Burnout is a state of physical or mental collapse caused by overwork or stress. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and ...patient care. The new COVID-19 pandemic has raised public health problems around the world and required a reorganization of health services. In this context, burnout syndrome and physical exhaustion have become even more pronounced. Resident doctors, and especially those in certain specialties, seem even more exposed due to the higher workload, prolonged exposure and first contact with patients. This article is a short review of the literature and a presentation of some considerations regarding the activity of the medical residents in a non-Covid emergency hospital in Romania, based on the responses obtained via a questionnaire. Burnout prevalence is not equal in different specialties. We studied its impact and imagine the potential steps that can be taken in order to reduce the increasing rate of burnout syndrome in the pandemics.
At the heart of the unparalleled crisis of COVID-19, healthcare workers (HCWs) face several challenges treating patients with COVID-19: reducing the spread of infection; developing suitable ...short-term strategies; and formulating long-term plans. The psychological burden and overall wellness of HCWs has received heightened awareness in news and research publications. The purpose of this study was to provide a review on current publications measuring the effects of COVID-19 on wellness of healthcare providers to inform interventional strategies. Between April 6-May 17, 2020, we conducted systematic searches using combinations of these keywords and synonyms in conjunction with the controlled vocabulary of the database: "physician," "wellness, "wellbeing," "stress," "burnout," "COVID-19," and "SARS-CoV-2." We excluded articles without original data, research studies regarding the wellness of non-healthcare occupations or the general public exclusively, other outbreaks, or wellness as an epidemic. A total of 37 studies were included in this review. The review of literature revealed consistent reports of stress, anxiety, and depressive symptoms in HCWs as a result of COVID-19. We describe published data on HCW distress and burnout but urge future research on strategies to enhance HCW well-being.
•The prevalence estimate of burnout was 49% and 5% for severe burnout in French physicians•Emergency physicians, junior residents and physicians with high number of night shifts were found at higher ...risk for burnout.•Some specialties like psychiatrists were insufficiently explored and may be targeted in future studies.
Burnout syndrome is the consequence of chronic work-related stress exposure and is 2–3 times higher than in physicians than in other professions. Many studies exploring burnout in French physicians have been published with inconsistent data regarding its prevalence and associated factors.
To assess the prevalence of burnout and associated factors in French physicians in a systematic review and meta-analysis.
Studies assessing the prevalence of French physician's burnout and its three dimensions emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA) were selected in the following databases from 2000 to April 2017: MEDLINE, BIOSIS WEB OF SCIENCE, PASCAL ET FRANCIS, SCIENCES DIRECT, PSYCHinfo, and BDSP. Burnout was defined by one abnormal score in one or more of the 3 dimensions of the MBI scale (EE, DP or PA). Severe burnout was defined by the association of high scores of EE and DP, and low score of PA. High EE was defined by an EE score ≥27. High DP was defined by a score ≥10. Low PA was defined by a score ≤33.
A total of 37 studies and 15,183 French physicians were included in the present meta-analysis. The random effects pooled prevalence estimate was 49% (95% CI 45%–53%, P < 0.001, I2 = 93.1%) for burnout, 5% (95% CI 4–7, P < 0.001, I2 = 92.7%) for severe burnout, 21% (95% CI 19–24, P < 0.001, I2 = 94.7%) for high EE, 29% (95% CI 25–33, P < 0.001, I2 = 96.7%) for high DP, and 29% (95% CI 24–34, P < 0.001, I2 = 97.7%) for low PA. Emergency physicians were found to have a trend to higher rates of burnout (P = 0.051), and significantly more severe burnout compared to other physicians (b = 0.05, seb = 0.02, P = 0.019). Junior residents were found to have higher rates of DP; junior residents, sample size, and monthly number of night shifts were associated with lower PA; and anesthesiologists were found to have lower rates of high EE and high DP.
Burnout is highly prevalent in French physicians. Some recommendations may be suggested to reduce this rate, including reducing the number or duration of night shifts to increase personal accomplishment and targeting emergency physicians and junior residents in priority. Other specialties should be explored in future studies.
This cross-sectional study evaluates the prevalence of and factors associated with burnout among frontline health care workers during the coronavirus disease 2019 (COVID-19) pandemic in Japan.
Burnout syndrome (BOS) occurs in all types of healthcare professionals and is especially common in individuals who care for critically ill patients. The development of BOS is related to an imbalance ...of personal characteristics of the employee and work-related issues or other organizational factors. BOS is associated with many deleterious consequences, including increased rates of job turnover, reduced patient satisfaction, and decreased quality of care. BOS also directly affects the mental health and physical well-being of the many critical care physicians, nurses, and other healthcare professionals who practice worldwide. Until recently, BOS and other psychological disorders in critical care healthcare professionals remained relatively unrecognized. To raise awareness of BOS, the Critical Care Societies Collaborative (CCSC) developed this call to action. The present article reviews the diagnostic criteria, prevalence, causative factors, and consequences of BOS. It also discusses potential interventions that may be used to prevent and treat BOS. Finally, we urge multiple stakeholders to help mitigate the development of BOS in critical care healthcare professionals and diminish the harmful consequences of BOS, both for critical care healthcare professionals and for patients.
The prevalence of physician burnout is well documented, and resilience training has been proposed as an option to support physician well-being. However, the resilience of physicians compared with ...that of the US working population is not established, and the association between resilience and physician burnout is not well understood.
To evaluate resilience among physicians and US workers, and to determine the association between resilience and burnout among US physicians.
A cross-sectional national survey study of 5445 US physicians and a probability-based sample of 5198 individuals in the US working population was conducted between October 12, 2017, and March 15, 2018.
