Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017

ObjectiveTo evaluate the prevalence of burnout and satisfaction with work-life integration among physicians and other US workers in 2017 compared with 2011 and 2014.Participants and MethodsBetween October 12, 2017, and March 15, 2018, we surveyed US physicians and a probability-based sample of the US working population using methods similar to our 2011 and 2014 studies. A secondary survey with intensive follow-up was conducted in a sample of nonresponders to evaluate response bias. Burnout and work-life integration were measured using standard tools.ResultsOf 30,456 physicians who received an invitation to participate, 5197 (17.1%) completed surveys. Among the 476 physicians in the secondary survey of nonresponders, 248 (52.1%) responded. A comparison of responders in the 2 surveys revealed no significant differences in burnout scores (P=.66), suggesting that participants were representative of US physicians. When assessed using the Maslach Burnout Inventory, 43.9% (2147 of 4893) of the physicians who completed the MBI reported at least one symptom of burnout in 2017 compared with 54.4% (3680 of 6767) in 2014 (P<.001) and 45.5% (3310 of 7227) in 2011 (P=.04). Satisfaction with work-life integration was more favorable in 2017 (42.7% [2056 of 4809]) than in 2014 (40.9% [2718 of 6651]; P<.001) but less favorable than in 2011 (48.5% [3512 of 7244]; P<.001). On multivariate analysis adjusting for age, sex, relationship status, and hours worked per week, physicians were at increased risk for burnout (odds ratio, 1.39; 95% CI, 1.26-1.54; P<.001) and were less likely to be satisfied with work-life integration (odds ratio, 0.77; 95% CI, 0.70-0.85; P<.001) than other working US adults.ConclusionBurnout and satisfaction with work-life integration among US physicians improved between 2014 and 2017, with burnout currently near 2011 levels. Physicians remain at increased risk for burnout relative to workers in other fields.     

¿Han llegado los millennials a la Facultad de Medicina? Perfil de personalidad de estudiantes de Medicina 1999-2014

ObjectiveMedical training not only requires the acquisition of knowledge and clinical skills, but also the development of attitudes and values, characteristics related to the personality profile. The present study focuses on assessing the personality profile of medical students, in relation to sociodemographic variables and generational change.Material and methodsCross-sectional observational study performed on 675 medical students,from 1999 to 2014. A sociodemographic questionnaire and the NEO-PI-R questionnaireto assess the personality profile was administrated.ResultsIn the present study, the highest mean scores were in the responsibility dimension, followed by kindness and openness to the experience. The lowest was neuroticism. As regards gender, women had higher scores in neuroticism, extraversion, kindness, and responsibility. The millennial students obtained significantly higher scores in the dimension of extraversion, kindness, and responsibility. These students are more assertive, sociable, compassionate, and more likely to fulfil their duty, organisation, order, and self-discipline. But this group also has a higher score in anxiety and obsessive traits, assuming an increased risk of stress and burn-out.ConclusionsSignificant differences have been found in the personality profiles between gender and among the millennial medical students, consistent with the personality profiles described in the literature on the millennium generation.     

Burnout and Resilience After a Decade in Palliative Care: What Survivors Have to Teach Us. A Qualitative Study of Palliative Care Clinicians With More Than 10 Years of Experience

ContextBurnout is common among palliative care clinicians (PCCs). Resilience helps to reduce burnout, compassion fatigue, and is associated with longevity in palliative care.ObjectivesWe aimed to study PCCs who have remained in the field for longer than 10 years to deepen our understanding on their views on burnout and resilience.MethodsWe conducted a qualitative study using semistructured interviews and purposive sampling on 18 PCCs – five doctors, 10 nurses, and three social workers who worked in various palliative care settings (hospital palliative care team, home hospice, and inpatient hospice). The mean age of the interviewees was 52 years, and the mean number of years practicing palliative care was 15.7 years (range 10–25). The interviews were recorded verbatim, transcribed, and analyzed using a grounded theory approach.ResultsFour major themes emerged from our analysis – struggling, changing mindset, adapting, and resilience. Intervening conditions, such as self-awareness, reflection, and evolution, were also important factors. The core phenomenon of our study was that of transformational growth – a process that PCCs have to go through before they achieve resilience. We also further classified resilience into both personal and collective resilience.ConclusionOur findings highlight the evolving process of transformational growth that PCCs must repeatedly undergo as they strive toward sustained resilience and longevity. It also stresses the importance of taking individual and collective responsibility toward building a culture of personal and team resilience.     

Mindfulness training for healthcare professional students: A waitlist controlled pilot study on psychological and work-relevant outcomes

ObjectivesTo fill gaps in the literature on the effects of mindfulness for healthcare professionals (HCPs), the current pragmatic trial investigated feasibility, acceptability, and effectiveness of Mindfulness for Interdisciplinary Healthcare Professional (MIHP) students on stress and work-relevant outcomes in the absence of offering school-based incentives.DesignA partially randomized waitlist-controlled design (intention-to-treat sample: 22 in the mindfulness group, 26 in the control group) was employed.InterventionMIHP is an eight-week intervention that incorporates meditation training, yoga, and discussion on the application of mindfulness principles to stressors commonly faced by HCPs and students.Main outcome measuresDomains of feasibility and acceptability; Maslach Burnout Inventory and other validated measures of psychological functioning; cognitive task performance on the Trail Making Test A & B; and the Work Productivity and Activity Impairment plus Classroom Impairment Questionnaire.ResultsResults supported the feasibility and acceptability of MIHP but found randomization to be unacceptable. Small to large effects were found for MIHP, relative to the control group, on outcomes of burnout, perceived stress, mindfulness, and activity impairment. No effect of MIHP was found on cognitive performance or work productivity outcomes.ConclusionsPreferential group allocation improved retention relative to randomization in the absence of school-based incentives. Results suggest that MIHP is feasible and acceptable and may have benefit for improving mindfulness and reducing burnout, stress, and activity impairment. Cognitive performance, work absenteeism, and work impairment did not change following MIHP. Results support future investigations into the effects of participant compensation on MIHP’s dissemination and effectiveness.     

