001-04-01 00:00:00
abstract::Despite the widespread use of tetracycline for treatment of dermatologic disorders and sexually transmitted diseases, the pharmacodynamics of oral contraceptive use in the presence of tetracycline has not been studied. Seven normal women ingested an oral contraceptive containing ethinyl estradiol 35 micrograms and nor...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90617-z
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:Our purpose was to evaluate the role of testing for intermediate- and high-risk human papillomavirus by use of a hybrid capture technique for predicting which patients with abnormal Papanicolaou smears are most likely to have squamous intraepithelial lesions or cancer. STUDY DESIGN:Cervical cytologic studies...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)91473-0
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare neonatal outcomes of pregnancies with preeclampsia or gestational hypertension with those of normotensive pregnancies that delivered at 35, 36, or 37 weeks of gestation separately. STUDY DESIGN:Secondary analysis of neonatal outcomes by week of delivery between 35 and...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ajog.2007.06.059
更新日期:2007-10-01 00:00:00