Personality and burnout among primary care physicians: an international study

New insights into physician burnout and turnover intent: a validated measure of physician fortitude

BACKGROUND

Given the increasing prevalence of the physician burnout, this study provides new insights into the antecedents driving burnout and turnover intent. By introducing the concept of physician fortitude, we develop a valid and statistically-reliable measure that increases our understanding of these issues.

METHODS

A two-sample design was employed. Using a sample of 909 physicians, Advanced Practice Providers (APPs) and healthcare leaders, exploratory factor analysis was employed to create a 12-item fortitude scale. In the second study, using a sample of 212 of practicing physicians, APPs and healthcare leaders, bivariate and tetrachoric correlations, and ordinary least square regression modeling were able to establish reliability and validity.

RESULTS

The fortitude scale shows sufficient reliability. Moreover, we found significant support for convergent and criterion-related validity. Fortitude was significantly related to all three subdimensions of burnout, including emotional exhaustion (r = -.62, p < .01), depersonalization (r = -.70, p < .01) and personal accomplishment (r = .65, p < .01), and turnover intent (r = -.55, p < .01). Moreover, the fortitude measure explained more variance in all three subdimensions of burnout and turnover intent compared to common measures, including grit, hardiness, mental toughness and resilience (p < .01).

CONCLUSIONS

Results from this study empirically demonstrate that fortitude is significantly related to burnout, and turnover intent. This new fortitude measure adds a new perspective to assist in the development of more effective interventions. Opportunities for future research are discussed.

Clinical teaching self-efficacy positively predicts professional fulfillment and negatively predicts burnout amongst Thai physicians: a cross-sectional survey

BACKGROUND

Clinician teachers (physicians who teach in clinical settings) experience considerable psychological challenges in providing both educational training and patient care. This study aimed to determine the prevalence of physician burnout and professional fulfillment, and to identify internal and external factors associated with mental health outcomes among Thai clinician teachers working in non-university teaching hospitals.

METHOD

A one-time online questionnaire was completed by physicians at 37 governmental, non-university teaching hospitals in Thailand, with 227 respondents being assessed in the main analyses. Four outcomes were evaluated including burnout, professional fulfillment, quality of life, and intentions to quit.

RESULTS

The observed prevalence of professional fulfillment was 20%, and burnout was 30.7%. Hierarchical regression analysis showed a significant internal, psychological predictor (clinical teaching self-efficacy) and external, structural predictors (multiple roles at work, teaching support), controlling for the background variables of gender, years of teaching experience, family roles, and active chronic disease, with clinical teaching self-efficacy positively predicting professional fulfillment (b = 0.29, p ≤.001) and negatively predicting burnout (b = - 0.21, p =.003).

CONCLUSIONS

Results highlight the importance of faculty development initiatives to enhance clinical teaching self-efficacy and promote mental health among Thai physicians.

Impact of confrontation to patient suffering and death on wellbeing and burnout in professionals: a cross-sectional study

BACKGROUND

Palliative care and oncology generate a risk of burnout and psychological distress in professionals. The purpose of this study is to identify both psychopathological and positive factors related to mental health at work. It aims (i) to explore the extent to which these professionals are confronted with suffering, illness, and death; and to explore the prevalence of psychological distress and/or burnout, (ii) to identify potential determinants of burnout and psychological wellbeing at work, (iii) to develop an integrative model of mental health; and to identify frequency and impact of confrontations with death, and (iv) to identify profiles of professionals are at risk of developing a mental health disorder or, conversely, characterized by wellbeing.

METHODS

A cross-sectional questionnaire study was conducted in palliative care and oncology evaluating confrontations with death, coping, burnout, psychological distress, personality, self-esteem, well-being and meaning at work. Regressions, clustering, and structural equation modeling analyses were performed.

RESULTS

109 professionals participated (58% from oncology and 42% from palliative care), of which 79% were female, and 65% were between 30 and 49 years old. Aim i: 30% witnessed an intolerable suffering at least 9 times a month, 45% reported moderate to high levels of burnout, 39% suffered from anxiety and 11% from depression. Aim ii: the determinants of burnout were the personality traits conscientiousness and neuroticism, low meaning of work, and low wellbeing (R2 = 0.44). The determinants of wellbeing were work meaning, depersonalization, self-esteem, fulfillment and low emotional exhaustion (R2 = 0.71). Aim iii: the integrative model included both well-being (self-esteem, conscientiousness) and psychopathology (neuroticism, anxiety) parameters, and strongly satisfied the standard SEM goodness of fit indices (e.g., CFI, IFI, and TLI ≥ 0.95). Aim iv: three profiles were identified: (a) a "distressed profile" with a majority of professionals at the patient's bedside, (b) a "disengaged profile" with professionals working as second-line consultants, (c) a "wellbeing profile" contains profiles of caregivers insensitive to psychological distress and with a high level of positive Impact of confrontation on different areas of their lives.

CONCLUSIONS

An integrative approach is essential to understand the full range of mental health issues for professionals. Meaning of work is a key factor in professional interventions that should primarily affect front-line professionals with limited experience.

