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Ashouri M, Mansourian B, Safari R, Mohammadzadeh N, Tadbir Vajargah K, Karimi A. Burnout in Surgical Residents of an Academic Hospital in Iran: A Cross-Sectional Study. World J Surg 2023; 47:72-77. [PMID: 36253552 DOI: 10.1007/s00268-022-06787-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Academic burnout has adverse effects on residents' professional behavior as well as personal aspects of their lives and can ultimately affect their performance in the workplace. This study aimed to determine the prevalence of burnout among surgical residents in Imam Khomeini hospital and the relationship between factors such as sex, marital status, living place, specialized field, and anxiety with burnout. METHODS We conducted a cross-sectional study in 2021. A validated version of the Maslach burnout inventory for students (MBI-SS), the Beck Anxiety Inventory, and a questionnaire on contributing factors were used. Statistical analysis for the prevalence of burnout and comparison between scores of groups were performed. RESULTS Of 130 surgical residents who answered the survey, 26% met the criteria for burnout. There was a significantly higher prevalence of burnout among PGY1 residents. Of these residents, 85.4% and 62.3% had high scores on emotional exhaustion and cynicism, respectively. We observed an association between different surgical disciplines and anxiety with burnout. CONCLUSIONS The prevalence of burnout among surgical residents was notable and higher than expected. There was a reliable association between anxiety and burnout. A longitudinal study on a group of students with a consideration of associated factors is suggested.
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Affiliation(s)
- Mohammad Ashouri
- Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Narjes Mohammadzadeh
- Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Aysa Karimi
- Tehran University of Medical Science, Tehran, Iran
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2
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Seow HY, Wu MHL, Mohan M, Mamat NHB, Kutzsche HE, Pau A. The effect of transactional analysis training on emotional intelligence in health professions students. BMC MEDICAL EDUCATION 2022; 22:383. [PMID: 35590318 PMCID: PMC9121543 DOI: 10.1186/s12909-022-03455-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Emotional intelligence (EI) is considered to present a significant predictor of work performance whereas Transactional analysis (TA) is the relational perspective in communication in managing emotions. We evaluated the effect of psycho-educational training in EI and TA (TEITA) on EI among health professions undergraduates, with post-training, and at 1-month follow-up. METHODS A total of 34 participants participated in the study where 17 participants were in the TEITA group and another 17 were in the control group. A quasi-experimental non-randomised, controlled cohort study was conducted, in which participants in the TEITA group were introduced to EI and TA concepts on a weekly basis for four weeks, at 90 min each time, and provided with opportunities for experiential sharing of emotions and coping mechanisms experienced in the previous week. Both TEITA and control groups received weekly EI and TA reading materials. All completed the 16-item Wong and Law EI Scale at baseline and post-training. The training group also completed the questionnaire at a 1-month follow-up. Wilcoxon Signed Ranks and Mann Whitney tests were used to analyse within a group and between group changes in EI scores. RESULTS Baseline EI scores in the TEITA group were lower than the control group. On completion of TEITA, EI scores in the TEITA group increased, and differences were not detected between groups. Within the TEITA group, paired increases in all domains were statistically significant, whereas, in the control group, the paired increase was only detected in the domain addressing regulations of emotion (ROE). Pre to post-training increases in EI scores were statically significantly greater in TEITA compared to control groups. At the 1-month follow-up, EI scores were sustained. CONCLUSION The psycho-educational training based on EI and TA is effective in enhancing EI among health professions undergraduates. Future research should investigate the effect of such training on observable inter-personal and socio-economic behaviours.
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Affiliation(s)
- Hui Yean Seow
- Private Dental Practitioner, Kuala Lumpur, Malaysia
- School of Dentistry, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Mabel Huey Lu Wu
- Private Dental Practitioner, Kuala Lumpur, Malaysia
- School of Dentistry, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Mandakini Mohan
- School of Dentistry, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia.
