1
|
Paúles-Cuesta IM, Montoro-Huguet M, Fueyo-Díaz R. [Burnout syndrome in health professionals at a university hospital in Spain]. Semergen 2023; 49:102023. [PMID: 37348253 DOI: 10.1016/j.semerg.2023.102023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/23/2023] [Accepted: 05/17/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To evaluate the risk of Burnout in the health professionals of the Huesca University Hospital, 50 years after its inauguration, to investigate the variables related to the work motivation of the hospital health personnel and to assess the predisposing and protective factors of the risk of Burnout. MATERIAL AND METHODS An observational, analytical, prospective and unicentric study was conducted from September 2017 to April 2019, evaluating all the health professionals who worked at the Hospital San Jorge de Huesca (n=209). RESULTS The mean age was 42.86 years. 72.2% were women. 12.4% had moderate risk of burnout. There was 12.4% of high emotional exhaustion, 36.8% of high depersonalization and 44.5% of low personal accomplishment. Burnout was statistically significant associated with the professional category (P=.010), work experience (P=.026), hours of work per week (P=.036), choice of the same profession (P=.001) and recommendation to the offspring (P<.001). CONCLUSIONS One tenth of the sample had a moderate risk of burnout. Almost half of the health workers confirmed a high degree of satisfaction with the work environment and the majority expressed an adequate use of well-being strategies and a high degree of autonomy, recognition and satisfaction at work.
Collapse
Affiliation(s)
- I M Paúles-Cuesta
- Medicina Familiar y Comunitaria, Centro de Salud Amando Loriga, Caspe, Zaragoza, España.
| | - M Montoro-Huguet
- Unidad de Gastroenterología y Hepatología, Hospital San Jorge, Huesca, España
| | - R Fueyo-Díaz
- Departamento de Psicología y Sociología, Facultad de Ciencias Humanas y de la Educación, Universidad de Zaragoza, Zaragoza, España
| |
Collapse
|
2
|
Shields BL, Chen CP. Does delayed gratification come at the cost of work-life conflict and burnout? CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04246-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
|
3
|
Drivers and sequelae of burnout in U.S. dermatology trainees. Int J Womens Dermatol 2021; 7:780-786. [PMID: 35028382 PMCID: PMC8714592 DOI: 10.1016/j.ijwd.2021.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/18/2021] [Accepted: 05/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background Burnout is a health care epidemic. Although burnout has been shown to affect dermatologists in multispecialty studies, there are no such studies in dermatology trainees. Objective We conducted a survey-based study of burnout in U.S. dermatology trainees to identify its drivers and sequelae. Methods All residents enrolled in a U.S. dermatology training program were eligible. The 45-question survey included the Maslach Burnout Inventory, a validated quality of life index, and 31 questions based on known drivers of burnout and new research questions. No identifying data were collected. Results A total of 180 residents responded, for a response rate of 14.4%. Notably, an analysis of the cohort showed that our sample was not statistically different from the national complement of trainees based both on proportion of female respondents and mean age (p = .9449 and .2376, respectively). Of the respondents, 59% were female. The average age was 30.6 years. Sixty-nine percent of trainees (124 of 180) met the criteria for burnout. On univariate analysis, age, sex, training year, and relationship status were not associated with burnout. Good work–life balance (p = .032), autonomy in the workplace (p = .0027), intradisciplinary respect (p = .022), and increased work hours (p = .0110) were protective. On multivariate analysis, autonomy in the workplace (odds ratio: 3.580; confidence interval, 1.32–9.71; p = .012) and good work–life balance (odds ratio: 0.262; confidence interval, 0.095–0.722; p = .0097) remained significant. Conclusion Improving control over working environment, as evidenced by the impact of work–life balance and autonomy, may lessen burnout in trainees. Further studies analyzing regional and program-specific variations will help improve trainee experience.