Effects of personal noise exposure, sleep quality, and burnout on quality of life: An online participation cohort study in Taiwan

Chronic noise exposure in daily life not only causes physical and mental illness but also reduces quality of life. However, collecting objective data on sound exposure and subjective acoustic comfort through a traditional one-shot survey is difficult. This study applied online chatbots in social media to explore the effects of daily sound exposure, personal characteristics, noise sensitivity, burnout status, and sleep quality on quality of life using a short-term participatory cohort design. During the two-month survey in 2022, 207 participants completed at least 15 days of collection of data on sound exposure and perception, as well as periodic structural questionnaires during the follow-ups. Linear regression and generalized linear models were applied to explore the factors influencing personal burnout, the Pittsburgh Sleep Quality Index, and quality of life. A chain mediation model was applied to explore the direct and indirect effects of noise exposure on quality of life. The results showed a better quality of life among respondents who rated their home environment better, were in good health, had better daily acoustic comfort, and were less exposed to noise during the week. In contrast, respondents with lower daily acoustic comfort and a higher frequency of noise-induced sleep disturbances and mood disorders were more likely to have poorer sleep quality. A higher personal burnout was associated with poorer health, longer exposure to noise during the week, a higher frequency of noise-induced illnesses, and neurotic traits. In the mediation analyses, noise-induced sleep disturbance and better daily acoustic comfort also had important direct influences on quality of life compared to the indirect pathway through sleep quality and personal burnout. In conclusion, noise exposure in daily life not only exacerbated poor sleep quality and personal burnout but also reduced quality of life.

Personality Traits, Burnout, and Psychopathology in Healthcare Professionals in Intensive Care Units-A Moderated Analysis

This study explored the associations between personality dimensions, burnout, and psychopathology in healthcare professionals in intensive care units (ICUs). This study further aimed to discern the differences in these relationships when considering the variables of critical care experience (less than 5 years, 5-10 years, and more than 10 years), profession (nurses versus intensivists), and the urban size of the city where the ICU is located (metropolitan cities versus smaller urban cities). This cross-sectional investigation's outcomes are based on data from 503 ICU personnel, including 155 intensivists and 348 nurses, in 31 ICU departments in Greece. Participants underwent a comprehensive assessment involving a sociodemographic questionnaire, the Eysenck Personality Questionnaire (EPQ), the Maslach Burnout Inventory (MBI), and the Symptom Checklist-90 (SCL-90). To analyze the interplay among critical care experience, burnout status, and psychopathology, a moderation analysis was conducted with personality dimensions (i.e., psychoticism, extraversion, and neuroticism) serving as the mediator variable. Profession and the urban size of the ICU location were considered as moderators influencing these relationships. Male healthcare professionals showed higher psychoticism levels than females, aligning with prior research. Experienced nurses reported lower personal achievement, hinting at potential motivation challenges for professional growth. Psychoticism predicted high depersonalization and low personal achievement. Neuroticism and psychoticism negatively impacted ICU personnel's mental well-being, reflected in elevated psychopathology scores and burnout status. Psychoticism appears to be the primary factor influencing burnout among the three personality dimensions, particularly affecting intensivists. In contrast, nurses are more influenced by their critical care experience on their mental health status.

A network analysis bridging the gap between the big five personality traits and burnout among medical staff

BACKGROUND

Burnout is a common issue among medical professionals, and one of the well-studied predisposing factors is the Big Five personality traits. However, no studies have explored the relationships between these traits and burnout from a trait-to-component perspective. To understand the specific connections between each Big Five trait and burnout components, as well as the bridging effects of each trait on burnout, we employed network analysis.

METHODS

A cluster sampling method was used to select a total of 420 Chinese medical personnel. The 15-item Chinese Big Five Personality Inventory-15 (CBF-PI-15) assessed the Big Five personality traits, while the 15-item Maslach Burnout Inventory-General Survey (MBI-GS) assessed burnout components. Network analysis was used to estimate network structure of Big Five personality traits and burnout components and calculate the bridge expected influence.

RESULTS

The study revealed distinct and clear relationships between the Big Five personality traits and burnout components. For instance, Neuroticism was positively related to Doubt significance and Worthwhile, while Conscientiousness was negatively related to Accomplish all tasks. Among the Big Five traits, Neuroticism displayed the highest positive bridge expected influence, while Conscientiousness displayed the highest negative bridge expected influence.

CONCLUSIONS

The network model provides a means to investigate the connections between the Big Five personality traits and burnout components among medical professionals. This study offers new avenues for thought and potential targets for burnout prevention and treatment in medical personnel, which can be further explored and tested in clinical settings.

Prevalence and factors associated with professional burnout in Polish oncologists-results of a nationwide survey

BACKGROUND

High rates of burnout are observed among health care professionals worldwide, which could have negative consequences on personal and organizational levels. We aimed to evaluate the burnout prevalence and factors associated with burnout among oncologists in Poland.

MATERIALS AND METHODS

An online survey was conducted using the validated Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and additional work/lifestyle questions. Descriptive statistics, parametric and nonparametric tests, and multivariate logistic regression were used to identify factors associated with burnout.