麻醉科住院医师职业倦怠现状调查与研究

目的： 采用调查问卷收集国内麻醉科住院医师的职业倦怠现状,分析影响职业倦怠的相关因素。
方法： 选择全国218家医院的麻醉专科共2 651名在职在岗的麻醉科住院医师为研究对象。通过问卷星设计和发放电子问卷,收集人口统计学特征、职业相关特征、心理弹性评分（康纳-戴维森复原力量表）。采用职业倦怠量表（MBI-HSS）对医师职业倦怠情况进行评估。对发生职业倦怠和非职业倦怠的医师进行组间比较,并采用多因素Logistic回归分析医师职业倦怠的危险因素。
结果： 本次问卷有效回收1 990份,回收率77.7%。住院医师职业倦怠发生率为53.4%（1 063/1 990）。与未发生职业倦怠的住院医师比较,职业倦怠的医师女性比例、三级医院比例、未婚比例、遇到有挑战的病例频率、参与值班和有科研任务比例明显升高,每周工作时间明显延长（P<0.05）。多元Logistic回归分析结果显示,女性（OR=1.58,95%CI 1.28～1.97,P<0.01）、工作时间延长（OR=1.62, 95%CI 1.45～1.81,P<0.01）、遇到有挑战的病例频率延长（OR=1.11,95%CI 1.11～1.40,P<0.01）是职业倦怠的危险因素,心理弹性评分升高是职业倦怠的保护因素（OR=0.86,95%CI 0.84～0.88,P<0.01）。
结论： 麻醉科住院医师职业倦怠发生率偏高,应重点关注并针对提升心理弹性且设计切实可行的预防规范措施,保证住院医师群体的身心健康。     

高校专职辅导员工作压力与职业倦怠：角色认知的中介效应

目的：考察高校专职辅导员工作压力与职业倦怠之间的关系,探索角色认知的中介效应。方法：采用职业倦怠调查普适量表（ MBI－GS）、大学教师工作压力量表、角色认知量表对504名符合一定入选标准的高校专职辅导员进行测查。结果：①工作压力、角色模糊、角色冲突与职业倦怠呈显著正相关（r ＝0．563～0．595,P ＜0．001）,两变量共解释职业倦怠52．3％的方差变异（Adjusted R2＝0．520）;②中介效应检验发现角色模糊、角色冲突在工作压力与职业倦怠间起部分中介作用,中介效应分别占总效应的28．32％、36．81％。结论：工作压力影响高校专职辅导员职业倦怠水平,角色认知在两者间具有部分中介效应。     

北京市社区护士工作倦怠及相关因素调查

目的调查社区护士工作倦怠现况,并分析人口学变量对工作倦怠的影响。方法采用工作倦怠普适量表(MBI-GS),对北京市海淀区3家社区卫生服务中心及下设社区卫生服务站的141名社区护士进行问卷调查。结果大多数社区护士的工作倦怠处于轻度水平,情绪衰竭、玩世不恭、成就感低落3个维度中高度倦怠的发生率分别为30.5%、19.8%和43.2%。年龄大者情绪衰竭和玩世不恭程度较高,自评健康状况较差者情绪衰竭程度较高,在社区卫生服务站工作者成就感较低。结论社区护士总体工作倦怠水平相对较低。年龄较大、自评健康状况较差、社区卫生服务站的社区护士工作倦怠水平相对较高。     

Common infections and the role of burnout in a Dutch working population

OBJECTIVE: To determine if burnout is a risk factor for common cold, flu-like illness and gastroenteritis. METHODS: We conducted a prospective cohort study among 12,140 employees at baseline, using three consecutive self-administered questionnaires. The Maslach Burnout Inventory-General Survey (MBI-GS) was used to define employees with burnout complaints (Level 1) and clinical burnout (Level 2). The cross-sectional relationship between burnout and the occurrence of common infections was assessed at baseline, using logistic regression analysis. Survival analysis with Cox regression was performed to study the longitudinal relationship between burnout and the subscales of the MBI-GS as risk factors for common infections. RESULTS: For both levels of burnout, an increased incidence of common infections was found at baseline. The largest effect was found for the relationship between burnout and gastroenteritis (OR: 1.86, CI: 1.57-2.21 for Level 1 and OR: 3.59, CI: 2.09-6.17 for Level 2). The longitudinal analyses showed comparable results, although less pronounced. The largest effect was again found for gastroenteritis (RR: 1.55, CI: 1.28-1.86 for Level 1 and RR: 2.09, CI: 1.09-3.98 for Level 2). For flu-like illness and common cold, we found smaller but significant effects at Level 1, but not at Level 2. The subscale "Exhaustion" was found to be the strongest predictor for infections at both levels of burnout. CONCLUSIONS: This study provides evidence for burnout as a risk factor for common infections in a large heterogeneous population. Taking into account that burnout or its subscales are not primary etiological agents for these common infections, the observed effects are large.