Collapse
|
4
|
Panse N, Panse S, Ravi S, Mankar H, Karanjkar A, Sahasrabudhe P. Burnout among Plastic Surgery Residents in India: An Observational Study. Indian J Plast Surg 2020; 53:387-393. [PMID: 33402769 PMCID: PMC7775248 DOI: 10.1055/s-0040-1719238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Introduction Burnout syndrome can be defined as emotional exhaustion, depersonalization, and perceived lack of personal accomplishment, all of which lead to decreased effectiveness at work. The Medscape burnout and depression report of 2018 suggests that the burnout range across various specialties ranges from 23 to 48%. There are no studies to assess the burnout among plastic surgery residents in India. This study is an attempt to assess the same. Materials and Methods An online survey was conducted in March and April 2019 for plastic surgery residents across India. Various parameters including those related to gender, year of the curriculum, hobbies, exercise, and marital status were assessed. There were multiple sections in the survey, which included the demographic details, stress-related variables, and the abbreviated Maslach Burnout Inventory. The abbreviated Maslach Burnout Inventory is a validated scale that has been used to assess the burnout among plastic surgery residents in India. The three subscales, emotional exhaustion, depersonalization, and personal accomplishment were measured on a Likert scale. Univariable and multivariable analysis of factors associated with burnout was performed. Results Of the 185 respondents, 48.4% experienced moderate-to-high burnout. Of these, 25% ( n = 46) were above the 75th centile of the overall burnout score, indicating severe burnout. Insufficient faculty involvement, insufficient time allotted for formalized teaching, conflict with colleagues, and lack of adequate support staff correlated with resident burnout on multivariate analysis. Residents who pursued their hobbies or performed physical activities for exercise had significantly lesser burnout. Conclusion The incidence of burnout in plastic surgery residents surveyed in our study was 48.4%. The faculty of the departments and the residents themselves, as well as the governing bodies, all have a role to play to address the issue of burnout among residents. Dedicated and persistent efforts toward improving physical and psychological well-being of plastic surgery residents will positively impact not only the well-being of the residents but also the quality of patient care.
Collapse
Affiliation(s)
- Nikhil Panse
- Department of Plastic Surgery, B. J. Government Medical College & Sassoon Hospital, Pune, India
| | - Smita Panse
- Department of Psychiatry, PCMC's Post Graduate Institute & YCM Hospital, Pimpri, Pune, India
| | - Swaminathan Ravi
- Department of Plastic Surgery, B. J. Government Medical College & Sassoon Hospital, Pune, India
| | - Hemant Mankar
- Department of Plastic Surgery, B. J. Government Medical College & Sassoon Hospital, Pune, India
| | - Ankur Karanjkar
- Department of Plastic Surgery, B. J. Government Medical College & Sassoon Hospital, Pune, India
| | - Parag Sahasrabudhe
- Department of Plastic Surgery, B. J. Government Medical College & Sassoon Hospital, Pune, India
| |
Collapse
|
5
|
Lungu DA, Pennucci F, De Rosis S, Romano G, Melfi F. Implementing successful systematic Patient Reported Outcome and Experience Measures (PROMs and PREMs) in robotic oncological surgery-The role of physicians. Int J Health Plann Manage 2019; 35:773-787. [PMID: 31793689 DOI: 10.1002/hpm.2959] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 01/04/2023] Open
Abstract
Patient Reported Outcome and Experience Measures (PROMs and PREMs) play an increasingly important role in monitoring the quality of the oncological pathway. The aim of this study is to describe the case of five hospitals a year after the adoption of PROMs and PREMs for robotic oncological colorectal surgery in Tuscany and to investigate how the clinicians can impact the process of implementation and the efficacy of such measures. We used 14 months of data from the five robotic centers in Tuscany. Above all, the physician's personal motivation to improve the treatment of patients, the teamwork, and the possibility to use data for research purposes proved to be the essential factors for their engagement and the successful implementation of patient reported measures. Physicians play a key role in the adoption of systematic PROMs and PREMs. The higher their level of engagement, the higher the collection success, both in terms of number of patients enrolled and response rates. Moreover, the collection of patient reported measures may become part of physicians' daily practice and may lead to a change in their relationship and communication with patients, as clinicians accept to have their job reviewed and are not afraid to be evaluated by their patients.
