Gender differences in burnout among Dutch dentists

OBJECTIVES: Differences between the sexes in the manifestation of burnout have been reported for different occupational groups. Although some gender-specific explanations for this finding have been forwarded, there is a paucity of studies in which the relation with other work-related gender differences is examined. The objective of this study was to analyze gender differences in burnout among dentists and to identify possible concomitant factors. METHODS: Male (n = 411) and female (n = 81) Dutch dentists filled out the Dutch version of the Maslach Burnout Inventory (MBI) together with several health and work-related questionnaires. RESULTS: Results showed male dentists to report a higher score on the depersonalization dimension of the MBI than did female dentists. No gender differences were found on the other dimensions (i.e. emotional exhaustion and personal accomplishment). Moreover, no gender-related differences in experienced work-stress or health-related aspects were found. It was found, however, that male dentists put in working hours and see more patients per week when compared to female dentists. Also, a difference in mean age was found. Our main finding was that the difference in depersonalization disappears when controlling for working hours and age. CONCLUSIONS: Gender differences in burnout among dentists do exist. However, our results indicate that underlying factors, such as working hours, have a profound effect on these differences. These results can have direct practical consequences, for instance, in distinguishing between groups concerning the way burnout scores should be interpreted.     

Burnout and health among Dutch dentists

In this study, it was hypothesised that dentists with a high burnout risk would experience more health complaints and show more unhealthy behaviour when compared with dentists with a low burnout risk. With a response rate of 75%, a representative group of 709 actively practising dentists responded to a questionnaire containing the Dutch version of the Maslach Burnout Inventory (MBI-NL), a health complaints measure (VOEG), and items on health behaviour. Results showed that dentists with a high burnout risk reported health complaints to a greater extent than dentists with a low burnout risk. They also reported more unhealthy behaviour in some aspects (physical exercise/sporting, increase in alcohol consumption, unhealthy diet), but not in others. It also appeared that one out of ten dentists reported having poor general health, and that three out of ten reported to have poor physical condition. In general, dentists' self-reports appeared favourable in comparison with the Dutch population. It is concluded from this study that among dentists burnout and poor health are strongly related. It is discussed that in order to deal preventively with burnout in dentistry, attention to physical health, including ergonomics, is essential.     

Using the Maslach Burnout Inventory among dentists: burnout measurement and trends

Abstract – Objectives: To extend our knowledge about the applicability of the Maslach Burnout Inventory (MBI) among dentists and to investigate trends in burnout risk among dental professionals. Methods: The structure of the MBI is examined among two independent, representative samples of dentists (n = 493 and 497, respectively). Moreover, results are compared to those of other independently‐practicing health professionals (i.e., general practitioners and physiotherapists). In addition, the percentage of dentists that are at risk for burnout are compared in samples from 1997, 2000, and 2001. Results: Correlations between the Emotional Exhaustion and Depersonalization subscales among dentists were higher than those found elsewhere. Additionally, a considerable increase in burnout risk was found since 1997. Conclusions: It was confirmed that the MBI can be considered a suitable instrument for use among dentists. It is argued that certain specific aspects of entrepreneur‐like occupations are reflected in deviating responses to the MBI. Given the clear increase in burnout risk found, this topic should remain under investigation among dentists.     

Professional burnout among Dutch dentists

Professional burnout, a long-term consequence of occupational stress, is considered to be a factor that explains a substantial proportion of incapacity for work. Burnout is defined as emotional exhaustion, depersonalization, and diminished personal accomplishment. AIMS: To investigate levels of burnout among Dutch practising dentists, to compare dentists' scores with norm scores, and to determine the percentage of dentists "at risk". METHODS: The instrument used was the Dutch version of the Maslach Burnout Inventory (MBI-NL), a 20-item modified version of the original MBI. A highly representative group of Dutch dentists participated (n = 709, 75% response rate). RESULTS: Mean levels (and standard deviations) of burnout were: emotional exhaustion 13.7 (8.6); depersonalization 5.9 (3.9); personal accomplishment 30.8 (5.9). Dentists had more favourable means compared with standard scores, although in the 95th percentile dentists showed more emotional exhaustion than standards indicate. While no overall sex differences were found, male middle-aged dentists tended to show more burnout. Of the working Dutch dentists, 21% had a certain risk, 13% had high overall levels of burnout, and 2.5% were highly burned out. CONCLUSION: It is concluded that Dutch dentists have relatively favourable mean levels of burnout, but those who are exhausted are extremely exhausted. The male dentist in his forties appears to be most vulnerable to burnout.     