| | | | - Hildegunn Ellinor Kutzsche
- IMU Clinical Skills and Simulation Centre, International Medical University, Kuala Lumpur, Malaysia
- Norwegian Women's Public Health Association, Oslo, Norway
| | - Allan Pau
- School of Dentistry, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
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Mijakoski D, Cheptea D, Marca SC, Shoman Y, Caglayan C, Bugge MD, Gnesi M, Godderis L, Kiran S, McElvenny DM, Mediouni Z, Mesot O, Minov J, Nena E, Otelea M, Pranjic N, Mehlum IS, van der Molen HF, Canu IG. Determinants of Burnout among Teachers: A Systematic Review of Longitudinal Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095776. [PMID: 35565168 PMCID: PMC9104901 DOI: 10.3390/ijerph19095776] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 12/03/2022]
Abstract
We aimed to review the determinants of burnout onset in teachers. The study was conducted according to the PROSPERO protocol CRD42018105901, with a focus on teachers. We performed a literature search from 1990 to 2021 in three databases: MEDLINE, PsycINFO, and Embase. We included longitudinal studies assessing burnout as a dependent variable, with a sample of at least 50 teachers. We summarized studies by the types of determinant and used the MEVORECH tool for a risk of bias assessment (RBA). The quantitative synthesis focused on emotional exhaustion. We standardized the reported regression coefficients and their standard errors and plotted them using R software to distinguish between detrimental and protective determinants. A qualitative analysis of the included studies (n = 33) identified 61 burnout determinants. The RBA showed that most studies had external and internal validity issues. Most studies implemented two waves (W) of data collection with 6–12 months between W1 and W2. Four types of determinants were summarized quantitatively, namely support, conflict, organizational context, and individual characteristics, based on six studies. This systematic review identified detrimental determinants of teacher exhaustion, including job satisfaction, work climate or pressure, teacher self-efficacy, neuroticism, perceived collective exhaustion, and classroom disruption. We recommend that authors consider using harmonized methods and protocols such as those developed in OMEGA-NET and other research consortia.
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Affiliation(s)
- Dragan Mijakoski
- Institute of Occupational Health of RNM, WHO Collaborating Center, 1000 Skopje, North Macedonia;
- Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, 1000 Skopje, North Macedonia
- Correspondence:
| | - Dumitru Cheptea
- Faculty of Medicine and Pharmacy, Nicolae Testemitanu State University of Medicine and Pharmacy, 2004 Chisinau, Moldova;
| | - Sandy Carla Marca
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland; (S.C.M.); (Y.S.); (Z.M.); (O.M.); (I.G.C.)
| | - Yara Shoman
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland; (S.C.M.); (Y.S.); (Z.M.); (O.M.); (I.G.C.)
| | - Cigdem Caglayan
- Department of Public Health, Faculty of Medicine, Kocaeli University, İzmit 41001, Turkey;
| | - Merete Drevvatne Bugge
- National Institute of Occupational Health (STAMI), 0363 Oslo, Norway; (M.D.B.); (I.S.M.)
| | - Marco Gnesi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Lode Godderis
- Department of Primary Care and Public Health, University of Leuven, 3000 Leuven, Belgium;
| | - Sibel Kiran
- Department of Occupational Health and Safety, Institute of Public Health, Hacettepe University, Ankara 06100, Turkey;
| | - Damien M. McElvenny
- Research Group, Institute of Occupational Medicine, Edinburgh EH14 4AP, UK;
- Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK
| | - Zakia Mediouni
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland; (S.C.M.); (Y.S.); (Z.M.); (O.M.); (I.G.C.)
| | - Olivia Mesot
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland; (S.C.M.); (Y.S.); (Z.M.); (O.M.); (I.G.C.)
| | - Jordan Minov
- Institute of Occupational Health of RNM, WHO Collaborating Center, 1000 Skopje, North Macedonia;
- Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, 1000 Skopje, North Macedonia
| | - Evangelia Nena
- Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Marina Otelea
- Clinical Department 5, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Nurka Pranjic
- Department of Occupational Medicine, School of Medicine, University of Tuzla, 75000 Tuzla, Bosnia and Herzegovina;
- Clinic of Occupational Pathology and Toxicology, University Institute of Primary Health, 75000 Tuzla, Bosnia and Herzegovina
| | - Ingrid Sivesind Mehlum
- National Institute of Occupational Health (STAMI), 0363 Oslo, Norway; (M.D.B.); (I.S.M.)
- Institute of Health and Society, University of Oslo, 0373 Oslo, Norway
| | - Henk F. van der Molen
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Netherlands Center for Occupational Diseases, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands;
- Amsterdam Public Health Research Institute, Societal Participation & Health, 1105 BP Amsterdam, The Netherlands
| | - Irina Guseva Canu
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland; (S.C.M.); (Y.S.); (Z.M.); (O.M.); (I.G.C.)