Collapse
Affiliation(s)
- Daniel Adrian Lungu
- Health and Management Laboratory (MeS Lab), Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Francesca Pennucci
- Health and Management Laboratory (MeS Lab), Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Sabina De Rosis
- Health and Management Laboratory (MeS Lab), Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Gaetano Romano
- Minimally Invasive and Robotic Thoracic Surgery, Robotic Multispecialty Center of Surgery, University Hospital of Pisa, Pisa, Italy
| | - Franca Melfi
- Minimally Invasive and Robotic Thoracic Surgery, Robotic Multispecialty Center of Surgery, University Hospital of Pisa, Pisa, Italy
| |
Collapse
|
6
|
|
7
|
Murali K, Banerjee S. Burnout in oncologists is a serious issue: What can we do about it? Cancer Treat Rev 2018; 68:55-61. [DOI: 10.1016/j.ctrv.2018.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 11/24/2022]
|
8
|
Murali K, Makker V, Lynch J, Banerjee S. From Burnout to Resilience: An Update for Oncologists. Am Soc Clin Oncol Educ Book 2018; 38:862-872. [PMID: 30231394 DOI: 10.1200/edbk_201023] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Physician burnout remains a highly complex and topical issue. The negative impact of burnout on physicians, patients, and institutions has become increasingly apparent. Globally, a multitude of professional bodies and organizational leaders are giving this important subject much-deserved attention. In this review, we provide a summary of the latest evidence, with a focus on solutions and future strategies, while incorporating our own perspectives as practicing oncologists.
Collapse
Affiliation(s)
- Krithika Murali
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
| | - Vicky Makker
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
| | - James Lynch
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
| | - Susana Banerjee
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
| |
Collapse
|
9
|
Affiliation(s)
- Abby R. Rosenberg
- Center for Clinical and Translational Research and Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, Washington; Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington; and Division of Hematology/Oncology, Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington
| |
Collapse
|
10
|
Baimas-George M, Fleischer B, Slakey D, Kandil E, Korndorffer JR, DuCoin C. Is it All About the Money? Not All Surgical Subspecialization Leads to Higher Lifetime Revenue when Compared to General Surgery. JOURNAL OF SURGICAL EDUCATION 2017; 74:e62-e66. [PMID: 28705484 DOI: 10.1016/j.jsurg.2017.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/21/2017] [Accepted: 06/24/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE It is believed that spending additional years gaining expertise in surgical subspecialization leads to higher lifetime revenue. Literature shows that more surgeons are pursuing fellowship training and dedicated research years; however, there are no data looking at the aggregate economic impact when training time is accounted for. It is hypothesized that there will be a discrepancy in lifetime income when delay to practice is considered. DESIGN Data were collected from the Medical Group Management Association's 2015 report of average annual salaries. Fixed time of practice was set at 30 years, and total adjusted revenue was calculated based on variable years spent in research and fellowship. All total revenue outcomes were compared to general surgery and calculated in US dollars. PARTICIPANTS The financial data on general surgeons and 9 surgical specialties (vascular, pediatric, plastic, breast, surgical oncology, cardiothoracic, thoracic primary, transplant, and trauma) were examined. RESULTS With fellowship and no research, breast and surgical oncology made significantly less than general surgery (-$1,561,441, -$1,704,958), with a difference in opportunity cost equivalent to approximately 4 years of work. Pediatric and cardiothoracic surgeons made significantly more than general surgeons, with an increase of opportunity cost equivalent to $5,301,985 and $3,718,632, respectively. With 1 research year, trauma surgeons ended up netting less than a general surgeon by $325,665. With 2 research years, plastic and transplant surgeons had total lifetime revenues approximately equivalent to that of a general surgeon. CONCLUSIONS Significant disparities exist in lifetime total revenue between surgical subspecialties and in comparison, to general surgery. Although most specialists do gross more than general surgeons, breast and surgical oncologists end up netting significantly less over their lifetime as well as trauma surgeons if they do 1 year of research. Thus, the economic advantage of completing additional training is dependent on surgical field and duration of research.
