Effects of organisational and patient factors on doctors' burnout: a national survey in China

Influencing factors of life satisfaction among medical staff of rehabilitation departments based on a structural equation model

Life satisfaction (LS) exhibited gender differences and was associated with age, income, and negative emotions. There is no research on the relationship between professional values and LS, although professional values are essential for medical staff and correlate with negative emotions. This study aimed to explore the relationship between professional values and LS, the action mechanism of influencing factors of LS, and gender differences among medical staff of rehabilitation departments in China. A total of 284 participants (108 men and 176 women) completed the questionnaires. Data were analyzed using SPSS19.0 and Amos21.0. Age, length of service, and anxiety differed significantly between genders. Professional values had a direct effect on LS and an indirect effect on LS via anxiety and depression. Therefore, enhancing professional values and reducing anxiety and depression could increase the medical staff's LS. Moreover, the LS of female medical staff improved with age.

The prevalence and factors associated with posttraumatic growth after 3-years outbreak of COVID-19 among resident physicians in China: a cross-sectional study

Introduction

The Coronavirus disease 2019 (COVID-19) pandemic is a global traumatic event that has profoundly struck individuals' mental health. However, this might potentially promote positive transformation such as posttraumatic growth (PTG). Studies have indicated that the COVID-19 pandemic negatively affected the well-being of resident physicians, but little is known about PTG among this vulnerable population in China. Therefore, this study investigated the prevalence and associated factors of PTG among Chinese resident physicians after 3-years outbreak of COVID-19.

Methods

An online survey was conducted from 9 March to 20 March in 2023. PTG was assessed using the 10-item Posttraumatic Growth Inventory-Short Form (PTGI-SF). Scores ≥30 implied moderate-to-high PTG. We also collected possible associated factors for PTG, including socio-demographic and psychological variables. Data was analyzed by applying descriptive statistics, univariable and multivariable logistic regression models.

Results

In total, 2267 Chinese resident physicians provided validated data. 38.7% of them reported moderate-to-high PTG. In the multivariable logistic regression models, age (odds ratio, OR = 1.039; 95% confidence interval, 95%CI = 1.008-1.070), female (OR = 1.383, 95%CI = 1.151-1.662), satisfied or neutral with annual income (OR = 2.078, 95%CI = 1.524-2.832; OR = 1.416, 95%CI = 1.157-1.732), sufficient support at work (OR = 1.432, 95%CI = 1.171-1.751) and resilience (OR = 1.171, 95%CI = 1.096-1.252) were significantly positively associated with moderate-to-high PTG. On the contrary, burnout (OR = 0.653, 95%CI = 0.525-0.812), depression symptoms (OR = 0.700, 95%CI = 0.552-0.889), and stress (OR = 0.757, 95%CI = 0.604-0.949) were significantly negatively associated with moderate-to-high PTG.

Discussion

Overall, resident physicians in China experienced relatively high prevalence of PTG that could be associated with several psychosocial factors. Findings may provide evidence to develop interventions for resident physicians to systematically and constructively process traumatic events related to the pandemic and foster their PTG.

The Performance of Primary Healthcare in China: The Need for a Systematic Design for Improvement Comment on "Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China"

In the paper "Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China," Rasooly and colleagues provide an in-depth analysis of the ways in which Shanghai manages the quality and performance of the primary healthcare (PHC). The present commentary extends the analytical perspective offered in this paper from the city of Shanghai to the entire Chinese Mainland. In so doing, it points out certain systemic shortcomings in the capabilities of family doctors, the unreasonable competition between primary, secondary, and tertiary forms of healthcare, and the negative incentives in the salary system for PHC providers that must be overcome to improve performance. This commentary also proposes strategies and other recommendations for overcoming the bottlenecks identified in the paper as a means of systematically enhancing PHC performance across Mainland China.

Determinants Influencing the Adoption of Internet Health Care Technology Among Chinese Health Care Professionals: Extension of the Value-Based Adoption Model With Burnout Theory

BACKGROUND

The global COVID-19 pandemic has been widely regarded as a catalyst for adopting internet health care technology (IHT) in China. IHT consists of new health care technologies that are shaping health services and medical consultations. Health care professionals play a substantial role in the adoption of any IHT, but the consequences of doing so can often be challenging, particularly when employee burnout is prevalent. Few studies have explored whether employee burnout influences the adoption intention of IHT in health care professionals.

OBJECTIVE

This study aims to explain the determinants influencing the adoption of IHT from the perspective of health care professionals. To do so, the study extends the value-based adoption model (VAM) with consideration for employee burnout as a determining factor.

METHODS

A cross-sectional web-based survey using a sample of 12,031 health care professionals selected through multistage cluster sampling from 3 provinces in mainland China was conducted. The hypotheses of our research model were developed based on the VAM and employee burnout theory. Structural equation modeling was then used to test the research hypotheses.