RESULTS

A total of 228 physicians participated in the survey, including 168 medical oncologists, 43 radiation oncologists, and 17 from other specialties. Data collected from 211 medical and radiation oncologists were included in the final analyses. Most participants were female (71.6%) and ≤40 years of age (70.1%). A self-reported feeling of burnout was present in 65.9% of participants. Based on the MBI-HSS, 74.9% showed evidence of burnout with burnout subdomains as follows: depersonalization 37.0%; emotional exhaustion 64.5%; low accomplishment 43.1%. There were no differences in burnout rates based on specialization (oncology/haematology-75.6%, radiotherapy-72.1%), career stage, gender, or age groups. Lack of work-life balance was the only significant factor associated with the risk of burnout in the logistic regression (relative risk 2.6, 95% confidence interval 1.3-5.4). Only 20.9% of physicians had access to psychological support in their workplace; however, 70.1% desired such support. Three main factors impacting burnout in cancer care workers were: bureaucracy and administrative duties overload, admissions of many patients, and poor work culture.

CONCLUSIONS

Burnout is common among medical and radiation oncologists in Poland. There is a high demand for psychological support and organizational changes in the workplace to reduce risk and mitigate the adverse effects of burnout among health care professionals.

High prevalence of burnout syndrome in Czech general practitioners: A cross-sectional survey

Objective

A wide range in prevalence rates of burnout among general practitioners (GPs) has been reported in various regions, with an increasing trend. This nationwide cross-sectional study aimed to estimate the prevalence and associated determinants of burnout in Czech GPs.

Methods

1000 randomly selected physicians from the Czech Society of General Practitioners (through a pseudorandom number generator) were emailed an online survey based on the Maslach Burnout Inventory - Human Services Survey. Data collection was performed between January and February 2023.

Results

331 questionnaires were obtained (227 females and 104 males, mean age - 49.9 years, the mean number of registered patients - 1951). 21.8 % of GPs scored a high level of burnout in all three of its dimensions and 23.9 % in no dimension at all. The most prevalent dimension was reduced personal accomplishment (PA, 56.2 %) followed by emotional exhaustion (EE, 50.2 %) and depersonalization (DP, 40.5 %). Reaching burnout in all three dimensions was significantly more frequent in males and in GPs registering a number of patients above the median. Increasing age and years of practice were protective factors for DP but risk factors for reduced PA. Employed GPs had lower EE scores than GP practice owners. The respondents' basic characteristics reflected their presence among Czech GPs, which testifies against selection bias.

Conclusions

The high rate of burnout (∼22 %) should be addressed by promoting personal resources along with the perception of the importance of GPs in society. A sufficiently dense network of GPs should allow them to register a lower number of patients.

Impact of COVID-19 pandemic on pediatric healthcare burnout in acute care: a longitudinal study

BACKGROUND

COVID-19 pandemic introduced significant challenges that may have exacerbated healthcare worker (HCW) burnout. To date, assessments of burnout during COVID-19 pandemic have been cross-sectional, limiting our understanding of changes in burnout. This longitudinal study assessed change across time in pediatric HCW burnout during the COVID-19 pandemic and whether demographic and psychological factors were associated with changes in burnout.

METHODS

This longitudinal study included 162 physicians, physician assistants, nurses, and medical technicians within the emergency department (ED), intensive care, perioperative, and inter-hospital transport services in a children's hospital. HCW demographics, anxiety and personality traits were reported via validated measures. HCWs completed the Maslach Burnout Inventory in April 2020 and March 2021. Data were analyzed using generalized estimating equations.

RESULTS

The percentage of HCWs reporting high emotional exhaustion and/or depersonalization burnout increased significantly across time (18.5% to 28.4%, P = 0.010). Factors associated with increased emotional exhaustion included working in the ED (P = 0.011) or perioperative department (P < 0.001), being a nurse or medical technician (P's < 0.001), not having children (P < 0.001), and low conscientiousness (P < 0.001).

CONCLUSIONS

Pediatric HCW burnout significantly increased over 11-months of the COVID-19 pandemic. Results suggest that certain demographic and psychological factors may represent potential area to target for intervention for future pandemics.

IMPACT

This longitudinal study revealed that the COVID-19 pandemic has had a significant impact on pediatric healthcare worker burnout. The percentage of healthcare workers reporting high levels of emotional exhaustion and depersonalization burnout increased significantly over 11-months of the COVID-19 pandemic. Results suggest that certain demographic and psychological factors may represent potential targets for future interventions.