Collapse
Affiliation(s)
- Maria Baimas-George
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Brian Fleischer
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Douglas Slakey
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Emad Kandil
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - James R Korndorffer
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Christopher DuCoin
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
| |
Collapse
|
11
|
Mavrogenis AF, Scarlat MM, Mauffrey C, Kehr P. A career in orthopaedics. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2017. [PMID: 28638949 DOI: 10.1007/s00590-017-2000-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Andreas F Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 41 Ventouri Street, Holargos, 15562, Athens, Greece.
| | | | - Cyril Mauffrey
- Department of Orthopaedics, Denver Health Medical Center, Denver, CO, USA
| | | |
Collapse
|
12
|
Stress and burnout among gynecologic oncologists: A Society of Gynecologic Oncology Evidence-based Review and Recommendations. Gynecol Oncol 2016; 143:421-427. [PMID: 27575910 DOI: 10.1016/j.ygyno.2016.08.319] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 08/10/2016] [Accepted: 08/17/2016] [Indexed: 11/20/2022]
|
13
|
Veyssier-Belot C. Le syndrome d’épuisement professionnel chez les médecins. Rev Med Interne 2015; 36:233-6. [DOI: 10.1016/j.revmed.2014.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 09/17/2014] [Indexed: 11/26/2022]
|
14
|
Quand perte de sens rime avec souffrance : analyse qualitative du vécu des médecins à l’annonce d’une mauvaise nouvelle en oncologie. PSYCHO-ONCOLOGIE 2015. [DOI: 10.1007/s11839-015-0503-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Alleyne TS. Work Life Balance - What Balance? Front Pediatr 2015; 3:102. [PMID: 26779463 PMCID: PMC4705299 DOI: 10.3389/fped.2015.00102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/09/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tricia Shinelle Alleyne
- Department of Pediatrics, Division of Critical Care, University of Tennessee Health Sciences Center , Memphis, TN , USA
| |
Collapse
|
16
|
Wall M, Schenck-Gustafsson K, Minucci D, Sendén MG, Løvseth LT, Fridner A. Suicidal ideation among surgeons in Italy and Sweden - a cross-sectional study. BMC Psychol 2014; 2:53. [PMID: 25520811 PMCID: PMC4266411 DOI: 10.1186/s40359-014-0053-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 11/17/2014] [Indexed: 12/01/2022] Open
Abstract
Background Suicidal ideation is more prevalent among physicians, compared to the population in general, but little is known about the factors behind surgeons’ suicidal ideation. A surgeon’s work environment can be competitive and characterised by degrading experiences, which could contribute to burnout, depression and even thoughts of suicide. Being a surgeon has been reported to be predictor for not seeking help when psychological distressed. The aim of the present study was to investigate to what extent surgeons in Italy and Sweden are affected by suicidal ideation, and how suicidal ideation can be associated with psychosocial work conditions. Methods A cross-sectional study of surgeons was performed in Italy (N = 149) and Sweden (N = 272), where having suicidal ideation was the outcome variable. Work-related factors, such as harassment, depression and social support, were also measured. Results Suicidal ideation within the previous twelve months was affirmatively reported by 18% of the Italian surgeons, and by 12% of the Swedish surgeons in the present study. The strongest association with having recent suicidal ideation for both countries was being subjected to degrading experiences/harassment at work by a senior physician. Sickness presenteeism, exhaustion and disengagement were related to recent suicidal ideation among Italian surgeons, while role conflicts and sickness presenteeism were associated with recent suicidal ideation in the Swedish group. For both countries, regular meetings to discuss situations at work were found to be protective. Conclusions A high percentage of surgeons at two university hospitals in Italy and Sweden reported suicidal ideation during the year before the investigation. This reflects a tough workload, including sickness presenteeism, harassment at work, exhaustion/disengagement and role conflicts. Regular meetings to discuss work situations might be protective.
