Doctor Burnout Research Articles

Research on risk factors for doctor burnout during COVID-19 epidemic

Burnout, recognized as a syndrome linked to chronic workplace stress by the World Health Organization (WHO), is a prevalent issue across various professions, irrespective of title or rank. Identifying exhaustion indicators and implementing preventive or corrective measures are vital to mitigate long-term adverse impacts on quality of life. Utilizing the "Maslach Burnout Inventory Human Services Survey (MBI-HSS)" through online analysis, this study aimed to establish the frequency of Burnout Syndrome (BOS) within the target population. The risk of BOS development doubled when participants financed their endeavors and faced abuse from patients' family members, while decreasing with participants' average age. Female gender correlated with higher emotional fatigue, and male gender predicted depersonalization (DP). Infection with or death from COVID-19 among coworkers or family members associated with elevated Employee Engagement (EE) and diminished Personal Accomplishment (PA). The COVID-19 epidemic introduced additional elements contributing to BOS, prompting measures such as providing psychological support, organizing working hours, adjusting pay, supplying personal protective equipment, and offering instruction on safety measures.

Message applications in the doctor-patient relationship as a stressor.

SUMMARYOBJECTIVE:The aim of this study was to assess the use of smartphones’ messaging apps as a stressor affecting the well-being of gynecologists who use this tool to communicate with patients.METHODS:A cross-sectional study was conducted with gynecologists who use message applications to communicate with patients. Participants answered the WhatsApp Stress Scale, Oldenburg Burnout Inventory, and the techno-stress questionnaire. The population sample consisted of gynecologists and obstetricians selected by convenience.RESULTS:Physicians who spent more time using WhatsApp to communicate with patients had higher levels of stress (p=0.010), Burnout (p<0.001), and techno-invasion score (p<0.05).CONCLUSIONS:A positive association was found between the high frequency of WhatsApp usage for communication with patients and doctor's Burnout and stress, negatively influencing professional's well-being.

969 A Quality Improvement Project Centred Around the Introduction of an Exception Reporting Pathway

Abstract Aim Exception Reporting (ER) is applicable to surgical training so can therefore be used for a variety of reasons. This Quality Improvement Project aims to positively change the attitudes and ease the process of ER. Method We conducted a qualitative survey distributed amongst medical and surgical trainees and supervisors from the Royal Liverpool and Aintree Hospitals which focused on assessing their attitudes towards ER. The second measure was a retrospective review in which we compared the number of ER from September-December in 2019 and 2020. We created a poster showing a clear pathway to ER and the repeated the cycle above including both measures. Results We received over a hundred responses to our original survey, with half being trainees and the other being supervisors. It was clear that, huge deficits were discernible in trainee and supervisor understanding of the process and its outcomes. After introducing the ER pathway, a significant improvement in understanding towards ER was noted with 98.4% (from 84.5%) of trainees and supervisors understanding what ER is and 52.8% (from 42.7%) better understanding outcomes. Despite this, there seems to be a shift in attitude toward ER with a 10.7% increase in exception reporting within a 10-month period. Conclusions Our project highlights the importance of exception reporting, and its perception between clinical staff. With the presence of COVID rotas, the introduction of new trainees to the trust, and the higher emphasis on doctor burnout and patient safety in the news, ER measures remain our closest tool to observing such dynamic attitudes and acting on them.

TP8.2.30 Bleep paralysis: preventing inefficiency on the general surgical on-call

Abstract Aims The demand on surgical services is increasing. In our Trust, all surgical referrals and queries are directed through the Senior House Officer (SHO) on-call. This leads to inefficiency, with many hours spent on the telephone and away from clinical duties. Such constant intensity can cause increased stress and anxiety amongst those involved. Junior doctor burnout and stress-related sickness are increasing concerns amongst the current surgical workforce. In an attempt to alleviate these factors, we instigated an intervention to evenly distribute workload during surgical on-calls. Method The number of bleeps through the surgical SHO on-call were audited for four consecutive thirteen hour shifts. Each call was estimated to take an average of five minutes to resolve. A separate GP referral phone was introduced to reduce the volume of traffic through the SHO bleep. The number of calls through the SHO and referral phone were re-audited following this intervention. Results Before introduction of a referral phone, the mean length of time spent by the SHO per shift answering calls was 232.5 minutes, with a maximum of 330 minutes. Post intervention, the SHO spent an average of 92.5 minutes per shift answering calls and referrals through the GP phone averaged 43.75 minutes. Conclusion The introduction of a single point GP referral system has significantly reduced the volume of calls through the SHO, thus has also minimised time spent away from on-call duties. Not only does this improve efficiency within the on-call team, but also reduces risk of burnout amongst trainees.