Relationship between burnout levels of nurses and their circadian preference, sleep quality, and personality traits

Occupational stress and burnout are widely encountered among many healthcare professionals, including nurses and doctors, as well as among members of other professions. For example, nurses, who have disrupted circadian rhythms, are seen to have sleep problems. In addition, their personality traits are also considered to be related with burnout. This study aimed to identify nurses' circadian preference and personality traits along with their effects on sleep quality and their relationship with burnout. In this study, 211 nurses (40 male, 171 female) using the correlational model from quantitative research methods was used since the variables of morningness/eveningness, personality trait, sleep quality, and burnout were aimed to be investigated at once, without intervention, within the predictivity context of the relationship among them. When the scores obtained from the burnout scale were examined, it was observed that the emotional exhaustion and personal accomplishment subdimensions were so close to the median value and mean, while depersonalization was quite low compared to these sub-dimensions. The participants' sleep quality was seen to be at the lowest step of the poor sleep quality class. When the scores obtained from the MESSI scale are examined, it is seen that the scores obtained from the morning affect dimension are above the median value, and the highest average according to the Five-Factor Personality Traits Scale is obtained in the subdimensions of agreeableness and conscientiousness. Female gender, constantly work at night, having a high number of weekly working hours increased burnout level. Additionally Evening chronotype, poor sleep quality, neuroticism, agreeableness, extroversion and conscientiousness personality traits were found to be associated with burnout in this study. In the study, being of different chronotypes, having other personality traits, and varying sleep quality scores were seen to affect the sub-dimensions of burnout.

Big five model personality traits and job burnout: a systematic literature review

BACKGROUND

Job burnout negatively contributes to individual well-being, enhancing public health costs due to turnover, absenteeism, and reduced job performance. Personality traits mainly explain why workers differ in experiencing burnout under the same stressful work conditions. The current systematic review was conducted with the PRISMA method and focused on the five-factor model to explain workers' burnout risk.

METHODS

The databases used were Scopus, PubMed, ScienceDirect, and PsycINFO. Keywords used were: "Burnout," "Job burnout," "Work burnout," "Personality," and "Personality traits".

RESULTS

The initial search identified 3320 papers, from which double and non-focused studies were excluded. From the 207 full texts reviewed, the studies included in this review were 83 papers. The findings show that higher levels of neuroticism (r from 0.10** to 0.642***; β from 0.16** to 0.587***) and lower agreeableness (r from - 0.12* to - 0.353***; β from - 0.08*** to - 0.523*), conscientiousness (r from -0.12* to -0.355***; β from - 0.09*** to - 0.300*), extraversion (r from - 0.034** to - 0.33***; β from - 0.06*** to - 0.31***), and openness (r from - 0.18*** to - 0.237**; β from - 0.092* to - 0.45*) are associated with higher levels of burnout.

CONCLUSIONS

The present review highlighted the relationship between personality traits and job burnout. Results showed that personality traits were closely related to workers' burnout risk. There is still much to explore and how future research on job burnout should account for the personality factors.

Burnout among Male Physicians: A Controlled Study on Pathological Personality Traits and Facets

There is a high prevalence of job burnout in physicians, impacting both the professional and personal levels. This study aimed to investigate whether physicians with burnout show specific pathological traits and facets of their personalities compared with healthy controls, according to the dimensional personality models in the ICD-11 and DSM-5. The role of perceived stress, anxiety, and depression were exploratively investigated regarding group differences. Male physicians (n = 60) were recruited into two groups (burnout vs. healthy). The Personality Inventory for the DSM-5 Brief Form Plus (PID5BF+) and the Maslach Burnout Inventory (MBI) were applied. The Wilcoxon rank-sum test (WRS) showed group differences in five of the six traits and in six of the seventeen facets of the PID5BF+. Multiple binary logistic regression, controlling for age, showed that deceitfulness (3.34 (1.36–9.35), p = 0.013) and impulsivity (10.20 (2.4–61.46), p = 0.004) significantly predicted burnout. Moreover, the WRS showed significant group differences in perceived stress, depressive, and anxiety symptoms (all p < 0.00)]. The findings suggest a relationship between pathological personality facets and burnout in a sample of male physicians. In particular, the facets of deceitfulness and impulsivity appear to play an important role. Furthermore, burnout showed well-known associations with perceived stress, depressive, and anxiety symptoms.

Burnout among general practitioners, a systematic quantitative review of the literature on determinants of burnout and their ecological value

Burnout is a major social and economic problem, specifically among general practitioners (GPs). The amount of literature on generic determinants of burnout is impressive. However, the size of the library on occupation-specific determinants of burnout among GPs are minimal. With the present study, we aim to gain insight into the existing academic literature on generic and occupation-specific determinants of burnout among GPs. Moreover, we aim to contribute to the ecological validity of this study by emphasizing occupation-specific determinants. We conducted a systematic quantitative literature review in which we followed the PRISMA statement and performed quality assessments according to the AXIS, CASP, MMAT, and 3-MIN procedures. Furthermore, we assessed frequency effect sizes (FES) and intensity effect sizes (IES). By performing Fisher's exact tests, we investigated whether the quality of the studies influenced the outcomes. An extensive literature search revealed 60 eligible studies among which 28 strong studies, 29 moderate studies, and 3 weak studies were identified. Analyzing those studies delivered 75 determinants of burnout, of which 33 were occupation-specific for GPs. According to the average FES, occupation-specific determinants play a significant role in acquiring burnout compared to the generic determinants. The results of the Fisher exact tests provided evidence that the quality of the 60 studies did not affect the outcomes. We conclude that it is surprising that a profession with such an important social position and such a high risk of burnout has been so little researched.