Burnout development among dentists: a longitudinal study

Knowledge on the development of burnout among dentists is important for purposes of prevention and intervention. Using a two‐wave longitudinal design, this study examined the chronological sequence of the three dimensions of the Maslach Burnout Inventory: emotional exhaustion; depersonalization; and personal accomplishment. Structural Equation Modelling was employed among a representative sample of Dutch dentists to examine the fit of several models proposed in earlier research. The results indicated that a model in which emotional exhaustion precedes depersonalization, which in turn precedes personal accomplishment, shows an adequate fit among dentists. However, an alternative model, in which personal accomplishment precedes emotional exhaustion, had an even better fit. In addition to the test of these a priori models, an ad hoc model was constructed that best fitted the current data. This model indicated emotional exhaustion to precede the development of depersonalization and personal accomplishment independently. Although not univocal, the results showed that emotional exhaustion should not be discarded as an early sign of burnout. This is in line with the view that emotional exhaustion can be considered as the key dimension of burnout.     

Burnout and its causes in Finnish dentists

In the spring of 1986 burnout and its relation to social and physical environments and the nature of work were studied using a questionnaire sent to a sample of 232 dentists aged under 62 living in the province of Uusimaa, Finland. Most male and female dentists (71 and 67%, respectively) were working in group practices and most (88%) employed an assistant. Professional problems were generally (71%) solved by consulting colleagues. Half of those responding were very satisfied with their relationship to other dental staff. All but 9% of dentists experienced problems in their physical working environments and 22% felt that their uncomfortable working posture interfered significantly with job satisfaction. Women reported chronic work-related conditions diagnosed by a physician more often than men (21 vs. 10%, respectively). At the time of the study, most dentists were experiencing pain in connection with work on patients and 41% of women and 59% of men were experiencing occupational stress. Most dentists experienced at least temporary psychological fatigue as a result of their work and almost half were exhausted at the end of each day. Despite this, most enjoyed working with patients and were enthusiastic about their work. Three aspects of burnout emerged on factor analysis: psychological fatigue, loss of enjoyment of work, and hardening. One third of dentists experienced some hardening and ceased to care greatly what happened to some of their patients. Of the factors associated with working environments, only dissatisfaction with relationships with patients, problems relating to the physical environment and poor working posture significantly increased burnout.(ABSTRACT TRUNCATED AT 250 WORDS)     

Burnout and professional quality of life among Israeli dentists: the role of sensory processing sensitivity

Aim: Dentistry is a stressful and exhausting profession with high levels of burnout. Sensory processing sensitivity (SPS) is a basic personality trait characterised by a gradient of sensitivity to both internal and external stimuli, including social and emotional cues. In this study, the influence of SPS on burnout and professional quality of life among Israeli dentists was analysed. Methods: Two-hundred and forty-three Israeli dentists responded to questionnaires that collected information on their SPS and professional quality of life (burnout, satisfaction at work and level of secondary traumatic stress), as well demographic variables, professional specialisation and workload. Results: Linear regression analyses showed that burnout can be predicted by the three aspects of SPS (ease of excitation, low sensory threshold and aesthetic sensitivity; 32% of the variance). Additionally, the same three aspects of SPS also predicted dentists’ satisfaction at work (24% of the variance). Ease of excitation and low sensory threshold, but not aesthetic sensitivity, predicted dentists’ reaction to their patients’ stress and trauma (23% of the variance). Conclusions: Sensory processing sensitivity can serve as a tool to identify dentists who are prone to develop burnout and whose professional quality of life can be adversely affected by their profession.Key words: Dentistry, sensory processing sensitivity, burnout, secondary traumatic stress, professional quality of life, compassion satisfaction     

Professional burnout and work engagement among dentists

A recent development within burnout research is the shift to its conceptual opposite: work engagement. This study aimed to unravel the concepts of burnout and work engagement, and to determine their levels among dentists. A representative sample of 497 Dutch general dental practitioners was included (survey response rate of 59%), consisting of 372 men and 121 women (the gender of 4 dentists remained unknown). The hypothesized three-factor structure of work engagement (vigor, dedication, and absorption), as measured by the Utrecht Work Engagement Scale (UWES), was substantiated among dentists. It was also found that work engagement was related negatively to burnout, as measured by the Maslach Burnout Inventory (MBI). However, a model consisting of a reduced ('core') burnout factor and an 'enhanced' engagement factor (composed of the three original factors plus the burnout factor, personal accomplishment) showed the best fit. Overall burnout levels among dentists are low, and the levels of engagement indicate that dentists have a positive working attitude.     