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Chen ZR, Zhang L, Chen YW, Xu MY, Jia H, Li MY, Lou YH, Lan L. Correlation analysis between physicians' evaluations of doctor-patient relationship and their preferences for shared decision-making in China. Front Psychiatry 2022; 13:946383. [PMID: 36276337 PMCID: PMC9579421 DOI: 10.3389/fpsyt.2022.946383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/05/2022] [Indexed: 11/28/2022] Open
Abstract
Shared decision-making (SDM) is a scientific and reasonable decision-making model. However, whether physicians choose SDM is usually influenced by many factors. It is not clear whether the strained doctor-patient relationship will affect physicians' willingness to choose SDM. Through a survey by questionnaire, 304 physicians' evaluations of doctor-patient relationship (DPR) were quantified by the difficult DPR questionnaire-8. Their preferences for SDM and the reasons were also evaluated. The correlation between physicians' evaluations of DPR and their preferences for SDM were analyzed. 84.5% physicians perceived DPR as poor or strained, 53.3% physicians preferred SDM, mainly because of the influences of medical ethics and social desirability bias. Their preferences for SDM were not significantly correlated with their evaluations of DPR (P > 0.05). Physicians with different evaluations of DPR (good, poor, and strained) all had similar preferences for SDM (42.6, 56.4, and 42.9%), with no significant difference (P > 0.05). There was no correlation between physicians' evaluations of DPR and their preferences for SDM. Physicians' evaluations of poor DPR did not affect their preferences for SDM. This may be influenced by the medical ethics and social desirability bias.
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Affiliation(s)
- Zhuo-Ran Chen
- Henan No.3 Provincial People's Hospital, Zhengzhou, China
| | - Li Zhang
- The Third People's Hospital of Zhengzhou, Zhengzhou, China
| | - Ya-Wei Chen
- GeneCast Biotechnology Co., Ltd., Beijing, China
| | | | - Hang Jia
- Nanyang City Center Hospital, Nanyang, China
| | | | - Yu-Han Lou
- Henan Provincial People's Hospital, Zhengzhou, China.,People's Hospital of Zhengzhou University, Zhengzhou, China.,People's Hospital of Henan University, Zhengzhou, China
| | - Ling Lan
- Henan Provincial People's Hospital, Zhengzhou, China.,People's Hospital of Zhengzhou University, Zhengzhou, China.,People's Hospital of Henan University, Zhengzhou, China
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Greiner B, Gandhi R, Abrol R, Patel M, Hartwell M. National disparities in colorectal cancer screening in patients with comorbid conditions: an analysis of the Behavioral Risk Factor Surveillance System. J Osteopath Med 2021; 121:657-662. [PMID: 33892528 DOI: 10.1515/jom-2021-0066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/29/2021] [Indexed: 01/05/2023]
Abstract
CONTEXT Each year, approximately 53,200 people die in the U.S. from colorectal cancer (CRC), indicating a need to increase screening efforts. Some studies have suggested mammography use is higher in patients with comorbid conditions, a reflection of increased follow up. Another study found that patients with obesity were less likely to be screened for CRC than nonobese patients. However, no study has assessed the impact of multiple comorbidities on CRC screening. OBJECTIVES To analyze CRC screening rates in patients with comorbidities compared with healthy patients, and to assess whether the number of comorbid diagnoses impacted screening rates. METHODS A cross sectional analysis of patients who received CRC screening was performed using the 2018 and 2019 Behavioral Risk Factor Surveillance System (BRFSS). Respondents were classified as having had CRC screening if they answered "yes" to either of the following: "Have you ever had a blood stool test?" or "Have you ever had a sigmoidoscopy/colonoscopy?" Respondents younger than age 50 were excluded. A weighted multivariate logistic regression model was constructed to determine adjusted risk ratios (ARR). Confidence intervals (CI) were reported at 95%. RESULTS We identified 279,784 respondents who met inclusion criteria. Of those, 79.7% (sample n=222,879; population N=46,304,360) of respondents had received CRC screening. Patients with diabetes, hypertension, skin cancer, chronic obstructive pulmonary disease (COPD), arthritis, depression, and chronic kidney disease were significantly more likely to be screened than those without comorbidities. There was no statistically significant difference in screening rates between patients with and without cardiovascular disease. Compared with patients with zero comorbidities, those with one were significantly more likely to receive screening (ARR, 1.11; CI, 1.09-1.12) as were those with two to four (ARR, 1.2; CI, 1.18-1.22). Patients with five or more comorbidities were significantly less likely to be screened than those with two to four (ARR, 1.12; CI, 1.1-1.14). CONCLUSIONS Patients with one or more comorbidities were more likely to be screened than those without comorbidities, but those with five or more conditions were less likely to be screened than patients with two to four conditions. This indicates that physicians may be more fatigued and less likely to recommend CRC screening to patients with many comorbidities compared with patients diagnosed with only a few conditions. The results of this study add to the literature by identifying an interaction between the number of comorbidities and likelihood of being screened for CRC.