Perfectionism as a predictor of physician burnout

Background

Burnout is common among physicians and has detrimental effects on patient care and physician health. Recent editorials call attention to perfectionism in medicine; however, no studies to date have examined the effect of perfectionism on burnout in physicians practicing in the United States. This study examined associations among demographics, perfectionism and personality traits, and burnout among practicing physicians.

Methods

This cross-sectional study included general pediatric and pediatric sub-specialist physicians. Out of the 152 physicians contacted, 69 enrolled (Meanage = 44.16 ± 9.98; 61% female). Emotional exhaustion, depersonalization, and personal accomplishment burnout were assessed via the Maslach Burnout Inventory. Validated instruments were used to measure personality and perfectionism. Data were analyzed using linear regression models.

Results

Across physicians assessed, 42% reported either high emotional exhaustion burnout or depersonalization burnout. High self-critical perfectionism uniquely predicted both high emotional exhaustion burnout (B = 0.55, 95%CI 0.25–0.85) and depersonalization burnout (B = 0.18, 95%CI 0.05–0.31). Low conscientiousness (B = -6.12; 95%CI, -10.95- -1.28) predicted higher emotional exhaustion burnout and low agreeableness (B = -3.20, 95%CI -5.93- -0.46) predicted higher depersonalization burnout.

Conclusions

Perfectionism is understudied among physicians and the current findings suggest that addressing system and individual-level factors that encourage perfectionism is warranted and may reduce risk for physician burnout.

Social Support, Social Isolation, and Burnout: Cross-Sectional Study of U.S. Residents Exploring Associations With Individual, Interpersonal, Program, and Work-Related Factors

PURPOSE

To examine associations of social support and social isolation with burnout, program satisfaction, and organization satisfaction among a large population of U.S. residents and fellows and to identify correlates of social support and social isolation.

METHOD

All residents and fellows enrolled in graduate medical education programs at Mayo Clinic sites were surveyed in February 2019. Survey items measured social support (emotional and tangible), social isolation, burnout, program satisfaction, and organization satisfaction. Factors of potential relevance to social support were collected (via the survey, institutional administrative records, and interviews with program coordinators and/or program directors) and categorized as individual, interpersonal, program, or work-related factors (duty hours, call burden, elective time, vacation days used before survey administration, required away rotations, etc.). Multivariable regression analyses were conducted to examine relationships between variables.

RESULTS

Of 1,146 residents surveyed, 762 (66%) from 58 programs responded. In adjusted models, higher emotional and tangible support were associated with lower odds of burnout and higher odds of program and organization satisfaction, while higher social isolation scores were associated with higher odds of burnout and lower odds of program satisfaction and organization satisfaction. Independent predictors of social support and/or social isolation included age, gender, relationship status, parental status, postgraduate year, site, ratings of the program leadership team, ratings of faculty relationships and faculty professional behaviors, satisfaction with autonomy, and vacation days used before survey administration.

CONCLUSIONS

This study demonstrates that social support and social isolation are strongly related to burnout and satisfaction among residents and fellows. Personal and professional relationships, satisfaction with autonomy, and vacation days are independently associated with social support and/or social isolation, whereas most program and work-related factors are not. Additional studies are needed to determine if social support interventions targeting these factors can improve well-being and enhance satisfaction with training.

Burnout among primary health-care professionals in low- and middle-income countries: systematic review and meta-analysis

Objective

To estimate the prevalence of burnout among primary health-care professionals in low- and middle-income countries and to identify factors associated with burnout.

Methods

We systematically searched nine databases up to February 2022 to identify studies investigating burnout in primary health-care professionals in low- and middle-income countries. There were no language limitations and we included observational studies. Two independent reviewers completed screening, study selection, data extraction and quality appraisal. Random-effects meta-analysis was used to estimate overall burnout prevalence as assessed using the Maslach Burnout Inventory subscales of emotional exhaustion, depersonalization and personal accomplishment. We narratively report factors associated with burnout.

Findings

The search returned 1568 articles. After selection, 60 studies from 20 countries were included in the narrative review and 31 were included in the meta-analysis. Three studies collected data during the coronavirus disease 2019 pandemic but provided limited evidence on the impact of the disease on burnout. The overall single-point prevalence of burnout ranged from 2.5% to 87.9% (43 studies). In the meta-analysis (31 studies), the pooled prevalence of a high level of emotional exhaustion was 28.1% (95% confidence interval, CI: 21.5-33.5), a high level of depersonalization was 16.4% (95% CI: 10.1-22.9) and a high level of reduced personal accomplishment was 31.9% (95% CI: 21.7-39.1).

Conclusion

The substantial prevalence of burnout among primary health-care professionals in low- and middle-income countries has implications for patient safety, care quality and workforce planning. Further cross-sectional studies are needed to help identify evidence-based solutions, particularly in Africa and South-East Asia.

Did Personality Type Influence Burn Out Syndrome Manifestations During Covid-19 Pandemic?

