Abstract

ObjectiveTo determine the profile of Chinese medical professionals with burnout symptoms at the national level and identify the association between capability well-being and burnout.Design and SettingA cross-sectional study in a nonrandom national sample of medical staff from 6 provinces across western, central and eastern China.ParticipantsPhysicians, medical laboratory scientists, nurses, and general practitioners aged 18 years or above who submitted a completed online questionnaire from June 2019 to January 2020 successfully (N = 25,120).Main Outcome MeasuresThe prevalence of burnout symptoms was assessed by the 22-item Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which consists of three domains: emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). The overall high burnout was defined as EE score ≥27 or DP score ≥10. The capability well-being was measured by the Investigating Choice Experiments Capability Measure for Adults (ICECAP-A) and the overall ICECAP-A score was calculated using the UK value set, ranging from a score of 0–1. Multivariable logistic regression analysis was used to identify the association between well-being and the overall high burnout.ResultsAmong the 25,120 participants, 60.8% of the participants reported at least one symptom of burnout, whereas 11.2% reported all three symptoms of burnout. In the adjusted model, ICECAP-A score was independently associated with high burnout (AOR = 0.018, 95% CI = 0.015–0.022). Medical staff who were males, with shorter working years, working in tertiary hospitals, and those with the specialties of psychiatry, intensive care, emergency medicine, internal medicine, oncology, and pediatrics were at higher risk of reporting burnout symptoms.ConclusionThe burnout symptoms were relatively common among Chinese medical staff and they were found to be independently associated with capability well-being in health professionals. Interventions should be enhanced on vulnerable groups to reduce burnout and promote well-being in future studies.

Highlights

  • Physician burn-out is a global crisis [1], but Chinese doctors may have suffered more

  • This is a cross-sectional study at the national level performed by the Peking Union Medical College Hospital (PUMCH) and the Chinese University of Hong Kong (CUHK) from June 2019 to January 2020

  • Among the 25,120 participants, 35.5% of them experienced high emotional exhaustion (EE), 30.0% experienced high DP, and 38.4% had a low sense of personal achievement (PA)

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Summary

Introduction

Physician burn-out is a global crisis [1], but Chinese doctors may have suffered more. The ratio of doctors to the general population in China is 1:735, which is substantially lower than that in Western countries (where the ratio ranges from 1:280 to 1:640) [2]. The number of medical staff injured during medical disputes rose from 2,604 in 2002 to 5,519 in 2006 and to 17,000 in 2010 [4, 5]. According to the 2016 and 2017 surveys by the Chinese Medical Doctor Association (2018), more than 60% of medical workers surveyed experienced doctor–patient conflicts [6]. It is not surprising that Chinese medical staff has suffered from a large variety of physical and mental health problems, including burnout [8]

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