Collapse
Affiliation(s)
- Maja Wall
- Department of Psychology, Stockholm University, Sweden, SE-10691 Sweden
| | | | - Daria Minucci
- Departments of Obstetrics & Gynaecology, Padua University Hospital, Padua, Italy
| | | | - Lise Tevik Løvseth
- Department of Research and Development, Division of Mental Health Care, St. Olav's University Hospital, Trondheim, Norway
| | - Ann Fridner
- Department of Psychology, Stockholm University, Sweden, SE-10691 Sweden ; Department of Medicine, Centre of Gender Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
17
|
Spiliopoulos K, Gansera L, Weiland HC, Schuster T, Eichinger W, Gansera B. Chronic stress and coping among cardiac surgeons: a single center study. Braz J Cardiovasc Surg 2014; 29:308-15. [PMID: 25372902 PMCID: PMC4412318 DOI: 10.5935/1678-9741.20140083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 06/22/2014] [Indexed: 11/20/2022] Open
Abstract
Introduction Cardiac surgeons stress may impair their quality of life and professional
practice. Objective To assess perceived chronic stress and coping strategies among cardiac surgeons.
Methods Twenty-two cardiac surgeons answered two self-assessment questionnaires, the Trier
Inventory for Chronic Stress and the German SGV for coping strategies. Results Participants mean age was 40±14.1 years and 13 were male; eight were senior
physicians and 14 were residents. Mean values for the Trier Inventory for Chronic
Stress were within the normal range. Unexperienced physicians had significantly
higher levels of dissatisfaction at work, lack of social recognition, and
isolation (P<0.05). Coping strategies such as play down,
distraction from situation, and substitutional satisfaction were also
significantly more frequent among unexperienced surgeons. "Negative" stress-coping
strategies occur more often in experienced than in younger colleagues
(P=0.029). Female surgeons felt more exposed to overwork
(P=0.04) and social stress (P=0.03). Conclusion Cardiac surgeons show a tendency to high perception of chronic stress phenomena
and vulnerability for negative coping strategies.
Collapse
Affiliation(s)
| | - Laura Gansera
- Department of Cardiovascular Surgery, Clinic Bogenhausen, Munich, Germany
| | | | - Tibor Schuster
- Institute for Medical Statistics and Epidemiology, Technical University Munich, Germany
| | - Walter Eichinger
- Department of Cardiovascular Surgery, Clinic Bogenhausen, Munich, Germany
| | - Brigitte Gansera
- Department of Cardiovascular Surgery, Clinic Bogenhausen, Munich, Germany
| |
Collapse
|
18
|
J. Edward Berk distinguished lecture: avoiding burnout: finding balance between work and everything else. Am J Gastroenterol 2014; 109:511-4. [PMID: 24642578 DOI: 10.1038/ajg.2014.44] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 02/02/2014] [Indexed: 12/11/2022]
Abstract
Burnout has been defined as "a state of mental exhaustion caused by one's professional life." Increasing evidence shows high rates of burnout among medical professionals, including gastroenterologists. Factors that contribute to burnout include work-home conflict and longer work hours. Among gastroenterologists, the risk for burnout seems to be highest during the first three years on the job after fellowship. Strategies to treat and prevent burnout include identifying and balancing personal and professional goals, shaping one's career to optimize meaning, identifying stressors, and nurturing wellness strategies.
