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JAMA Sep 2018Burnout is a self-reported job-related syndrome increasingly recognized as a critical factor affecting physicians and their patients. An accurate estimate of burnout... (Review)
Review
IMPORTANCE
Burnout is a self-reported job-related syndrome increasingly recognized as a critical factor affecting physicians and their patients. An accurate estimate of burnout prevalence among physicians would have important health policy implications, but the overall prevalence is unknown.
OBJECTIVE
To characterize the methods used to assess burnout and provide an estimate of the prevalence of physician burnout.
DATA SOURCES AND STUDY SELECTION
Systematic search of EMBASE, ERIC, MEDLINE/PubMed, psycARTICLES, and psycINFO for studies on the prevalence of burnout in practicing physicians (ie, excluding physicians in training) published before June 1, 2018.
DATA EXTRACTION AND SYNTHESIS
Burnout prevalence and study characteristics were extracted independently by 3 investigators. Although meta-analytic pooling was planned, variation in study designs and burnout ascertainment methods, as well as statistical heterogeneity, made quantitative pooling inappropriate. Therefore, studies were summarized descriptively and assessed qualitatively.
MAIN OUTCOMES AND MEASURES
Point or period prevalence of burnout assessed by questionnaire.
RESULTS
Burnout prevalence data were extracted from 182 studies involving 109 628 individuals in 45 countries published between 1991 and 2018. In all, 85.7% (156/182) of studies used a version of the Maslach Burnout Inventory (MBI) to assess burnout. Studies variably reported prevalence estimates of overall burnout or burnout subcomponents: 67.0% (122/182) on overall burnout, 72.0% (131/182) on emotional exhaustion, 68.1% (124/182) on depersonalization, and 63.2% (115/182) on low personal accomplishment. Studies used at least 142 unique definitions for meeting overall burnout or burnout subscale criteria, indicating substantial disagreement in the literature on what constituted burnout. Studies variably defined burnout based on predefined cutoff scores or sample quantiles and used markedly different cutoff definitions. Among studies using instruments based on the MBI, there were at least 47 distinct definitions of overall burnout prevalence and 29, 26, and 26 definitions of emotional exhaustion, depersonalization, and low personal accomplishment prevalence, respectively. Overall burnout prevalence ranged from 0% to 80.5%. Emotional exhaustion, depersonalization, and low personal accomplishment prevalence ranged from 0% to 86.2%, 0% to 89.9%, and 0% to 87.1%, respectively. Because of inconsistencies in definitions of and assessment methods for burnout across studies, associations between burnout and sex, age, geography, time, specialty, and depressive symptoms could not be reliably determined.
CONCLUSIONS AND RELEVANCE
In this systematic review, there was substantial variability in prevalence estimates of burnout among practicing physicians and marked variation in burnout definitions, assessment methods, and study quality. These findings preclude definitive conclusions about the prevalence of burnout and highlight the importance of developing a consensus definition of burnout and of standardizing measurement tools to assess the effects of chronic occupational stress on physicians.
Topics: Burnout, Professional; Compassion Fatigue; Depersonalization; Humans; Job Satisfaction; Physicians; Prevalence; Surveys and Questionnaires
PubMed: 30326495
DOI: 10.1001/jama.2018.12777 -
PloS One 2018Burnout is a psychological syndrome that is very common among medical residents. It consists of emotional exhaustion (EE), depersonalization (DP) and reduced personal... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Burnout is a psychological syndrome that is very common among medical residents. It consists of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA).
OBJECTIVE
To estimate burnout among different medical residency specialties.
METHODS
A systematic review with meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of bibliographic databases and grey literature was conducted, from inception to March 2018. The following databases were accessed: Embase, PubMed, Web of Science, Google Scholar and Scopus, and 3,575 studies were found. Methodological quality was evaluated by Agency for Healthcare Research and Quality Methodology Checklist for Cross-Sectional/Prevalence Study. In the final analysis, 26 papers were included. Their references were checked for additional studies, but none were included.
RESULTS
4,664 medical residents were included. High DP, EE and low PA proportions were compared. Specialties were distributed into three groups of different levels of burnout prevalence: general surgery, anesthesiology, obstetrics/gynecology and orthopedics (40.8%); internal medicine, plastic surgery and pediatrics (30.0%); and otolaryngology and neurology (15.4%). Overall burnout prevalence found for all specialties was 35.7%.
CONCLUSION
The prevalence of burnout syndrome was significantly higher among surgical/urgency residencies than in clinical specialties.