Introduction

Emergency department (ED) health care providers had one of the highest incidences of burnout just before the pandemic. Personality type influences the way we communicate and relate to others, as well as our reaction to stress. In evaluating the causes of burnout, we take into account several factors, the most important of which being the conditions of the professional environment, interpersonal relationships and personality traits. This study aims to identify and analyze the relationships between personality traits and burnout syndrome in medical staff in the Emergency Department.

Material and Methods

A descriptive, multicenter cross-sectional study project was used to collect data from 60 physicians and nurses from the Emergency Department of the County Emergency Clinical Hospital Galati. The tools used, distributed to participants to collect socio-demographic details, included the Eysenck Personality Inventory (EPI), and a pilot questionnaire. The questionnaire consisted of 11 questions, concerning exhaustion level, and focused on stress-generating elements and emotional management in the Emergency Department during the pandemic.

Results

A large percentage of doctors in ED (45.8%) (n = 24) indicated a high level of exhaustion, while only 30.6% (n = 36) of nurses indicated a high level of exhaustion. Physicians displayed a higher level of stress than nurses, with 66.6% (n = 24) of physicians indicating an increased level of stress, compared to only 36.1% (n = 36) of nurses. A large percentage of nurses indicated a high level of depression (36.1%), whereas only 25% of Emergency Department physicians indicated a high level of depression.

Discussion

The individuals with a melancholic and choleric temperament, as rated by the EPI, appeared more susceptible to developing burnout syndrome. The indication of instability or neuroticism appears to enhance the occurrence of burnout syndrome. There was also a correlation between extraversion and a high level of burnout, with extraverted individuals more easily reaching a high level of burnout.

Conclusion

The results indicate a greater occurrence of exhaustion and stress in Emergency Department physicians compared to nurses in the Emergency Department. From the results, we can propose that there is a relationship between the personality traits as measured by the EPI and the occurrence of burnout syndrome. These findings may help to understand the vulnerability of medical staff to burnout, and to pre-emptively support them to deal effectively with stressors in the work environment.

Physician challenges and supports during the first wave of the COVID-19 pandemic: A mixed methods study

INTRODUCTION

During the COVID-19 pandemic, physicians encountered significant COVID-19-related negative experiences and psychological distress in both their personal and professional lives. To understand the factors that negatively impact physician well-being, a number of studies have pointed to multiple work system factors such as excessive workload and workflow interruptions. In addition, studies have shown that positive interpersonal relationships that provide social support may also serve as a buffering role against psychological distress. The aim of our study explores the challenges and sources of support for physicians relative to mental health symptoms.

METHODS

In this study, We used a cross-sectional study design with a convergent parallel mixed method approach combining both qualitative and quantitative data collected in parallel from a self-report questionnaire immediately following the first wave of COVID-19. The aim of our study explores the challenges and sources of support for physicians relative to mental health symptoms.

RESULTS

Of the 457 physicians in the study, the most frequently potential negative occupational experiences were, "Being at risk of contracting COVID-19 from patients/co-workers" (90.5%) and "Contact with distressed family members who cannot be with a loved one" (69.5%). We identified five common themes for main sources of social support (e.g. emotional support from family/friends) and six themes for challenges (e.g., work-related demands exacerbated by the pandemic).

DISCUSSION

Our study highlights COVID-19 and other pandemic-related challenges that negatively impacted the mental health of physicians. Interventions that provide targeted organizational supports (e.g. sufficient PPE and child support), as well as specific sources of support (e.g. family and emotional), can attenuate those challenges and stressors experienced during a pandemic.

Burnout and resilience in doctors in clinical and preclinical departments in a tertiary care teaching and dedicated COVID-19 hospital

BACKGROUND

The worldwide COVID-19 pandemic has significantly altered our life. Doctors more so than the general public because of their involvement in managing the COVID-infected individuals, some of them 24/7 end in burnout. Burnout in doctors can lead to reduced care of patients, increased medical errors, and poor health. Burnout among frontline health-care workers has become a major problem in this ongoing epidemic. On the other hand, doctors in preclinical department have a lack of interaction with patients, with not much nonclinical professional work to boot, find the profession less gratifying which perhaps increase their stress level.

AIM

The aim was to study the prevalence of burnout and measure resilience in doctors in clinical and in preclinical departments.

MATERIALS AND METHODS

This observational, cross-sectional, comparative study was carried out in a tertiary care teaching hospital and COVID care center. By purposive sampling 60 preclinical and 60 clinical doctors in a tertiary health care center were included in the study. After obtaining the Institutional Ethics Committee approval and informed consent, the doctors were administered a self made socio-demographic questionnaire, the Copenhagen Burnout Inventory, and the Connor-Davidson Resilience Scale. Doctors were given a self-made questionnaire, the Copenhagen Burnout Inventory, and the Connor-Davidson Resilience Scale.

RESULTS

The prevalence of burnout was seen more in clinical doctors (55.47) and the resilience was observed more in preclinical doctors (88.9).

DISCUSSION

Resident doctors are a major force to combat COVID-19 as frontline health workers; hence, one can visualize burnout amongst them. On an individual basis, the work-related burnout was severely high in the clinical group owing to the workload which has been corresponding to a number of western studies. Nonclinical department doctors from pathology, community medicine, and microbiology did show burnout but showed a greater score in resilience. Psychological resilience has been identified as a component in preventing burnout.