Collapse
|
19
|
Shanafelt TD, Kaups KL, Nelson H, Satele DV, Sloan JA, Oreskovich MR, Dyrbye LN. An interactive individualized intervention to promote behavioral change to increase personal well-being in US surgeons. Ann Surg 2014; 259:82-8. [PMID: 23979287 DOI: 10.1097/sla.0b013e3182a58fa4] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Evaluate the utility of a computer-based, interactive, and individualized intervention for promoting well-being in US surgeons. BACKGROUND Distress and burnout are common among US surgeons. Surgeons experiencing distress are unlikely to seek help on their own initiative. A belief that distress and burnout are a normal part of being a physician and lack of awareness of distress level relative to colleagues may contribute to this problem. METHODS Surgeons who were members of the American College of Surgeons were invited to participate in an intervention study. Participating surgeons completed a 3-step, interactive, electronic intervention. First, surgeons subjectively assessed their well-being relative to colleagues. Second, surgeons completed the 7-item Mayo Clinic Physician Well-Being Index and received objective, individualized feedback about their well-being relative to national physician norms. Third, surgeons evaluated the usefulness of the feedback and whether they intended to make specific changes as a result. RESULTS A total of 1150 US surgeons volunteered to participate in the study. Surgeons' subjective assessment of their well-being relative to colleagues was poor. A majority of surgeons (89.2%) believed that their well-being was at or above average, including 70.5% with scores in the bottom 30% relative to national norms. After receiving objective, individualized feedback based on the Mayo Clinic Physician Well-Being Index score, 46.6% of surgeons indicated that they intended to make specific changes as a result. Surgeons with lower well-being scores were more likely to make changes in each dimension assessed (all Ps<0.001). CONCLUSIONS US surgeons do not reliably calibrate their level of distress. After self-assessment and individualized feedback using the Mayo Clinic Physician Well-Being Index, half of participating surgeons reported that they were contemplating behavioral changes to improve personal well-being.
Collapse
Affiliation(s)
- Tait D Shanafelt
- *Mayo Clinic, Rochester, MN †University of California, San Francisco Fresno; and ‡University of Washington, Seattle
| | | | | | | | | | | | | |
Collapse
|
20
|
Zambrano SC, Chur-Hansen A, Crawford GB. How Do Surgeons Experience and Cope with the Death and Dying of Their Patients? A Qualitative Study in the Context of Life-limiting Illnesses. World J Surg 2013; 37:935-44. [DOI: 10.1007/s00268-013-1948-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
21
|
Kawase K, Kwong A, Yorozuya K, Tomizawa Y, Numann PJ, Sanfey H. The Attitude and Perceptions of Work–life Balance: A Comparison Among Women Surgeons in Japan, USA, and Hong Kong China. World J Surg 2012; 37:2-11. [DOI: 10.1007/s00268-012-1784-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
22
|
Edmonds C, Lockwood GM, Bezjak A, Nyhof-Young J. Alleviating emotional exhaustion in oncology nurses: an evaluation of Wellspring's "Care for the Professional Caregiver Program". JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:27-36. [PMID: 22042712 DOI: 10.1007/s13187-011-0278-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
A high level of burnout has been demonstrated in oncologists, nurses, and other health professionals. Interventions developed in response demonstrate mixed results. Wellspring, a community cancer support organization, has developed a 1-day session called Care for the Professional Caregiver Program (CPCP) and has delivered it to over 700 healthcare workers. The present study assessed the effects of the CPCP on three groups of oncology nurses (pediatric, surgical, and general oncology staff) and one group of nurse managers. Subjects completed the Maslach burnout inventory (MBI), the General health questionnaire (GHQ) and the short form of the Marlowe-Crowne social desirability scale (M-C) prior to receiving the intervention. They then completed the MBI and GHQ at 1-month and 7-month follow-ups. Six months after the original session, a small subset of subjects was randomly selected to participate in a 1-day CPCP booster session. At baseline, one third of the nurses showed high burnout on the MBI. The nurses demonstrated a significant decrease in emotional exhaustion and an improvement on the GHQ, at the 1-month follow-up testing (p = 0.003 and 0.001, respectively) and 7-month follow-up testing (p = 0.002 and 0.001). The booster session proved difficult to deliver because of institutional scheduling problems due to nurse shortages, so only a small percentage (22%) of the sample participated; however, it was well received. Thus, the CPCP is effective in ameliorating emotional exhaustion, an intrinsic aspect of burnout.