PROSPERO REGISTRATION
CRD42018090270.
Topics: Burnout, Psychological; Depersonalization; Humans; Internal Medicine; Internship and Residency; Physicians; Prevalence; Specialties, Surgical
PubMed: 30418984
DOI: 10.1371/journal.pone.0206840 -
Psychiatria Danubina Mar 2018French expression standing for the phrase "already seen" is a déjà vu. It is thought that as much as 97% of the population have experienced déjà vu at least once in... (Review)
Review
French expression standing for the phrase "already seen" is a déjà vu. It is thought that as much as 97% of the population have experienced déjà vu at least once in their lifetime and 67% experience it regularly. The explanations of this phenomenon in novels and poems include reincarnation, dreams, organic factors, and unconscious memories. In this narrative review connection between déjà vu and various other conditions has been mentioned: false memories, temporal lobe epilepsy and other neurological conditions. In psychiatric patients déjà vu phenomenon is more often seen in patients with anxiety and people with derealisation/ depersonalization. It seems that temporal region is the origin of déjà vu phenomena in both healthy individuals and in individuals with neurological and psychiatric conditions, but the exact mechanism of this phenomenon is however still unknown. More attention should also be given to déjà vu from philosophical and religious perspectives as well. Déjà vu is still an enigma which could only be revealed with multidisciplinary approach through cooperation between neurologists, brain scientists, psychiatrists and experimental psychologists.
Topics: Adult; Brain; Deja Vu; Depersonalization; Epilepsy, Temporal Lobe; Humans; Interdisciplinary Communication; Intersectoral Collaboration; Male; Neurocognitive Disorders; Repression, Psychology
PubMed: 29546854
DOI: 10.24869/psyd.2018.21 -
International Journal of Medical... Oct 2016To describe levels of burnout and impostor syndrome (IS) in medical students, and to recognize demographic differences in those experiencing burnout and IS.
OBJECTIVES
To describe levels of burnout and impostor syndrome (IS) in medical students, and to recognize demographic differences in those experiencing burnout and IS.
METHODS
Anonymous survey administered online in 2014 that included demographic data, the Maslach Burnout Inventory and an IS screening questionnaire. Main outcome measures were level of burnout, and presence or absence of imposter syndrome. The presence of IS and burnout components were analyzed across age, gender, race, year of training, intention to pursue fellowship training, and greater than one year of work experience outside of medicine using chi-squared tests. The association between burnout and IS was also compared using chi-squared tests.
RESULTS
One hundred and thirty-eight students completed the questionnaire. Female gender was significantly associated with IS (χ=10.6, p=0.004) with more than double the percentage of females displaying IS than their male counterparts (49.4% of females versus 23.7% of males). IS was significantly associated with the burnout components of exhaustion (χ =5.9, p=0.045), cynicism (χ=9.4, p=0.004), emotional exhaustion (χ=8.0, p=0.018), and depersonalization (χ =10.3, p=0.006). The fourth year of medical school was significantly associated with IS (χ=10.5, p=0.015).
CONCLUSIONS
Almost a quarter of male medical students and nearly half of female students experience IS and IS was found to be significantly associated with burnout indices. Given the high psychological morbidity of these conditions, this association cannot be ignored. It behooves us to reconsider facets of medical education (i.e. shame-based learning and overall teaching style) and optimize the medical learning environment.
Topics: Adolescent; Adult; Burnout, Professional; Cross-Sectional Studies; Depersonalization; Female; Humans; Male; Mass Screening; Middle Aged; Pilot Projects; Stress, Psychological; Students, Medical; Surveys and Questionnaires; Syndrome; United States; Young Adult
PubMed: 27802178
DOI: 10.5116/ijme.5801.eac4 -
International Journal of Environmental... Dec 2018Research findings concerning burnout prevalence rate among nurses from the medical area are contradictory. The aim of this study was to analyse associated factors, to... (Meta-Analysis)
Meta-Analysis
Research findings concerning burnout prevalence rate among nurses from the medical area are contradictory. The aim of this study was to analyse associated factors, to determine nurse burnout levels and to meta-analyse the prevalence rate of each burnout dimension. A systematic review, with meta-analysis, was conducted in February 2018, consulting the next scientific databases: PubMed, CUIDEN, CINAHL, Scopus, LILACS, PsycINFO and ProQuest Health & Medical Complete. In total, 38 articles were extracted, using a double-blinded procedure. The studies were classified by the level of evidence and degrees of recommendation. The 63.15% (n = 24) of the studies used the MBI. High emotional exhaustion was found in the 31% of the nurses, 24% of high depersonalisation and low personal accomplishment was found in the 38%. Factors related to burnout included professional experience, psychological factors and marital status. High emotional exhaustion prevalence rates, high depersonalisation and inadequate personal accomplishment are present among medical area nurses. The risk profile could be a single nurse, with multiple employments, who suffers work overload and with relatively little experience in this field. The problem addressed in this study influence the quality of care provided, on patients' well-being and on the occupational health of nurses.