RESULTS

The results indicate that perceived usefulness, perceived enjoyment, and perceived complexity positively correlate with perceived value (β=.131, P=.01; β=.638, P<.001; β=.198, P<.001, respectively). Perceived value had a positive direct effect on adoption intention (β=.725, P<.001), perceived risk negatively correlated with perceived value (β=-.083, P<.001), and perceived value negatively correlated with employee burnout (β=-.308, P<.001). In addition, employee burnout was negatively related to adoption intention (β=-.170, P<.001) and mediated the relationship between perceived value and adoption intention (β=.052, P<.001).

CONCLUSIONS

Perceived value, perceived enjoyment, and employee burnout were the most important determinants of IHT adoption intention by health care professionals. In addition, while employee burnout was negatively related to adoption intention, perceived value inhibited employee burnout. Therefore, this study finds that it is necessary to develop strategies to improve the perceived value and reduce employee burnout, which will benefit the promotion of the adoption intention of IHT in health care professionals. This study supports the use of the VAM and employee burnout in explaining health care professionals' adoption intention regarding IHT.

Physician burnout levels and associated factors in The Covid-19 pandemic

Introduction: Burnout, characterized by emotional exhaustion, depersonalization, and low personal accomplishment, is frequently observed in physicians. Aim: The purpose of this study was to determine burnout levels and associated factors in physicians during the pandemic. Material and Method: This cross-sectional study was performed online with 288 physicians from various fields in Erzurum. Sociodemographic questions and the Maslach Burnout Inventory represented the data collection tools. The data were collected online in May and June 2021. Statistical analysis: Descriptive statistics, Student's t and ANOVA tests And Multiple ordinal logistic regression analysis were used. p values <0.05 were regarded as significant. Analysis was performed on SPSS 22. Results: Physicians' mean emotional exhaustion, depersonalization, and personal accomplishment component scores were 20.1±8.3, 6.7±4.5, and 21.1±4.5, respectively. Analysis showed that 49.7% of physicians exhibited moderate-high emotional exhaustion, 35.8% high-moderate depersonalization, and 69.8% signs of low personal accomplishment. Job title, regret concerning selecting the medical profession, satisfaction with the working environment, number of additional monthly out-of-hours shifts worked, regular sporting activity, and assessment of the physical conditions in the working environment emerged as factors affecting burnout components at regression analysis. Conclusion: The participants' burnout levels were high. The planning of effective interventions addressing individual and work-related factors with a holistic approach is essential to halt this rapidly growing epidemic.

Influential Factors of Burnout among Village Doctors in China: A Cross-Sectional Study

(1) Background: The heavy workload and understaffed personnel of village doctors is a challenge to the rural healthcare system in China. Previous studies have documented the predictors of doctors’ burnout; however, little attention has been paid to village doctors. This study aims to investigate the prevalence and influential factors of burnout among village doctors. (2) Methods: Data was collected by a self-administered questionnaire from 1248 village doctors who had worked at rural clinics for more than a year. Burnout was measured using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) with three dimensions—emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). A logistic regression model was applied to estimate the influential factors of burnout. (3) Results: The prevalence of overall burnout was 23.6%. Being male (OR = 0.58, 95%CI: 0.41–0.82), poor health status (OR = 0.80, 95%CI: 0.67–0.94), low income (OR = 0.62, 95%CI: 0.40–0.95), and a poor doctor–patient relationship (OR = 0.57, 95%CI: 0.48–0.67) were significantly related to burnout. Conclusion: Burnout is prevalent among Chinese village doctors. Policies such as increasing village doctors’ income and investing more resources in rural healthcare system should be carried out to mitigate and prevent burnout.

Professional Quality of Life among Medical Doctors Working in Kathmandu: A Descriptive Cross-sectional Study

INTRODUCTION

The practice of medicine is an honorable profession besides being accompanied by a demanding environment. This study aimed to find out the professional quality of life of medical doctors working in Kathmandu valley.

METHODS

A descriptive cross-sectional study was conducted among 174 Nepalese medical doctors working in different hospitals of Kathmandu valley. Ethical approval was taken from the Ethical Review Board of the Nepal Health Research Council (Reference Number: 830). The data collection tool used in the study was WHO Professional Quality of Life Scale-5 to collect data about Compassion satisfaction, Burnout and Secondary traumatic stress among medical doctors working in Kathmandu valley. Data analysis was done in the Statistical Package for the Social Sciences version 16.0.

RESULTS

Out of 174 participants, 101 (58%), 126 (72.4%) and 135 (77.6%) were found to have moderate level of Compassion satisfaction, Burnout and Secondary Traumatic Stress respectively.

CONCLUSIONS

More than half, nearly two-third, and more than two-third participants had moderate levels of Compassion satisfaction, Burnout and Secondary Traumatic Stress respectively. The overall study findings reflected good balance between Compassion satisfaction and Compassion fatigue (burnout and secondary traumatic stress) among the Nepalese medical doctors. Further assessment of professional quality of life of doctors as well as other health care workers via Multifaceted and large-scale study is recommended.