Collapse
Affiliation(s)
- Claire Edmonds
- Canadian Partnership Against Cancer, Toronto, ON, Canada
| | | | | | | |
Collapse
|
23
|
Ramondetta LM, Urbauer D, Brown AJ, Richardson G, Thaker PH, Koenig HG, Levenback C, Sun C. Work related stress among gynecologic oncologists. Gynecol Oncol 2011; 123:365-9. [PMID: 21777966 PMCID: PMC7418502 DOI: 10.1016/j.ygyno.2011.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 06/06/2011] [Accepted: 06/09/2011] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Up to one third of oncologists experience burnout. The objective was to determine correlates of work related stress in gynecologic oncologists (GOs). METHODS Using an online tool, we surveyed 273 members of the International Gynecologic Cancer (IGCS) Society (60% from North America) to examine demographic, psychological and spiritual correlates of work related stress (WRS) and burnout. Measures of death anxiety (DA) and locus of control (LOC) were also administered. RESULTS WRS did not correlate with religion, religiosity, race, or gender, but did correlate with DA (r=0.23, p=0.0006). WRS was also associated with younger age (p=0.01) and fewer years out of training (p=0.0286), higher scores on LOC Chance (r=0.18, p=0.007), higher scores on Powerful Other (r=0.30, p<0.0001), and lower scores on LOC Internality (r=-0.30, p<0.0001). CONCLUSION Responses from younger and less experienced GOs, correlate with higher WRS scores especially if their LOC is weighted toward chance and powerful others. Responses of GO's with these two characteristics also correlate with higher DA scores and reports of difficulty talking about death.
Collapse
Affiliation(s)
- Lois M Ramondetta
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Balch CM, Shanafelt T. Combating Stress and Burnout in Surgical Practice: A Review. Thorac Surg Clin 2011; 21:417-30. [DOI: 10.1016/j.thorsurg.2011.05.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
25
|
Chittenden EH, Ritchie CS. Work-Life Balancing: Challenges and Strategies. J Palliat Med 2011; 14:870-4. [DOI: 10.1089/jpm.2011.0095] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Christine S. Ritchie
- University of Alabama at Birmingham and Birmingham VA Medical Center, Birmingham, Alabama
| |
Collapse
|
26
|
Balch CM, Shanafelt TS. Dynamic Tension Between Success in a Surgical Career and Personal Wellness: How Can We Succeed in a Stressful Environment and a “Culture of Bravado”? Ann Surg Oncol 2011; 18:1213-6. [DOI: 10.1245/s10434-011-1629-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
27
|
Surgeon Distress as Calibrated by Hours Worked and Nights on Call. J Am Coll Surg 2010; 211:609-19. [DOI: 10.1016/j.jamcollsurg.2010.06.393] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2010] [Accepted: 06/29/2010] [Indexed: 11/15/2022]
|
28
|
Balch CM, Shanafelt TD, Sloan J, Satele DV, Kuerer HM. Burnout and Career Satisfaction Among Surgical Oncologists Compared with Other Surgical Specialties. Ann Surg Oncol 2010; 18:16-25. [DOI: 10.1245/s10434-010-1369-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Indexed: 11/18/2022]
|
29
|
Abstract
The practice of surgery offers the potential for tremendous personal and professional satisfaction. Few careers provide the opportunity to have such a profound effect on the lives of others and to derive meaning from work. Surgeons choose this arduous task to change the lives of individuals facing serious health problems, to experience the joy of facilitating healing, and to help support those patients for whom medicine does not yet have curative treatments. Despite its virtues, a career in surgery brings with it significant challenges, which can lead to substantial personal distress for the individual surgeons and their family. By identifying the priorities of their personal and professional life, surgeons can identify values, choose the optimal practice type, manage the stressors unique to that career path, determine the optimal personal work-life balance, and nurture their personal wellness. Being proactive is better than reacting to burnout after it has damaged one's professional life or personal wellness. Studies like the ACS survey can benefit surgeons going through a personal crisis by helping them to know that they are not alone and that many of their