CONCLUSION

Therapy sessions can be used in clinical doctors facing burnout to build up their resilience.

The prevalence of burnout, risk factors, and job-related stressors in gastroenterologists: A systematic review

BACKGROUND AND AIMS

Burnout is an important occupational hazard, and the scale of the problem within gastroenterology remains poorly understood. The primary objective of this study was to understand the prevalence of burnout in gastroenterology and ascertain if there was a common prevalence within the field. The secondary objective was to identify factors and job-related stressors that commonly contribute to burnout in gastroenterologists.

METHODS

Systematic searches were conducted in PubMed, Scopus, Cochrane, and PsycINFO by two reviewers independently for articles published to 1 September 2020. The primary outcome measure was the reported prevalence of burnout in gastroenterologists. The secondary outcome measures were (i) the prevalence of non-somatic burnout symptoms (emotional exhaustion, depersonalization, and low personal accomplishment) and (ii) the frequency of risk factors and stressors reported in studies. Data were presented, and limited meta-analyses discussed.

RESULTS

Data were extracted from 11 studies. 54.5% (6/11) of these studies reported the prevalence of burnout in gastroenterologists; this ranged from 18.3% to 64.4%. Similar to burnout prevalence, burnout symptoms showed geographical variation and were common in gastroenterologists (up to 63.9%). Factors associated with work volume, age, and female gender were the three most frequently reported risk factors for increased levels of stress and burnout in 72.7% (8/11), 54.5% (6/11), and 45.5% (5/11) of studies, respectively. Significant methodological and clinical heterogeneity was observed.

CONCLUSIONS

Burnout and its non-somatic symptoms are common in gastroenterologists, but the syndrome is understudied within the field. Further research and good quality data are needed to help address the problem.

Impact of the COVID-19 Pandemic on Burnout in Primary Care Physicians in Catalonia

Background: Recent demands to raise the clinical quality, improve the patient experience, and decrease costs have progressively increased burnout among primary care physicians. This overstretched situation has been greatly aggravated since the onset of the COVID-19 pandemic. The aim of the study is to analyse the prevalence of burnout among primary care physicians and to assess the impact of the COVID-19 pandemic on burnout. Methods: This was a multicentre longitudinal descriptive study of occupational factors and burnout before and since the start of the COVID-19 pandemic. In order to assess the impact of the pandemic on burnout in primary care physicians, two paired groups of physicians were compared using Wilcoxon’s and McNemar’s tests. Results: In January 2019, 10% of primary care physicians scored high on all burnout domains. Seven months into the COVID-19 pandemic (October 2020), this percentage increased to 50%. Paired groups analysis showed unprecedented worsening due to the pandemic: emotional exhaustion, which already affected 55% of primary care physicians, jumped to 77%. Conclusions: Burnout is endemic among primary care physicians. It has been associated with lower patient satisfaction, reduced health outcomes, and increased costs. The COVID-19 pandemic has pushed burnout in primary care professionals to the edge.

Personal and psychosocial factors of burnout: A survey within the French neurosurgical community

Object

The neurosurgical community is particularly exposed to burnout. The objectives of this study were to report the prevalence and associated factors of burnout within the French neurosurgical community using validated academic and psychologic scales.

Methods

A national survey was sent to 141 French residents and 432 neurosurgeons between April and July 2019. Burnout was surveyed using the Maslach burnout inventory. The survey included demographic data and several academic psychologic scales. A stepwise multiple regression was used to determine factors that are associated with burnout scores.

Results

The response rate was 100% and 23.6% for residents and neurosurgeons, respectively. Prevalence of burnout within the French neurosurgical community was 49%. There were no significant differences between residents and neurosurgeons. Two categories of factors were associated with the main dimensions of burnout during the stepwise multiple regression: personality and factors related with neurosurgical practice. Personality types such as neuroticism were negatively associated with burnout while agreeableness was protective. Work addictive profile with excessive work and absorption at work were negatively associated. Factors associated with neurosurgical practice such as conflict of work into family life, unbalanced effort to reward ratio, work duration were negatively associated. Pleasure at work was protective.

Conclusion

Prevalence of burnout is high among French neurosurgeons. Predictive models can be used to identify and prevent burnout among profiles at risk.