Resilience was measured using the 2-item Connor-Davidson Resilience Scale (total scores range from 0-8; higher scores indicate greater resilience); burnout was measured using the full Maslach Burnout Inventory with overall burnout indicated by a score of at least 27 on the 0 to 54 emotional exhaustion subscale and/or at least 10 on the depersonalization subscale (higher scores indicate greater burnout).
Of 30 456 physicians who received an invitation to participate, 5445 (17.9%) completed surveys (2995 men 62.1%; median IQR age of 53 42-62 years). In multivariable analysis, mean (SD) resilience scores were higher among physicians than the general employed population (6.49 1.30 vs 6.25 1.37; adjusted mean difference, 0.25 points; 95% CI, 0.19-0.32; P < .001). Among physicians, resilience was associated with burnout. Physicians without overall burnout had higher mean (SD) resilience scores than physicians with burnout (6.82 1.15 vs 6.13 1.36; adjusted mean difference, 0.68 points, 95% CI, 0.61-0.76; P < .001). Each 1-point increase in resilience score was associated with 36% lower odds of overall burnout (odds ratio, 0.64; 95% CI, 0.60-0.67; P < .001). However, 392 of 1350 physicians (29%) with the highest possible resilience score had burnout.
The findings of this national survey study suggest that physicians exhibited higher levels of resilience than the general working population in the US. Resilience was inversely associated with burnout symptoms, but burnout rates were substantial even among the most resilient physicians. Additional solutions, including efforts to address system issues in the clinical care environment, are needed to reduce burnout and promote physician well-being.
Objective
To summarise articles reporting on burnout among medical students and residents (trainees) in a narrative review.
Methods
MEDLINE was searched for peer‐reviewed, English language articles ...published between 1990 and 2015 reporting on burnout among trainees. The search used combinations of Medical Subject Heading terms medical student, resident, internship and residency, and burnout, professional. Reference lists of articles were reviewed to identify additional studies. A subset of high‐quality studies was selected.
Results
Studies suggest a high prevalence of burnout among trainees, with levels higher than in the general population. Burnout can undermine trainees’ professional development, place patients at risk, and contribute to a variety of personal consequences, including suicidal ideation. Factors within the learning and work environment, rather than individual attributes, are the major drivers of burnout. Limited data are available regarding how to best address trainee burnout, but multi‐pronged efforts, with attention to culture, the learning and work environment and individual behaviours, are needed to promote trainees’ wellness and to help those in distress.
Conclusion
Medical training is a stressful time. Large, prospective studies are needed to identify cause‒effect relationships and the best approaches for improving the trainee experience.
Discuss ideas arising from the article at http://www.mededuc.com discuss.
Physician burnout in the United States has reached epidemic proportions and is rising rapidly, although burnout in other occupations is stable. Its negative impact is far reaching and includes harm ...to the burned-out physician, as well as patients, coworkers, family members, close friends, and healthcare organizations.
The purpose of this review is to provide an accurate, current summary of what is known about physician burnout and to develop a framework to reverse its current negative impact, decrease its prevalence, and implement effective organizational and personal interventions.
I completed a comprehensive MEDLINE search of the medical literature from January 1, 2000, through December 28, 2016, related to medical student and physician burnout, stress, depression, suicide ideation, suicide, resiliency, wellness, and well-being. In addition, I selectively reviewed secondary articles, books addressing the relevant issues, and oral presentations at national professional meetings since 2013.
Healthcare organizations within the United States were studied.
The literature review is presented in 5 sections covering the basics of defining and measuring burnout; its impact, incidence, and causes; and interventions and remediation strategies.
All US medical students, physicians in training, and practicing physicians are at significant risk of burnout. Its prevalence now exceeds 50%. Burnout is the unintended net result of multiple, highly disruptive changes in society at large, the medical profession, and the healthcare system. Both individual and organizational strategies have been only partially successful in mitigating burnout and in developing resiliency and well-being among physicians. Two highly effective strategies are aligning personal and organizational values and enabling physicians to devote 20% of their work activities to the part of their medical practice that is especially meaningful to them. More research is needed.
Burnout in health care professionals could have serious negative consequences on quality of patient care, professional satisfaction and personal life. Our aim was to investigate the burnout ...prevalence, work and lifestyle factors potentially affecting burnout amongst European oncologists≤40 (YOs).
A survey was conducted using the validated Maslach Burnout Inventory (MBI) and additional questions exploring work/lifestyle factors. Statistical analyses were carried out to identify factors associated with burnout.
Total of 737 surveys (all ages) were collected from 41 European countries. Countries were divided into six regions. Results from 595 (81%) YOs were included (81% medical oncologists; 52% trainees, 62% women). Seventy-one percent of YOs showed evidence of burnout (burnout subdomains: depersonalization 50%; emotional exhaustion 45; low accomplishment 35%). Twenty-two percent requested support for burnout during training and 74% reported no hospital access to support services. Burnout rates were significantly different across Europe (P<0.0001). Burnout was highest in central European (84%) and lowest in Northern Europe (52%). Depersonalization scores were higher in men compared with women (60% versus 45% P=0.0001) and low accomplishment was highest in the 26–30 age group (P<0.01). In multivariable linear regression analyses, European region, work/life balance, access to support services, living alone and inadequate vacation time remained independent burnout factors (P<0.05).
This is the largest burnout survey in European Young Oncologists. Burnout is common amongst YOs and rates vary across Europe. Achieving a good work/life balance, access to support services and adequate vacation time may reduce burnout levels. Raising awareness, support and interventional research are needed.
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