Modification of Calgary Cambridge for Indonesian medical students: Communication guidelines

Effective communication skill applied by doctors in the doctor-patient consultation process becomes one of important factors that can improve the consultation outcomes such as patient satisfaction, adherence to treatment and recovery process. However, effective doctor-patient communication is rarely applied in practice. Limited consultation time, patient overload, doctor burnout, and poor communication skills are among the factors that cause ineffective doctor-patient communication process. This study aimed to develop a new effective communication guideline for doctor-patient communication in Indonesia by modifying the Calgary Cambridge medical interview guide. This study uses qualitative approach within four stages: expert panel, student panel and focus group discussion, expert review, and trials. Informants were chosen purposively. Three points of high category, 24 points of middle category and 44 points of low category are resulted from expert panel stage which consists of specialist representatives from 12 clinical divisions in Dr. Moehammad Hoesin central public hospital (RSMH), Palembang, South Sumatera, Indonesia. The high and middle category were discussed by two groups of internships doctors in RSMH in student panel and focus group discussion (FGD) session. The results were validated by a doctor-patient communication expert (expert reviewer) and then tested by the internship doctors through role play at the trial stage. The final result yields eight main points and eleven effective tips of the Calgary Cambridge Guide checklist modification with five to six minutes effective consultation time. This modified guideline is appropriately applicable for doctor-patient communication in daily consultation in Indonesian practical, social and cultural context.

The relationship between psychological resilience and burnout in Irish doctors.

There has been a considerable amount of research focused upon assessing doctor burnout. However, psychological resilience (PR) has been examined far less frequently. To examine the relationship between PR and burnout in Irish doctors in order to identify how PR can be improved-with a particular focus on how doctors can be empowered to strengthen their PR. The ResMed PR survey and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) were distributed to doctors from an Irish teaching hospital. A total of 322 completed online and paper surveys were received. Response rate for the paper surveys was 42.0% (168/400). Depersonalisation and personal accomplishment were significant predicators of job gratification (taking satisfaction from the job of a physician). Emotional exhaustion and personal accomplishment were significant predicators of protective attitudes (attitudes that promote or sustain PR; e.g. not taking things personally). Being a man was more positively related to protective attitudes than being a woman. Emotional exhaustion and personal accomplishment were significant predicators of protective practices (approaches to building/maintaining resilience; e.g. good time management). The research reported in this paper provides insights in to how healthcare leaders could empower frontline doctors to change how they work in order to allow them to improve their psychological resilience and help them to thrive, rather than just survive.

Electronic health records: a critical appraisal of strengths and limitations.

Electronic health record (EHR) was hailed as a major step towards making healthcare more transparent and accountable. All the developed nations digitised their health records which were meant to be safe, secure and could be accessed on demand. This was intended to benefit all stakeholders. However, the jury is still out if the EHR has been worth it. There have been incidences of data breaches despite cybersecurity checks and of manipulation compromising clinicians' integrity and patients' safety. EHRs have also been blamed for doctor burnout in overloading them with a largely avoidable administrative burden. The lack of interoperability amongst various EHR software systems is creating obstacles in seamless workflow. Artificial intelligence is now being used to overcome deficiencies of the EHR. Emerging data from real-world usage of EHR is providing useful inputs which would be helpful in making it a better system. This review critically appraises the current status and issues with the EHR and provides an overview of the key innovations which are being implemented to make the system more efficient for health care providers leading to a reduction in their administrative burden.

Burnout Among Doctors in China Through 2018: A Systematic Review and Meta-Analysis

Background: Burnout negatively impacts doctors' mental and physical health, and even leads to poor patient care. In China, the situation is severe and the epidemiological characteristics of physician burnout need to be revealed for developing improved methods to alleviate it. Methods: We comprehensively searched the China National Knowledge Infrastructure, WANFANG, PubMed, EMBASE, PsycINFO and Cochrane Library databases from their inception to December 2018. Observational studies describing the prevalence of burnout among Chinese doctors were eligible for inclusion. The potential bias and methodological quality of the included studies were assessed using a risk of bias tool and the Cochrane guidelines for observational studies. Findings: The final analysis included 69,722 Chinese doctors from 95 studies. The total prevalence of burnout among Chinese doctors was 80.63% (95% CI, 74.70-85.93; I2 =99.57%), increasing from 2004 to 2018. The total prevalence of high burnout was 8.74% (95% CI, 6.15-11.73; I2 =98.14%). The prevalence of moderate to high levels of burnout was higher in eastern China (49.19%) than in western (43.60%), and both regions had a higher prevalence than central China (14.21%). The prevalence of high levels of burnout gradually increased with the hospital grade from community hospitals (4.93%) to secondary hospitals (14.13%) and finally tertiary hospitals (16.88%). Men had a higher DP score than women, and married doctors had a higher PA score than single doctors. Doctors with junior professional positions scored higher than those with intermediate professional positions on the EE dimension, but the opposite occurred on the DP dimension. Interpretation: The total prevalence of doctor burnout in China is very high and varies by location. Gender, marital status and professional title all affect burnout scores. Funding Statement: This study is supported by the Beijing Science and Technology Planning Project (project number Z171100001017227). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: PROSPERO registration number is CRD42018104249.

