Le burn-out des médecins généralistes : influence de l’iniquité perçue et de l’orientation communautaire

Abstract

Several studies suggest that general practitioners (GP) are among the professional groups particularly exposed to burnout. However, to date, only a few studies have investigated the causes of this psychological syndrome among GP. In the present study, we hypothesized that a perceived lack of reciprocity in relationships with patients impinges on GP's burnout. Indeed, some scholars have pointed out that establishing reciprocal relationships at work is essential for the individual's well being. According to equity theory, people pursue a balance between their investments in and the rewards gained from their work, such that their own investment/reward ratio is the same as that of similar others. Disturbance of this balance is expected to result in a variety of negative outcomes. Therefore, it was hypothesized that the lack of reciprocity in relationships with patients will be linked to burnout among GP. However, in situations of perceived inequity, the individual characteristic of communal orientation (i.e., a desire to give benefits in response to the perceived needs of others), has been found to buffer burnout. We therefore expected a moderating effect of communal orientation on burnout among GP who were high in communal orientation and who perceived their relationships with patients as inequitable. A sample of 259 GP (Response rate = 52%) completed a questionnaire designed to evaluate perceived inequity, communal orientation, and burnout. Perceived inequity was measured using Adam's formula. Communal orientation was measured using the French version of the scale elaborated by Clarks, Ouellette, Powell, & Milberg. Burnout was measured using the Maslach Burnout Inventory. Our results revealed a high prevalence of burnout in our sample. Furthermore, we observed that the majority of GP (52.4 %) felt underbenefited in their relationships with patients. And, as predicted, Analysis of Variance (ANOVA) confirmed that when they perceived their relationships with patients as inequitable, in particular when they experienced feeling of being underbenefited, general practitioners were more vulnerable to burnout. We also observed, as expected, a moderating effect of communal orientation on burnout in situations of perceived inequity. Therefore, this study confirmed that equity enhances our understanding of the influence of relationships with patients on the burnout of GP.