Medical and health industry is a profession with high requirements and low sense of control, and a profession with high incidence of burnout[9]. At present, there are 76000 anaesthesiologists in China. The number of anaesthesiologists per 10000 people in China is about 0.4, compared with 3 in the United States and 2.8 in the United Kingdom. According to British and American standards, China should have 310000 anaesthesiologists. In fact, the total number of anaesthesiologists in China is less than 100000, and also less than 1 / 3 of the standard configuration, and the gap is 200000[10]. At the same time, China's surgery volume accounts for about 10% of the global surgery volume, and it is still growing at a rate of 10%[11]. In recent years, the doctor-patient relationship has become increasingly tense, coupled with factors such as the income, promotion and physical condition of anaesthesiologists, which make the environment of anaesthesiologists worse. so that the job stress and burnout are increasing day by day[12].
As for emotional exhaustion, the phenomenon of emotional exhaustion with working years of 5-10 years is serious. Most anaesthesiologists who have worked for 5-10 years have accumulated professional knowledge and skills and can play an independent role at work. In hospitals at all levels, they are the main force of their department. Therefore, their emotional exhaustion is severe, which is consistent with the research results of Filippo[13]. With the increase of working years, the phenomenon of emotional exhaustion began to ease. This may be explained by the fact that, with the continuous increase of working years, their medical experience continues to be accumulated, and technical literacy is more and more suitable for the needs of the post, then the burnout will reduce. The higher the annual operation volume is, the more serious the emotional exhaustion is. The increase of workload will directly lead to the excessive fatigue of anaesthesiologists. The excessive fatigue not only affects the physical and mental health of anaesthesiologists, but also causes great potential harm to patients. In the study of Gordon[14], it was found that as many as 50% of the anaesthesiologists interviewed admitted that they had medical errors when they were tired.
With the increase of age, working years and professional titles of anaesthesiologists, their depersonalization is more and more serious. With the increasing age and working years of an anaesthesiologist, the accumulated fatigue, work pressure, dissatisfaction and sub-health will reach a peak, which makes the phenomenon of depersonalization more serious. The phenomenon is manifested in the negative work and indifference to colleagues. From the correlation analysis, it is found that the length of working years is positively related to the occurrence of the depersonalization, while the health status is negatively related to the occurrence of the depersonalization, the difference is statistically significant. Therefore, the relevant departments should pay attention to the physical and mental health of anaesthesiologists, which will help to delay the depersonalization and improve burnout[15].
In Northwest China, the better an anaesthesiologist's health is, the higher his accomplishment will be. In Northwest China, the economy is underdeveloped and the medical level is relatively backward. People are still in the dilemma of difficult and expensive medical treatment[16]. Novel coronavirus pneumonia (COVID-19) has been prevalent worldwide in 2020, which has caused millions of people to die. The number of deaths has reached 60 thousand, and the number of infections and deaths is rising[17, 18]. This makes us more convinced that nothing matters except for a healthy body. Healthy body can bring more sense of personal achievement to anaesthesiologists in Northwest China. There was a positive correlation between personal accomplishment and physical health, working years, the difference was statistically significant. With the accumulation of working years, the academic level, experience and technology, salary and income of anaesthesiologists will reach a new level, and the sense of personal accomplishment will naturally increase. Coupled with a healthy body, a great sense of personal accomplishment can often be obtained, reducing the occurrence of burnout.
88.1% of anaesthesiologists in this questionnaire had high job stress, among whom the greater the workload, the worse the physical health, the higher the job stress of anaesthesiologists, the difference was statistically significant. In the correlation analysis, job stress was negatively correlated with physical health were, the difference was statistically significant. The aforementioned shortage of anaesthesiologists in China and the increasing workloadlead to the physical and mental fatigue of medical staff and the sudden rise of pressure[19]. In addition, the sudden death rate of anaesthesiologists is increasing year by year. According to the researchers such as Shan, the proportion of sudden death of anaesthesiologists in China is the highest, reaching 26%[20]. As for the reasons of excessive workload, worry about medical litigation, sleep deprivation and interpersonal relationship processing, anaesthesiologists will often be in a certain degree of physiological or psychological disease state[21], and anaesthesiologists in sick state will naturally feel the job stress increase at work. Therefore, the healthy body and mind of an anaesthesiologist are the premise and guarantee of his normal work.
In conclusion, burnout and high job pressure are common among anaesthesiologists in Northwest China. The increasing workload, unfair promotion system and long-term sub-health lead to the decline of their physical health. In terms of anaesthesiologists themselves, they should improve their psychological quality, maintain their mental health, constantly enrich and improve their professional level, and improve the communication ability between doctors and patients[22]. For the department leaders and the health administrative departments, we should first reduce the risk of occupation exposure of anaesthesiologists, then adjust the overall allocation of resources in the hospital, pay attention to the improvement and renewal of medical equipment, and more importantly, ensure the fairness and impartiality of the salary and promotion system, strengthen the overall input and construction of the anaesthesiology department, and strive to establish contact with the international community soon[23]. Only when we pay attention to the problems of anaesthesiologists, can we guarantee the safety and service quality of patients in the northwest region and even in the whole country, and the anaesthesiology in China can make great progress[24].