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Affiliation(s)
- Benjamin Greiner
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Ronak Gandhi
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Robinder Abrol
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Milee Patel
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Micah Hartwell
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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6
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Chidiebere OI, Ikenna N, Ewenitie EU, Uchenna E, Isaac A, Ezinne N. Evaluation of physician burnout syndrome among pediatric resident doctors in Nigeria. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_134_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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7
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Massey A. How social problems became medical issues. Occup Med (Lond) 2020; 70:84-85. [DOI: 10.1093/occmed/kqz153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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May RW, Terman JM, Foster G, Seibert GS, Fincham FD. Burnout Stigma Inventory: Initial Development and Validation in Industry and Academia. Front Psychol 2020; 11:391. [PMID: 32226404 PMCID: PMC7080824 DOI: 10.3389/fpsyg.2020.00391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/20/2020] [Indexed: 11/13/2022] Open
Abstract
Although burnout is a risk factor for various negative mental and physical outcomes, its prevention is hampered by the stigma associated with burnout. The current research therefore reports on the initial development and validation of a novel measure of perceived burnout stigma. Study 1 (n = 318) describes the construction and initial evaluation of scale items derived from established mental health stigma and burnout scales. Study 2 (n = 705) then replicated the burnout stigma factor structure established in the initial study. Additionally, it evaluates relationships between occupational and school burnout stigma and indicators of mental health. Hierarchical multiple regressions showed that burnout stigma accounted for variance in depression, anxiety, and stress over and beyond that of burnout. Study 3 (n = 682) extended these findings via cross-lagged and bidirectional models, demonstrating that burnout stigma predicted mental health indicators 6 weeks later. Study 4 (n = 717) supplemented earlier exploratory and confirmatory factor analyses using item response theory to further demonstrate that perceived burnout stigma is a unidimensional construct potentially applicable to both work and school settings. Overall, the current research resulted in an eight-item burnout stigma instrument (BSI-8) with excellent psychometric properties that predicts indicators of mental health.
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Affiliation(s)
- Ross W May
- Family Institute, The Florida State University, Tallahassee, FL, United States
| | - Julia M Terman
- Department of Psychological Science, University of Vermont, Burlington, VT, United States
| | | | - Gregory S Seibert
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Frank D Fincham
- Family Institute, The Florida State University, Tallahassee, FL, United States
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Kansoun Z, Boyer L, Hodgkinson M, Villes V, Lançon C, Fond G. Burnout in French physicians: A systematic review and meta-analysis. J Affect Disord 2019; 246:132-147. [PMID: 30580199 DOI: 10.1016/j.jad.2018.12.056] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/06/2018] [Accepted: 12/16/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Burnout syndrome is the consequence of chronic work-related stress exposure and is 2-3 times higher than in physicians than in other professions. Many studies exploring burnout in French physicians have been published with inconsistent data regarding its prevalence and associated factors. OBJECTIVE To assess the prevalence of burnout and associated factors in French physicians in a systematic review and meta-analysis. MATERIAL AND METHODS Studies assessing the prevalence of French physician's burnout and its three dimensions emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA) were selected in the following databases from 2000 to April 2017: MEDLINE, BIOSIS WEB OF SCIENCE, PASCAL ET FRANCIS, SCIENCES DIRECT, PSYCHinfo, and BDSP. Burnout was defined by one abnormal score in one or more of the 3 dimensions of the MBI scale (EE, DP or PA). Severe burnout was defined by the association of high scores of EE and DP, and low score of PA. High EE was defined by an EE score ≥27. High DP was defined by a score ≥10. Low PA was defined by a score ≤33. RESULTS A total of 37 studies and 15,183 French physicians were included in the present meta-analysis. The random effects pooled prevalence estimate was 49% (95% CI 45%-53%, P < 0.001, I2 = 93.1%) for burnout, 5% (95% CI 4-7, P < 0.001, I2 = 92.7%) for severe burnout, 21% (95% CI 19-24, P < 0.001, I2 = 94.7%) for high EE, 29% (95% CI 25-33, P < 0.001, I2 = 96.7%) for high DP, and 29% (95% CI 24-34, P < 0.001, I2 = 97.7%) for low PA. Emergency physicians were found to have a trend to higher rates of burnout (P = 0.051), and significantly more severe burnout compared to other physicians (b = 0.05, se[b] = 0.02, P = 0.019). Junior residents were found to have higher rates of DP; junior residents, sample size, and monthly number of night shifts were associated with lower PA; and anesthesiologists were found to have lower rates of high EE and high DP. CONCLUSION Burnout is highly prevalent in French physicians. Some recommendations may be suggested to reduce this rate, including reducing the number or duration of night shifts to increase personal accomplishment and targeting emergency physicians and junior residents in priority. Other specialties should be explored in future studies.