Burnout among doctors in China through 2018

Background:Burnout negatively impacts the mental and physical health doctors. More seriously, it leads to poor patient care. In China, the situation is severe and more efforts are needed to reveal the epidemiological characteristics of doctor burnout to develop improved strategies of alleviating it. Due to the large number of heterogeneous and sample size-restricted surveys currently published, meta-analysis and systematic reviews are critical to a thorough understanding of burnout among Chinese doctors.Methods:The Cochrane Collaboration criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) will be followed to conduct and report the systematic review. We will conduct a comprehensive search on the data bases of China National Knowledge Infrastructure (CNKI), WanFang, PubMed, EMBASE, PsycINFO, and the Cochrane Library from their inception to December 2018. Prospective cohort and cross-sectional studies that described the prevalence of Chinese doctors’ prevalence will be eligible for inclusion. The risk of bias and methodological quality of the included studies will be assessed using a risk of bias tool and the Cochrane guidelines for observational studies. A generalized linear mixed model framework with the Poisson likelihood and the log link function will be used to access the incidence rate ratio. Multivariate Poisson regression framework will be conducted to adjust modeling heterogeneity and confounders, like difference regions and time periods. The risk of bias, heterogeneity, and quality of evidence will be assessed in accordance with the aforementioned guidelines.Results:The primary outcome will be the prevalence and distribution of 3 dimension of burnout in Chinese doctors, and the second will be the difference of prevalence between difference regions and time periods.Discussion:This systematic review and meta-analysis will help us to reveal the prevalence, characteristics, timeline, and correlation between these factors in burnout; we expect our work may provide a scientific basis for further prevention and intervention of burnout in Chinese doctors, eventually to improve the quality of health care.PROSPERO registration number:CRD42018104249.

Work-family conflict and job burn-out among Chinese doctors: the mediating role of coping styles

Background Burn-out among doctors threatens their own health, and that of their patients. To identify risk factors of the doctor burn-out is vital to improving their health and increasing the...

Junior doctors, burnout and wellbeing: Understanding the experience of burnout in general practice registrars and hospital equivalents.

Australian junior doctors are stressed and report high rates of burnout. The aim of this study was to understand the experience of burnout in general practice registrars and hospital equivalents. Qualitative, semi-structured interviews were completed until saturation and thematically analysed. Stress was common among the interviewees, and the causes of stress were multifactorial. The junior doctors were aware of burnout prevention strategies but were not always effectively undertaking them. They were more likely to be feeling stressed when their expectations regarding workplace support were not met and when they believed they were practising beyond the level of their own abilities. On the basis of our findings, we propose a multifactorial model of junior doctor burnout. This model warrants further investigation to inform policies to reduce burnout in junior doctors and ensure a research-based solution is found to the progressive concerns regarding junior doctor burnout andsuicides.

Associations between emotional intelligence and doctor burnout, job satisfaction and patient satisfaction

The occupational health literature has long been dominated by stress-related topics. A more contemporary perspective suggests using a positive approach in the form of a health model focused on what is right with people, such as feelings of well-being and satisfaction. Using a positive perspective and multi-source data collection, this study investigated the inter-relationships among emotional intelligence (EI), patient satisfaction, doctor burnout and job satisfaction. In this observational study, 110 internists and 2872 out-patients were surveyed in face-to-face interviews. Higher self-rated EI was significantly associated with less burnout (p<0.001) and higher job satisfaction (p<0.001). Higher patient satisfaction was correlated with less burnout (p<0.01). Less burnout was found to be associated with higher job satisfaction (p<0.001). This study identified EI as a factor in understanding doctors' work-related issues. Given the multi-dimensional nature of EI, refinement of the definition of EI and the construct validity of EI as rated by others require further examination.

Relationship of doctor's occupational burnout with organizational factors

ObjectiveTo explore the relationship of organizational factors with occupational burnout among doctors. Method740 doctors were assessed by CMBI, Job Demands and Decision Latitude scale, Distributive and Procedural Justice scale, Cross-Culture Role Conflict, Ambiguity, and Overload scale, Work Interference With Family and Family Interference With Work scale, Social Support scale. ResultsHierarchical multiple regression indicated that 27.8% variance of doctors' Emotional Exhaustion(EE), 36.8% variance of Depersonalization(Dp), 21.0% variance of Reduced Personal Accomplishment(RPA) were explained by Organizational factors. Work Interference with family, role conflict, work-family conflict, distributive justice and workload can significantly predict EE(Standardized β was 0.204, 0.102, 0.249,-0.109,0.093); Family interference with work, role ambiguity, family support, procedural justice and workload can significantly predict Dp(Standardized β was 0.506,0.192,-0.122,0.105,-0.068); Role ambiguity, family support, job control, work Interference with family and superior support can significantly predict RPA(Standardized β was 0.245,-0.179,-0.172,-0.106,-0.069). ConclusionOrganizational factors have significantly effect on doctor's burnout, especially work-family conflict and role character. Key words: Occupational burnout; Doctor; Organizational factors