emotional intelligence; general practice; job burnout; self-compassion; social support; work environment; Family Practice
Abstract :
[en] [en] BACKGROUND: General practitioners (GPs) are particularly vulnerable to job burnout. Tailored prevention and intervention strategies are needed.
AIM: To investigate organisational, interpersonal and individual factors contributing to exhaustion and disengagement at work among GPs.
DESIGN & SETTING: We conducted a cross-sectional study in a sample of Belgian GPs.
METHOD: A total of 358 doctors (73% females, 301 with complete data) completed an online anonymous questionnaire assessing job burnout, psychosocial characteristics of the work environment, perceived social support in the private domain, emotional competence, and self-compassion.
RESULTS: GPs reported moderate levels of exhaustion and disengagement. Regression models showed that included factors jointly explained 69% of the variance in exhaustion and 63% in disengagement. Exhaustion was significantly predicted by sex (being a woman) (β effect size =-.1), high perceived emotional demands (β=.19), as well as low self-compassion (β=-.14) and low emotional competence (β=.09). Disengagement was significantly predicted by low seniority (β=-.12) and limited opportunities for development (β=-.16). Both exhaustion and disengagement were predicted by low perceived quality of work (β=-.19 and -.14 respectively), meaning of work (β=-.17 and -.31 respectively) and role clarity (β=.09 and .12 respectively), as well as high perceived work-life conflict (β=.46 and .21 respectively). Moreover, GPs working in a multidisciplinary group reported lower levels of exhaustion and disengagement than those working in a monodisciplinary group or a solo practice, and this difference was associated with factors such as work-life conflict.
CONCLUSION: Organisational, interpersonal and intrapersonal factors interact to predict a substantial part of burnout in general practice. The most significant risk factors were perceived work-life conflict and poor meaning of work. Policy-makers should work to support more sustainable practices based on the specific needs and constraints reported by GPs.
Disciplines :
General & internal medicine
Author, co-author :
Bayot, Marie ; Université de Liège - ULiège > Département des sciences cliniques > Médecine générale
Boone, Anke; Centre for Environment and Health, Katholieke Universiteit Leuven, Kapucijnenvoer, Leuven, Belgium
Godderis, Lode; Centre for Environment and Health, Katholieke Universiteit Leuven, Kapucijnenvoer, Leuven, Belgium ; Idewe, External Service for Prevention and Protection at Work, Interleuvenlaan 58, Heverlee, Belgium
Lenoir, Anne-Laure ; Université de Liège - ULiège > Département des sciences cliniques > Médecine générale
Language :
English
Title :
Multidimensional factors of burnout in general practice: a cross-sectional survey.
1. Maslach C, Jackson S. Burnout in the Health Professions: A Social Psychological Analysis. Hillsdale, NJ: Lawrence Erlbaum Associates; 1982.
2. Shanafelt TD, Balch CM, Dyrbye L, et al. Special report: suicidal Ideation among American Surgeons. Arch Surg 2011; 146(1): 54–62. DOI: https://doi.org/10.1001/archsurg.2010.292
3. Dewa CS, Loong D, Bonato S, Trojanowski L. The relationship between physician burnout and quality of Healthcare in terms of safety and acceptability: a systematic review. BMJ Open 2017; 7(6): e015141. DOI: https://doi.org/10.1136/bmjopen-2016-015141
4. Schaufeli WB, Taris TW. A critical review of the job demands-resources model: implications for improving work and health. In: Bauer GF, Hämmig O, eds. Bridging Occupational, Organizational and Public Health: A Transdisciplinary Approach. Dordrecht: Springer Netherlands; 2014. DOI: https://doi.org/10.1007/978-94-007-5640-3
5. Pantenburg B, Luppa M, König HH, Riedel-Heller SG. Burnout among young physicians and its association with physicians’ wishes to leave: results of a survey in Saxony, Germany. J Occup Med Toxicol 2016; 11(1): 2. DOI: https://doi.org/10.1186/s12995-016-0091-z
6. Prins JT, Hoekstra-Weebers J, Gazendam-Donofrio SM, et al. Burnout and engagement among resident doctors in the Netherlands: a national study. Med Educ 2010; 44(3): 236–247. DOI: https://doi.org/10.1111/j.1365-2923.2009.03590.x
7. Dyrbye LN, West CP, Satele D, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med 2014; 89(3): 443–451. DOI: https://doi.org/10.1097/ACM.0000000000000134
8. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med 2012; 172(18): 1377–1385. DOI: https://doi.org/10.1001/archinternmed.2012.3199
9. Arigoni F, Bovier PA, Mermillod B, et al. Prevalence of burnout among Swiss cancer Clinicians, paediatricians and general practitioners: who are most at risk. Support Care Cancer 2009; 17(1): 75–81. DOI: https://doi.org/10.1007/s00520-008-0465-6
10. Karuna C, Palmer V, Scott A, Gunn J. Prevalence of burnout among GPs: a systematic review and meta-analysis. Br J Gen Pract 2022; 72(718): BJGP.2021.0441: e316–e324:. DOI: https://doi.org/10.3399/BJGP.2021.0441
11. Sletta C, Tyssen R, Løvseth LT. Change in subjective well-being over 20 years at two Norwegian medical schools and factors linked to well-being today: a survey. BMC Med Educ 2019; 19(1): 45. DOI: https://doi.org/10.1186/s12909-019-1476-3
12. Jackson-Koku G, Grime P. Emotion regulation and burnout in doctors: a systematic review. Occup Med (Lond) 2019; 69(1): 9–21. DOI: https://doi.org/10.1093/occmed/kqz004
13. Bergmann C, Muth T, Loerbroks A. Medical students’ perceptions of stress due to academic studies and its interrelationships with other domains of life: a qualitative study. Med Educ Online 2019; 24(1): 1603526. DOI: https://doi.org/10.1080/10872981.2019.1603526
14. Chang Y. The relationship between maladaptive perfectionism with burnout: testing mediating effect of emotion-focused coping. Pers Individ Dif 2012; 53(5): 635–639. DOI: https://doi.org/10.1016/j.paid.2012.05.002
15. Babenko O, Mosewich A, Abraham J, Lai H. Contributions of psychological needs, self-compassion, leisure-time exercise, and achievement goals to academic engagement and exhaustion in Canadian medical students. J Educ Eval Health Prof 2018; 15: 2. DOI: https://doi.org/10.3352/jeehp.2018.15.2
16. Montero-Marin J, Zubiaga F, Cereceda M, et al. Burnout subtypes and absence of self-compassion in primary healthcare professionals: a cross-sectional study. PLoS One 2016; 11(6): e0157499. DOI: https://doi.org/10.1371/journal.pone.0157499
17. Szczygiel DD, Mikolajczak M. Emotional intelligence buffers the effects of negative emotions on job burnout in nursing. Front Psychol 2018; 9: 2649. DOI: https://doi.org/10.3389/fpsyg.2018.02649
18. Riley R, Spiers J, Buszewicz M, et al. What are the sources of stress and distress for general practitioners working in England? A qualitative study. BMJ Open 2018; 8(1): e017361. DOI: https://doi.org/10.1136/bmjopen-2017-017361
19. Goehring C, Bouvier Gallacchi M, Künzi B, Bovier P. Psychosocial and professional characteristics of Bournout in Swiss primary care practitioners: a cross-sectional survey. Swiss Med Wkly 2005; 135(7–8): 101–108. DOI: https://doi.org/10.4414/smw.2005.10841
20. Rabatin J, Williams E, Baier Manwell L, et al. Predictors and outcomes of burnout in primary care physicians. J Prim Care Community Health 2016; 7(1): 41–43. DOI: https://doi.org/10.1177/2150131915607799
21. Gan Y, Jiang H, Li L, et al. Prevalence of burnout and associated factors among general practitioners in Hubei, China: a cross-sectional study. BMC Public Health 2019; 19(1): 1607. DOI: https://doi.org/10.1186/s12889-019-7755-4
22. Dreher A, Theune M, Kersting C, et al. Prevalence of burnout among German general practitioners: comparison of physicians working in solo and group practices. PLoS One 2019; 14(2): e0211223. DOI: https://doi.org/10.1371/journal.pone.0211223
23. Biddle GJH, Thomas N, Edwardson CL, et al. Burnout, psychological wellbeing and musculoskeletal complaints in general practitioners. BJGP Open 2023; 7(4): BJGPO.2023.0007. DOI: https://doi.org/10.3399/BJGPO.2023.0007
24. Nielsen HG, Tulinius C. Preventing burnout among general practitioners: is there a possible route. Educ Prim Care 2009; 20(5): 353–359. DOI: https://doi.org/10.1080/14739879.2009.11493817
25. Galleta-Williams H, Esmail A, Grigoroglou C, Zghebi SS, et al. The importance of teamwork climate for preventing burnout in UK general practices. Eur J Public Health 2020; 30(Suppl_4): iv36–iv38. DOI: https://doi.org/10.1093/eurpub/ckaa128
26. Halbesleben JRB, Demerouti E. The construct validity of an alternative measure of burnout: investigating the English translation of the Oldenburg burnout inventory. Work Stress 2005; 19(3): 208–220. DOI: https://doi.org/10.1080/02678370500340728
27. Chevrier N. [Québec adaptation of the Oldenberg burnout inventory (OLBI)] Adaptation québécoise de l’Oldenberg burnout inventory (OLBI) (in French). [PhD Thesis]Université du Québec à Montréal; 2009.