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Affiliation(s)
- Ziad Kansoun
- Department of Psychiatry, Sainte-Marguerite University Hospital, Marseille, France.
| | - Laurent Boyer
- EA 3279-Public Health, Chronic Diseases and Quality of Life-Research Unit, Aix-Marseille University, 13005 Marseille, France
| | - Marianne Hodgkinson
- Department of Psychiatry, Centre Hospitalier Edouard Toulouse, Marseille, France
| | - Virginie Villes
- EA 3279-Public Health, Chronic Diseases and Quality of Life-Research Unit, Aix-Marseille University, 13005 Marseille, France
| | - Christophe Lançon
- Department of Psychiatry, Sainte-Marguerite University Hospital, Marseille, France; EA 3279-Public Health, Chronic Diseases and Quality of Life-Research Unit, Aix-Marseille University, 13005 Marseille, France
| | - Guillaume Fond
- Department of Psychiatry, Sainte-Marguerite University Hospital, Marseille, France; EA 3279-Public Health, Chronic Diseases and Quality of Life-Research Unit, Aix-Marseille University, 13005 Marseille, France
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Brooks E, Early SR, Gendel MH, Miller L, Gundersen DC. Helping the healer: population-informed workplace wellness recommendations for physician well-being. Occup Med (Lond) 2019; 68:279-281. [PMID: 29596682 DOI: 10.1093/occmed/kqy018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The need to keep physicians healthy and in practice is critical as demand for doctors grows faster than the supply. Workplace wellness programmes can improve employee health and retain skilled workers. Aims To broaden our understanding about ways to help doctors coping with mental health problems and to develop population-informed workplace wellness recommendations for physician populations. Methods Researchers surveyed physicians to document potential warning signs and prevention strategies. A survey was issued to doctors who presented to a physician health programme with mental health complaints. The survey captured respondents' feedback about how to identify and prevent mental health problems. Data were analyzed using simple descriptive statistics. Results There were 185 participants. Half of respondents believed their problems could have been recognized sooner and 60% said they exhibited signs that could aid in earlier detection. Potential warnings included fluctuations in mood (67%), increased comments about stress/burnout (49%) and behavioural changes (32%). To improve detection, prevention and care-seeking for mental health problems, doctors endorsed multiple items related to the use of interpersonal supports, personal factors and organizational dynamics throughout the survey. Conclusions The findings confirmed earlier work demonstrating the value of social and organizational support in maintaining physician health. It further indicated that earlier identification and/or prevention of mental health problems is not only possible, but that medical organizations are uniquely situated to carry out this work.
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Affiliation(s)
- E Brooks
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.,Colorado Physician Health Program, Denver, CO, USA
| | - S R Early
- Colorado Physician Health Program, Denver, CO, USA
| | - M H Gendel
- Colorado Physician Health Program, Denver, CO, USA
| | - L Miller
- University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
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Kalani SD, Azadfallah P, Oreyzi H, Adibi P. Interventions for Physician Burnout: A Systematic Review of Systematic Reviews. Int J Prev Med 2018; 9:81. [PMID: 30283613 PMCID: PMC6151971 DOI: 10.4103/ijpvm.ijpvm_255_18] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 08/13/2018] [Indexed: 01/08/2023] Open
Abstract
Occupational burnout is a common syndrome among physicians, and several individual-directed and organization-directed interventions have been implemented to reduce it. Until now, several review studies have tried to identify and introduce the most appropriate interventions. The aim of this article was to systematically review systematic review studies of interventions for physician burnout to evaluate and summarize their results, and ultimately guide researchers to select appropriate interventions. A search was conducted to find review studies and systematic reviews in Cochrane Database of Systematic Reviews, Medline, Google Scholar, PubMed, and PsycINFO. Two reviewers independently selected and evaluated the studies based on inclusion criteria. Four of seven obtained review studies and systematic reviews met the inclusion criteria. These studies have reviewed individual-directed and organization-directed interventions intended to reduce burnout among medical students, interns, physicians, residents, and fellows. Various studies of the effectiveness of individual- and organization-directed interventions have obtained different results. This research has shown that reaching conclusions about effective interventions (individual- or organization-directed) for physician burnout is not easy and that a number of mediating or moderating variables probably influence the effectiveness of these interventions. Therefore, it is necessary to understand approaches and interventions for the prevention or reduction of physician burnout to fill the gaps in research. In addition, review studies are required to be more precise in choosing their criteria to find more accurate results.