Topics: Burnout, Professional; Humans; Nurses; Prevalence; Risk Factors; Stress, Psychological
PubMed: 30544672
DOI: 10.3390/ijerph15122800 -
Mindfulness 2022Although depersonalization has been described as the antithesis of mindfulness, few studies have empirically examined this relationship, and none have considered how it...
OBJECTIVES
Although depersonalization has been described as the antithesis of mindfulness, few studies have empirically examined this relationship, and none have considered how it may differ across various facets of mindfulness, either alone or in interaction. The present study examined the relationship between symptoms of depersonalization and facets of dispositional mindfulness in a general population sample.
METHODS
A total of 296 adult participants (139 male, 155 female, 2 other) were recruited online via Qualtrics and completed the Cambridge Depersonalisation Scale; Depression, Anxiety, and Stress Scale; and Five Facet Mindfulness Questionnaire.
RESULTS
Controlling for general distress, depersonalization symptoms were positively associated with Observe, Describe, and Nonreactivity facets and negatively associated with Acting with Awareness and Nonjudgment facets. After controlling for intercorrelations among the facets, depersonalization symptoms remained significantly associated with higher Nonreactivity and lower Acting with Awareness. The overall positive relationship between depersonalization symptoms and the Observe facet was moderated by both Nonjudgment and Nonreactivity. Specifically, higher Observing was related to increased depersonalization symptoms at low levels of Nonjudgment and to decreased symptoms at low levels of Nonreactivity.
CONCLUSIONS
The current study provides novel insight into the relationship between depersonalization symptoms and various aspects of mindfulness. Experiences of depersonalization demonstrated divergent relationships with mindfulness facets, alone and in interaction. The results may inform theoretical models of depersonalization and mindfulness-based interventions for depersonalization.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s12671-022-01890-y.
PubMed: 35492870
DOI: 10.1007/s12671-022-01890-y -
Journal of the American Academy of... Dec 2017The purpose of this study was to examine the co-occurrence of posttraumatic stress disorder (PTSD) and dissociation in a clinical sample of trauma-exposed adolescents by...
OBJECTIVE
The purpose of this study was to examine the co-occurrence of posttraumatic stress disorder (PTSD) and dissociation in a clinical sample of trauma-exposed adolescents by evaluating evidence for the depersonalization/derealization dissociative subtype of PTSD as defined by the DSM-5 and then examining a broader set of dissociation symptoms.
METHOD
A sample of treatment-seeking, trauma-exposed adolescents 12 to 16 years old (N = 3,081) from the National Child Traumatic Stress Network Core Data Set was used to meet the study objectives. Two models of PTSD/dissociation co-occurrence were estimated using latent class analysis, one with 2 dissociation symptoms and the other with 10 dissociation symptoms. After model selection, groups within each model were compared on demographics, trauma characteristics, and psychopathology.
RESULTS
Model A, the depersonalization/derealization model, had 5 classes: dissociative subtype/high PTSD; high PTSD; anxious arousal; dysphoric arousal; and a low symptom/reference class. Model B, the expanded dissociation model, identified an additional class characterized by dissociative amnesia and detached arousal.
CONCLUSION
These 2 models provide new information about the specific ways PTSD and dissociation co-occur and illuminate some differences between adult and adolescent trauma symptom expression. A dissociative subtype of PTSD can be distinguished from PTSD alone in adolescents, but assessing a wider range of dissociative symptoms is needed to fully characterize adolescent traumatic stress responses.
Topics: Adolescent; Child; Depersonalization; Dissociative Disorders; Female; Humans; Male; Models, Psychological; Models, Statistical; Psychiatric Status Rating Scales; Stress Disorders, Post-Traumatic
PubMed: 29173740
DOI: 10.1016/j.jaac.2017.09.425 -
International Journal of Environmental... Sep 2022(1) Background: Various investigations have confirmed that burnout prevails in intensive and demanding contemporary working environments. Most of these studies have...