colleagues face similar issues. It is important that surgeons do not make the mistake of thinking: "I must not be tough enough," or "no one could possibly experience what I am going through." The available evidence suggests that those surgeons most dedicated to their profession and their patient may very well be most susceptible to burnout. Silence on career distress, as a strategy, simply does not work among professionals whose careers, well-being, and level of patient care may be in jeopardy. Additional research in these areas is needed to elucidate evidence-based interventions to address physician distress at both the individual and organizational level to benefit the individual surgeon and the patient they care for. Surgeons must also be able to recognize how and when their personal distress affects the quality of care they provide (both in the delivery of care and in the emotional support of patients and their families). There is no single formula for achieving a satisfying career in surgery. All surgeons deal with stressful times in their personal and professional life and must cultivate habits of personal renewal, emotional self-awareness, connection with colleagues, adequate support systems, and the ability to find meaning in work to combat these challenges. As surgeons, we also need to set an example of good health to our patients and future generations of surgeons. To provide the best care for our patients, we need to be alert, interested in our work, and ready to provide for our patient's needs. Maintaining these values and healthy habits is the work of a lifetime.
Collapse
Affiliation(s)
- Charles M Balch
- Johns Hopkins Medical Institutions, Department of Surgery, 1515 Orleans St. Cancer Research Building II, Room 507, Baltimore, MD 21231, USA.
| | | |
Collapse
|
30
|
Stafford L, Judd F. Mental health and occupational wellbeing of Australian gynaecologic oncologists. Gynecol Oncol 2009; 116:526-32. [PMID: 19932917 DOI: 10.1016/j.ygyno.2009.10.080] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Revised: 10/22/2009] [Accepted: 10/28/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate the prevalence of psychiatric morbidity and occupational burnout among Australian gynaecologic oncologists and to assess job stress and job satisfaction in this group. METHOD Anonymous, self-report questionnaires containing validated measures were sent to all practicing Australian gynaecologic oncologists in October 2008. RESULTS The response rate was 78.4% (N=29). More than one-third (35.7%) had high levels of emotional exhaustion, the central component of burnout. In the past 6 months, 42.9%, 57.1%, and 28.6% had seriously considered leaving for another position, reducing the number of hours worked, and taking early retirement, respectively. The most commonly reported source of stress (80.8%) was home-life disruption due to work. Compared to general population data and recommended national guidelines, rates of alcohol consumption were high. Psychological morbidity, global job stress and burnout were significantly correlated and each was associated with harmful alcohol use. Other factors associated with burnout were administrative/organizational demands and patient volume. More than half of respondents (58.6%) had high levels of job satisfaction and most had high levels of personal accomplishment (70.4%). Perceived adequacy of the training curriculum and proposed changes to the curriculum are reported. CONCLUSION Australian gynaecologic oncologists experience considerable occupational distress while possessing high levels of personal accomplishment and job satisfaction. To maintain a healthy workforce, it is important to build on existing supports while conducting further research to identify suitable evidence-based strategies for improving the mental health of these surgeons.
Collapse
Affiliation(s)
- Lesley Stafford
- Centre for Women's Mental Health, Royal Women's Hospital, Locked Bag 300, Victoria, Australia.
| | | |
Collapse
|
31
|
Hena MA. A career in surgical oncology: not finding meaning, balance, and personal satisfaction. Ann Surg Oncol 2009; 16:1060-1; author reply 1062. [PMID: 19169761 DOI: 10.1245/s10434-008-0202-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Accepted: 08/25/2008] [Indexed: 11/18/2022]
|