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Affiliation(s)
- Simin Dokht Kalani
- Department of Psychology, Faculty of Humanities Sciences, Tarbiat Modares University, Tehran, Iran
| | - Parviz Azadfallah
- Department of Psychology, Faculty of Humanities Sciences, Tarbiat Modares University, Tehran, Iran
| | - Hamidreza Oreyzi
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Peyman Adibi
- Department of Gastroenterology, School of Medicine, Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Ahmad W, Ashraf H, Talat A, Khan AA, Baig AA, Zia I, Sarfraz Z, Sajid H, Tahir M, Sadiq U, Imtiaz H. Association of burnout with doctor-patient relationship and common stressors among postgraduate trainees and house officers in Lahore-a cross-sectional study. PeerJ 2018; 6:e5519. [PMID: 30221087 PMCID: PMC6136394 DOI: 10.7717/peerj.5519] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 08/06/2018] [Indexed: 12/19/2022] Open
Abstract
Introduction Burnout is defined as a prolonged state of physical and psychological exhaustion. Doctors, due to the demanding nature of their job, are susceptible to facing burnout, which has far reaching implications on their productivity and motivation. It affects the quality of care they provide to patients, thus eroding the doctor-patient relationship which embodies patient centeredness and autonomy. The study aims at addressing the stressors leading to burnout and its effect on the doctor-patient relationship. Methods A descriptive, cross-sectional study design with convenience (non-probability) sampling technique was employed in six major hospitals of Lahore, Pakistan. A total of 600 doctors were approached for the study which included house officers or "HOs" (recent graduates doing their 1 year long internship) and post-graduate trainees or "PGRs" (residents for 4-5 years in their specialties). Burnout was measured using the Copenhagen Burnout Inventor (CBI) while attitudes towards the doctor-patient relationship was measured using the Patient Practitioner Orientation Scale (PPOS), which measures two components of the relationship: power sharing and patient caring. Pearson correlation and linear regression analysis were used to analyze the data via SPSS v.21. Results A total of 515 doctors consented to take part in the study (response rate 85.83%). The final sample consisted of 487 doctors. The burnout score was not associated with the total and caring domain scores of PPOS (P > 0.05). However, it was associated with the power sharing sub-scale of PPOS. Multiple linear regression analysis yielded a significant model, by virtue of which CBI scores were positively associated with factors such as female gender, feeling of burn out, scoring high on sharing domain of PPOS and a lack of personal control while CBI scores were negatively associated with private medical college education, having a significant other, accommodation away from home and a sense of never ending competition. Burnout levels varied significantly between house officers and post graduate trainees. Twenty-three percent of the participants (mostly house officers) had high/very high burnout levels on the CBI (Kristenson's burnout scoring). Both groups showed significant differences with respect to working hours, smoking status and income. Conclusion Although burnout showed no significant association with total and caring domain scores of PPOS (scale used to assess doctor-patient relationship), it showed a significant association with the power sharing domain of PPOS suggesting some impact on the overall delivery of patient care. Thus, it necessitates the monitoring of stressors in order to provide an atmosphere where patient autonomy can be practiced.
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Affiliation(s)
- Waqas Ahmad
- CMH Lahore Medical College, Lahore, Pakistan
| | - Huma Ashraf
- CMH Lahore Medical College, Lahore, Pakistan
| | - Afnan Talat
- CMH Lahore Medical College, Lahore, Pakistan
| | | | | | - Iqra Zia
- CMH Lahore Medical College, Lahore, Pakistan
| | | | - Hifsa Sajid
- CMH Lahore Medical College, Lahore, Pakistan
| | | | - Usman Sadiq
- CMH Lahore Medical College, Lahore, Pakistan
| | - Hira Imtiaz
- CMH Lahore Medical College, Lahore, Pakistan
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13
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Monsalve-Reyes CS, San Luis-Costas C, Gómez-Urquiza JL, Albendín-García L, Aguayo R, Cañadas-De la Fuente GA. Burnout syndrome and its prevalence in primary care nursing: a systematic review and meta-analysis. BMC FAMILY PRACTICE 2018; 19:59. [PMID: 29747579 PMCID: PMC5944132 DOI: 10.1186/s12875-018-0748-z] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 04/23/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND burnout syndrome is a significant problem in nursing professionals. Although, the unit where nurses work may influence burnout development. Nurses that work in primary care units may be at higher risk of burnout. The aim of the study was to estimate the prevalence of emotional exhaustion, depersonalization and low personal accomplishment in primary care nurses. METHODS We performed a meta-analysis. We searched Pubmed, CINAHL, Scopus, Scielo, Proquest, CUIDEN and LILACS databases up to September 2017 to identify cross-sectional studies assessing primary care nurses' burnout with the Maslach Burnout Inventory were included. The search was done in September 2017. RESULTS After the search process, n = 8 studies were included in the meta-analysis, representing a total sample of n = 1110 primary care nurses. High emotional exhaustion prevalence was 28% (95% Confidence Interval = 22-34%), high depersonalization was 15% (95% Confidence Interval = 9-23%) and 31% (95% Confidence Interval = 6-66%) for low personal accomplishment. CONCLUSIONS Problems such as emotional exhaustion and low personal accomplishment are very common among primary care nurses, while depersonalization is less prevalent. Primary care nurses are a burnout risk group.