28. Burr H, Berthelsen H, Moncada S, et al. The third version of the Copenhagen Psychosocial Questionnaire. Saf Health Work 2019; 10(4): 482–503. DOI: https://doi.org/10.1016/j.shaw.2019.10.002
29. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess 1988; 52(1): 30–41. DOI: https://doi.org/10.1207/s15327752jpa5201_2
30. Denis A, Callahan S, Bouvard M. Evaluation of the French version of the multidimensional scale of perceived social support during the postpartum period. Matern Child Health J 2015; 19(6): 1245–1251. DOI: https://doi.org/10.1007/s10995-014-1630-9
31. Mikolajczak M, Brasseur S, Fantini-Hauwel C. Measuring intrapersonal and interpersonal EQ: the Short Profile of Emotional Competence (S-PEC). Pers Individ Dif 2014; 65: 42–46. DOI: https://doi.org/10.1016/j.paid.2014.01.023
32. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the self-compassion scale. Clin Psychol Psychother 2011; 18(3): 250–255. DOI: https://doi.org/10.1002/cpp.702
33. Schoendorff B, Roberts S, Bergeron K. Translation of the short-form self-compassion scale validated by Raes et al [unpublished]. Centre d’études sur les TOC et les tics du Centre de recherche Fernand-Seguin; 2011.
34. Glowacz F, Schmits E, Kinard A. The impact of the COVID-19 crisis on the practices and mental health of psychologists in Belgium: between exhaustion and resilience. Int J Environ Res Public Health 2022; 19(21): 14410. DOI: https://doi.org/10.3390/ijerph192114410
35. Jefferson L, Golder S, Heathcote C, et al. GP wellbeing during the COVID-19 pandemic: a systematic review. Br J Gen Pract 2022; 72(718): e325–e333. DOI: https://doi.org/10.1101/2022.01.26.22269874
36. Shanafelt TD. Enhancing meaning in work: a prescription for preventing physician burnout and promoting patient-centered care. JAMA 2009; 302(12): 1338–1340. DOI: https://doi.org/10.1001/jama.2009.1385
37. Gerber Z, Anaki D. The role of self-compassion, concern for others, and basic psychological needs in the reduction of caregiving burnout. Mindfulness (N Y) 2021; 12(3): 741–750. DOI: https://doi.org/10.1007/s12671-020-01540-1
38. Bakker AB, Demerouti E, Sanz-Vergel AI. Burnout and work engagement: the JD–R approach. Annu Rev Organ Psychol Organ Behav 2014; 1(1): 389–411. DOI: https://doi.org/10.1146/annurev-orgpsych-031413-091235
39. Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ 2016; 50(1): 132–149. DOI: https://doi.org/10.1111/medu.12927
40. Bugaj TJ, Valentini J, Miksch A, Schwill S. Work strain and burnout risk in postgraduate trainees in general practice: an overview. Postgrad Med 2020; 132(1): 7–16. DOI: https://doi.org/10.1080/00325481.2019.1675361
41. Salvado M, Marques DL, Pires IM, Silva NM. Mindfulness-based interventions to reduce burnout in primary healthcare professionals: a systematic review and meta-analysis. Healthcare (Basel) 2021; 9(10): 1342. DOI: https://doi.org/10.3390/healthcare9101342