(1) Background: Various investigations have confirmed that burnout prevails in intensive and demanding contemporary working environments. Most of these studies have analyzed the associations between emotional exhaustion and various work factors. We studied the gap in the literature by simultaneously considering the three commonly recognized dimensions of burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) using a representative sample of telecommunication sales managers. (2) Methods: 849 survey respondents completed an anonymous questionnaire that included items representing psychosocial factors at work, lifestyle characteristics, and the Maslach Burnout inventory. The hierarchical regression analysis revealed the predictors of emotional exhaustion, depersonalization, and reduced personal accomplishment. (3) Results: job demands and witnessing bullying at the workplace were the most powerful predictors of emotional exhaustion, followed by self-rated health, night work, education, and physical inactivity. Witnessing bullying at the workplace, job control, self-rated health, and physical inactivity were the strongest predictors of depersonalization. Finally, direct experiences of negative acts at the workplace, job control, social support at work, bullying exposure duration, family crises, physical inactivity, smoking and alcohol, and body mass index were the most important predictors of reduced personal accomplishments. (4) Conclusions: the present study fills a gap in the research surrounding the three dimensions of burnout. The findings not only confirm that high job demands, low job control, and low social support at work contribute to burnout but also contribute to the novel understanding that workplace bullying plays an integral role.
Topics: Burnout, Professional; Burnout, Psychological; Humans; Job Satisfaction; Surveys and Questionnaires; Telecommunications; Workplace
PubMed: 36141531
DOI: 10.3390/ijerph191811249 -
BMC Health Services Research Nov 2022Burnout is common among physicians and has detrimental effects on patient care and physician health. Recent editorials call attention to perfectionism in medicine;...
BACKGROUND
Burnout is common among physicians and has detrimental effects on patient care and physician health. Recent editorials call attention to perfectionism in medicine; however, no studies to date have examined the effect of perfectionism on burnout in physicians practicing in the United States. This study examined associations among demographics, perfectionism and personality traits, and burnout among practicing physicians.
METHODS
This cross-sectional study included general pediatric and pediatric sub-specialist physicians. Out of the 152 physicians contacted, 69 enrolled (Mean = 44.16 ± 9.98; 61% female). Emotional exhaustion, depersonalization, and personal accomplishment burnout were assessed via the Maslach Burnout Inventory. Validated instruments were used to measure personality and perfectionism. Data were analyzed using linear regression models.
RESULTS
Across physicians assessed, 42% reported either high emotional exhaustion burnout or depersonalization burnout. High self-critical perfectionism uniquely predicted both high emotional exhaustion burnout (B = 0.55, 95%CI 0.25-0.85) and depersonalization burnout (B = 0.18, 95%CI 0.05-0.31). Low conscientiousness (B = -6.12; 95%CI, -10.95- -1.28) predicted higher emotional exhaustion burnout and low agreeableness (B = -3.20, 95%CI -5.93- -0.46) predicted higher depersonalization burnout.
CONCLUSIONS
Perfectionism is understudied among physicians and the current findings suggest that addressing system and individual-level factors that encourage perfectionism is warranted and may reduce risk for physician burnout.
Topics: Female; Humans; Child; Adult; Middle Aged; Male; Perfectionism; Cross-Sectional Studies; Burnout, Psychological; Physicians; Medicine
PubMed: 36443726
DOI: 10.1186/s12913-022-08785-7 -
International Journal of Scientific... Apr 2019'Burnout' among emergency healthcare workers needs focus as they make crucial life changing decisions every day and thus, their state of physical and mental wellbeing is...
OBJECTIVE
'Burnout' among emergency healthcare workers needs focus as they make crucial life changing decisions every day and thus, their state of physical and mental wellbeing is an absolute necessity. We aimed to find the level and factors contributing to burnout among the healthcare workers in the busiest Emergency Department of Northeast India. This is the first study done in this department to assess burnout.
METHOD
This cross-sectional, questionnaire-based study assessed burnout of the doctors, nurses, and paramedics working in an emergency department of a busy tertiary care teaching institute. Association of demographic variables and factors influencing burnout was explored. Results were analyzed by descriptive and inferential statistics.
RESULTS
Low level in emotional exhaustion, moderate level in depersonalization, and moderate level in the lack of personal accomplishment was reported by participants. Children and partner were found to be protective factors. Working hours, duration and status (permanent/contractual) of service influenced burnout.
CONCLUSION
Knowing the level of burnout and their determinants can help in formulating measures of improving the work environment. A healthy workforce ensures high quality of healthcare and patient satisfaction.
PubMed: 31069180
DOI: 10.15373/22778179