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Affiliation(s)
- Carolina S. Monsalve-Reyes
- Departamento de Ciencias Sociales, Universidad Católica de La Santísima Concepción, Concepción, Chile
- Doctorado en Psicología de la Salud, Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | - Jose L. Gómez-Urquiza
- Nursing Department, University of Granada, Granada, Spain
- Faculty of Health Sciences, University of Granada, Cortadura del Valle Street S/N, 51001 Ceuta, Spain
| | | | - Raimundo Aguayo
- Psychology Department, University of Granada, Granada, Spain
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Lundin RM, Bashir K, Bullock A, Kostov CE, Mattick KL, Rees CE, Monrouxe LV. "I'd been like freaking out the whole night": exploring emotion regulation based on junior doctors' narratives. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2018; 23:7-28. [PMID: 28315113 PMCID: PMC5801373 DOI: 10.1007/s10459-017-9769-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 03/08/2017] [Indexed: 05/09/2023]
Abstract
The importance of emotions within medical practice is well documented. Research suggests that how clinicians deal with negative emotions can affect clinical decision-making, health service delivery, clinician well-being, attentiveness to patient care and patient satisfaction. Previous research has identified the transition from student to junior doctor (intern) as a particularly challenging time. While many studies have highlighted the presence of emotions during this transition, how junior doctors manage emotions has rarely been considered. We conducted a secondary analysis of narrative data in which 34 junior doctors, within a few months of transitioning into practice, talked about situations for which they felt prepared or unprepared for practice (preparedness narratives) through audio diaries and interviews. We examined these data deductively (using Gross' theory of emotion regulation: ER) and inductively to answer the following research questions: (RQ1) what ER strategies do junior doctors describe in their preparedness narratives? and (RQ2) at what point in the clinical situation are these strategies narrated? We identified 406 personal incident narratives: 243 (60%) contained negative emotion, with 86 (21%) also containing ER. Overall, we identified 137 ER strategies, occurring prior to (n = 29, 21%), during (n = 74, 54%) and after (n = 34, 25%) the situation. Although Gross' theory captured many of the ER strategies used by junior doctors, we identify further ways in which this model can be adapted to fully capture the range of ER strategies participants employed. Further, from our analysis, we believe that raising medical students' awareness of how they can handle stressful situations might help smooth the transition to becoming a doctor and be important for later practice.
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Affiliation(s)
| | - Kiran Bashir
- School of Medicine, Cardiff University, Wales, UK
| | - Alison Bullock
- School of Social Sciences, Cardiff University, Wales, UK
| | | | - Karen L Mattick
- Centre for Research in Professional Learning, Graduate School of Education, University of Exeter, England, UK
| | - Charlotte E Rees
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Lynn V Monrouxe
- Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Linkou, No.5, Fuxing St., Guishan District, Taoyuan City, 33305, Taiwan, ROC.
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Bruschini M, Carli A, Burla F. Burnout and work-related stress in Italian rehabilitation professionals: A comparison of physiotherapists, speech therapists and occupational therapists. Work 2018; 59:121-129. [DOI: 10.3233/wor-172657] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Marco Bruschini
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Antonella Carli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Franco Burla
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
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16
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How to prevent burnout in cardiologists? A review of the current evidence, gaps, and future directions. Trends Cardiovasc Med 2018; 28:1-7. [DOI: 10.1016/j.tcm.2017.06.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 06/23/2017] [Accepted: 06/30/2017] [Indexed: 11/21/2022]
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17
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Michel JB, Sangha DM, Erwin JP. Burnout Among Cardiologists. Am J Cardiol 2017; 119:938-940. [PMID: 28065490 DOI: 10.1016/j.amjcard.2016.11.052] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/15/2016] [Accepted: 11/15/2016] [Indexed: 11/28/2022]
Abstract
Burnout is a loss of enthusiasm for work, cynicism, and a low sense of accomplishment. Loss of autonomy and authority, complex regulatory requirements, report cards, quality metrics, the rise of large integrated health care systems, and the demise of solo practice are just a few realities of medical practice that contribute to physician burnout. Physicians suffering burnout often focus on compensation and perceived status as antidotes, although evidence suggests they play no role. Randomized controlled trials suggest that interventions designed to improve coping and resiliency including cognitive behavioral therapy and physical and mental relaxations to reduce stress can be effective. Reduced work hours have also been shown to mitigate burnout. Successful prevention and management requires adaptations by both physicians and the health care systems in which they work. We believe that burnout also involves a loss of faith in the practice of medicine itself. Advances in cardiovascular medicine have led to large reductions in mortality and morbidity. However, the disruptive changes to health care that accompanied this success have contributed to physician alienation. In conclusion, we believe that to overcome burnout, cardiologists should dedicate themselves to a collective mission of patient care and work to restore faith in their profession.