What is known about paediatric nurse burnout: a scoping review

Burnout in healthcare providers has impacts at the level of the individual provider, patient, and organization. While there is a substantial body of literature on burnout in healthcare providers, burnout in pediatric nurses has received less attention. This subpopulation may be unique from adult care nurses because of the specialized nature of providing care to children who are typically seen as a vulnerable population, the high potential for empathetic engagement, and the inherent complexities in the relationships with families. Thus, the aim of this scoping review was to investigate, among pediatric nurses, (i) the prevalence and/or degree of burnout, (ii) the factors related to burnout, (iii) the outcomes of burnout, and (iv) the interventions that have been applied to prevent and/or mitigate burnout. This scoping review was performed according to the PRISMA Guidelines Scoping Review Extension. CINAHL, EMBASE, MEDLINE, PsycINFO, ASSIA, and The Cochrane Library were searched on 3 November 2018 to identify relevant quantitative, qualitative, and mixed-method studies on pediatric nurse burnout. Our search identified 78 studies for inclusion in the analysis. Across the included studies, burnout was prevalent in pediatric nurses. A number of factors were identified as impacting burnout including nurse demographics, work environment, and work attitudes. Similarly, a number of outcomes of burnout were identified including nurse retention, nurse well-being, patient safety, and patient-family satisfaction. Unfortunately, there was little evidence of effective interventions to address pediatric nurse burnout. Given the prevalence and impact of burnout on a variety of important outcomes, it is imperative that nursing schools, nursing management, healthcare organizations, and nursing professional associations work to develop and test the interventions to address key attitudinal and environmental factors that are most relevant to pediatric nurses.

A Novel Instrument for Integrated Measurement and Assessment of Intrinsic Motivation, Team Climate, and Burnout in Multidisciplinary Teams

INTRODUCTION

There is increasing recognition of the importance of intrinsic motivation, team dynamics, and burnout in multidisciplinary teams striving to achieve the Quadruple Aim.

OBJECTIVE

To assess self-rated team climate, intrinsic motivation, and burnout of a multidisciplinary team at an urgent primary care center and to explore potential relationships between the concepts.

METHODS

A scoping review of the English-language literature was conducted to identify any validated team climate, intrinsic motivation, and burnout measurement tools. The Team Climate Inventory Short Form and a single-item measure of burnout were chosen because of their validity, appropriateness to the study setting, and practicality. Daniel Pink's concept of motivation was operationalized into a novel, 13-question survey tool. The face validity of the motivation questions was assessed by various clinicians. The online survey was administered to a 38-member multidisciplinary team working at an urgent primary care center in Vancouver, Canada. Scores for team climate, motivation, and burnout were assessed, along with the tool's internal consistency.

RESULTS

The survey findings (33 responses) indicate a relatively high-performing multidisciplinary team, with high scores in all categories related to team climate and intrinsic motivation. Only 8% of 25 respondents met the threshold level of burnout, with no respondents indicating severe or complete burnout. Reliability analysis produced α coefficients of 0.956 and 0.945 for team climate and intrinsic motivation, respectively, indicating satisfactory reliability.

DISCUSSION

The burnout ratings align with the scores for team climate and intrinsic motivation. The study findings suggest that the clinic's current approach to leadership and management has been effective in promoting a healthy team and work environment. The small sample size does not permit statistical inferences without further testing and validation. Further exploration is warranted of various structural, organizational, system-level, and environmental factors that affect the survey's results.

CONCLUSION

The study fills a gap in the health services research literature pertaining to the performance of multidisciplinary teams.

Occupational Burnout Syndrome in Polish Physicians: A Systematic Review

Due to the nature of their work, physicians are exposed to chronic stress. This may potentially lead to the widespread occurrence of occupational burnout syndrome (BS). The aim of this systematic review study was to summarize available published data concerning the prevalence of BS in Polish doctors. The literature search was performed using the following databases: PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar. The last search was performed on September 27th, 2019. Only articles in English or Polish on graduated doctors practicing in Poland were taken into account. All types of original research were considered eligible. However, review articles, book chapters, case reports, case series, conference papers, study protocols and articles in languages other than English and Polish were excluded. There were no restrictions on age, seniority or specialty of study participants. The literature search revealed a total of 21 studies that met the inclusion criteria. The results of individual studies were very diverse, which makes it difficult to draw specific conclusions. However, the problem of burnout among Polish doctors is valid and worth special attention from society, health policy leaders, and doctors themselves. High-quality research is essential to for a better understanding of this topic.

Work strain and burnout risk in postgraduate trainees in general practice: an overview

Primary care physicians (general practitioners (GPs)) are burdened for various reasons and are particularly affected by stress-related complaints and an increasing prevalence of burnout. Thus, the prevention of physician burnout has become a major interest for health care services. Although many studies have addressed this issue in recent years, little seems to be known about the work strain and burnout rates in GP trainees. Therefore the objective of this article is to review the psychosocial burden and relevant prevention strategies for GPs with a special emphasis on GP trainees. Regardless of the specialty, burnout is more prevalent among medical trainees and so-called 'early career' physicians than among the age-matched population. Accordingly, burnout seems to be frequent among GP trainees, although there is some evidence that there are fewer doctors working in general medicine who were already heavily burdened at the time of choosing their career. The sudden assumption of responsibility in patient care as well as the fear of showing imperfection in front of their supervisors, or lack of recognition from senior doctors, the medical team, or patients might be stressors typical to this career stage. GP trainees might also feel burdened by the new level of personal involvement and thus have to develop or increase their individual level of professionality to deal with the patients' medical and personal problems. In conclusion, interventions to promote physical and mental health of GP trainees are a necessity to ensure passionate GPs in the future and should therefore be integrated into any postgraduate training curriculum in general practice.