Training for dentists in smoking cessation intervention

BACKGROUND: Although dentists are ideally placed to deliver smoking cessation advice and assistance to their patients, smoking cessation interventions are not often incorporated as a routine part of dental care. Research is needed to identify factors that facilitate and inhibit dentists' capacities to deliver smoking cessation advice. METHODS: An initial focus group discussion was conducted in Melbourne with 10 dentists. Six Victorian country dentists were interviewed in depth by telephone. Following this qualitative data collection, a random sample of 250 dentists (response rate of 57 per cent) was interviewed by telephone. Dentists were asked about their perceived role, current practices, knowledge of resources and services and opinions on training in relation to smoking cessation. RESULTS: Dentists are willing to ask and advise patients about smoking, but are less inclined to assist patients to quit or arrange follow-up. Dentists are more likely to implement one-off, opportunistic interventions rather than take a systematic preventive approach. Dentists are interested in attending further education and say they require training to be relevant to the context of their day-to-day running of the dental practice. CONCLUSIONS: Training should aim to legitimize the dentist's role in smoking cessation and provide strategies and resources so that dentists can practise interventions as part of their day-to-day work.     

Outcome of career expectancies and early professional burnout among newly qualified dentists

OBJECTIVES: To measure burnout development, outcome of expectations with regard to dental career and feelings of being unprepared for practice among newly graduated general dental practitioners. METHODS: In 1997, 50 dentists were approached to fill in the Maslach Burnout Inventory, Dutch version (UBOS) and some additional variables between six months and one year after graduation at the Academic Centre for Dentistry Amsterdam (ACTA) (76% response). Six years later, in 2003, the same 50 dentists, plus another 60 who had graduated in the same period at ACTA, were approached (78% response). RESULTS: Using Repeated Measures analysis, mean scores of dentists for whom two measurements were available on the three UBOS subscales (N=24) showed no statistically significant changes over six years on Emotional Exhaustion, Depersonalisation, or Personal Accomplishment. The same was true for group means of all in 1997 (N=33) compared with all in 2003 (N=82). However, according to manual criteria, varying percentages (7.2% - 24.4%) of dentists showed an unfavourable level on either one of the UBOS dimensions. Factors most frequently mentioned to be responsible for being unprepared for practice were: law and insurance matters (61.2%), practice organisation (56.6%) and staff management (55.2%). Most frequently reported factors that came out (much) worse than expected were: stressfulness of work (45.1%), and staff management (43.4%). CONCLUSIONS: Burnout appears no threat for the average newly qualified dentist. However, some individuals report alarmingly high burnout scores at an early professional stage. Practice management is the professional aspect about which young professionals worry most. It is recommended that dental schools pay attention to practice management skills and the stressfulness of work in the curriculum. Also, longitudinal monitoring of dental students and newly qualified dentists on burnout development is strongly advocated.     

Treatment of obstructive sleep apnoea patients in community dental care: knowledge and attitudes among general dental practitioners and specialist dentists

Obstructive sleep apnoea (OSA) is an increasing problem worldwide. Yet, a large number of patients may remain undiagnosed. Dentists could suspect OSA, but little is known about their knowledge and attitudes towards the topic. An email questionnaire was sent to dentists working in Helsinki Health Centre, Helsinki, Finland (n = 226). It consisted of demographic data, items on dentists' overall knowledge of OSA and factors associated with it, and their possibilities and willingness to take part in the recognition and treatment of OSA patients. Altogether, 70·9% (n = 134) of dentists eligible for the study completed the questionnaire. Of them, 79·1% (n = 106) were general practitioners and 20·9% (n = 28) dentists with specialty training. Continuous positive airway pressure (CPAP) (99·3%) and weight control (99·3%) were both generally acknowledged as effective methods to treat OSA. Regarding the efficacy of other treatment modalities, significant differences were found between general practitioners' and specialists' opinions. For example, mandibular advancement devices (MAD) were less often reported by general practitioners (69·8%) than specialists (89·3%) (P < 0·05). The possible risk factors, signs and symptoms, and consequences of OSA were overall well recognised regardless the years in dental profession, but specialists saw more often that nocturnal sweating (P < 0·01) and snoring (P < 0·05) may signify OSA. Dentists could play an important role in suspecting OSA, but they may need more education to cope with that.