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Affiliation(s)
- Jeffrey B Michel
- Cardiology Division, Scott and White Memorial Hospital, Temple, Texas; Texas A&M University Health Science Center College of Medicine, Temple, Texas
| | - Denisse M Sangha
- Cardiology Division, Scott and White Memorial Hospital, Temple, Texas
| | - John P Erwin
- Cardiology Division, Scott and White Memorial Hospital, Temple, Texas; Texas A&M University Health Science Center College of Medicine, Temple, Texas; Department of Medicine, Scott and White Memorial Hospital, Temple, Texas
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Asencio-López L, Almaraz-Celis GD, Carrillo Maciel V, Huerta Valenzuela P, Silva Goytia L, Muñoz Torres M, Monroy Caballero F, Regalado Tapia J, Dipp Martin K, López Miranda D, Medina Lavenant C, Pizarro Rodríguez K, Santiago Martínez C, Saucedo Aparicio AG, Flores Lepe R. Burnout syndrome in first to sixth-year medical students at a private university in the north of Mexico: descriptive cross-sectional study. Medwave 2016; 16:e6432. [PMID: 27187775 DOI: 10.5867/medwave.2016.03.6432] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 04/12/2016] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Burnout syndrome is a three-dimensional clinical syndrome caused by stress at work. It is frequent in professions which require direct contact with people. In Mexico, the presence of Burnout Syndrome in doctors and medical students, is characterized as a threat to their health, quality of life and professional performance. OBJECTIVES To evaluate the prevalence of burnout syndrome in students of years 1 through 6 of medical school at a private university in northern Mexico. METHODS Cross-sectional study in the Escuela de Medicina Campus Laguna de la Universidad Autónoma de Durango. The one-dimensional scale of Burnout Student (EUBE) and the Maslach Burnout Inventory (MBI) were applied to the participants. SPSS 19 was used to analyze the data. RESULTS Of the 344 students, 255 participated; 153 from years 1 to 3 (group 1); and 72 from years 4 to 6 (group 2). We found that 94.1% of the students of group 1 had mild burnout syndrome, and 2.8% had moderate burnout syndrome. In Group 2, 27.8% had moderate burnout syndrome, and 8.3% had severe burnout syndrome. The prevalence of severe burnout syndrome was higher in group 2 than in group 1 (p=0.02). CONCLUSIONS Burnout syndrome affects medical students across all stages of their studies, and develops in a progressive way. In our study, external factors have no influence on the development of burnout syndrome.
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Affiliation(s)
- Laura Asencio-López
- Facultad de Medicina de la Universidad Autónoma de Durango, Campus Laguna, Durango, México. Address: Circuito Industrial Durango 5001, Carretera a Santa Rita, Gómez Palacio, Durango, México.
| | | | | | | | - Luis Silva Goytia
- Facultad de Medicina de la Universidad Autónoma de Durango, Campus Laguna, Durango, México
| | - Marcos Muñoz Torres
- Facultad de Medicina de la Universidad Autónoma de Durango, Campus Laguna, Durango, México
| | | | - Joel Regalado Tapia
- Facultad de Medicina de la Universidad Autónoma de Durango, Campus Laguna, Durango, México
| | - Kerigma Dipp Martin
- Facultad de Medicina de la Universidad Autónoma de Durango, Campus Laguna, Durango, México
| | - Dinorah López Miranda
- Facultad de Medicina de la Universidad Autónoma de Durango, Campus Laguna, Durango, México
| | - Clyvia Medina Lavenant
- Facultad de Medicina de la Universidad Autónoma de Durango, Campus Laguna, Durango, México
| | | | | | | | - Rodolfo Flores Lepe
- Facultad de Medicina de la Universidad Autónoma de Durango, Campus Laguna, Durango, México
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