Burnout in French physicians: A systematic review and meta-analysis.

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, se[b] = 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.

Kansoun Z ，Boyer L ，Hodgkinson M ，Villes V ，Lançon C ，Fond G ... -  《-》

Burnout: Prevalence and Associated Factors Among Radiology Residents in New England With Comparison Against United States Resident Physicians in Other Specialties.

Guenette JP ，Smith SE 《-》

The prevalence, related factors and interventions of oncology nurses' burnout in different continents: A systematic review and meta-analysis.

Ma Y ，Xie T ，Zhang J ，Yang H ... -  《-》

Are French orthopedic and trauma surgeons affected by burnout? Results of a nationwide survey.

Burnout is a pathology that can affect care-giving professionals. It associates emotional exhaustion (EE), depersonalization (DP) and impaired personal accomplishment (PA). Surgery entails great responsibility and frequently heavy workloads, incurring risk of burnout. Data, however, are not available for French orthopedic and trauma surgeons. We therefore conducted a prospective survey to 1) assess burnout prevalence in French orthopedic surgeons, and 2) investigate risk factors and protective factors. Burnout prevalence is at least as high in French orthopedic surgeons as in other medical and surgical specialties. A nationwide survey was conducted in France between February and April 2017, using a digitized questionnaire sent out by e-mail. Burnout was assessed on the MBI (Maslach Burnout Inventory), and depressive symptoms on the GHQ-12 (General Health Questionnaire-12). Demographic and occupational data were also collected. Out of 1,900 surgeons contacted, 441 (23%) responded. Mean age was 50.2±10.1 years; 413 (93.7%) were male. Sixty one (14%) reported elevated EE, 100 (23%) elevated DP, and 82 (19%) impaired AP. One hundred and seventy two (39%) showed burnout symptomatology (e.g., pathologic score on one MBI scale), while 47 (10%) had pathologic scores on 2 or 3 scales, indicating severe burnout. One hundred and ninety three (43%) would not advise their children to take up orthopedic surgery. Thirty eight (8%) expressed suicidal ideation. Statistical analysis identified public-sector practice (OR=4.6; 95% CI: 2.1-10.7; p=0.0002) and pathologic GHQ-12 score (OR=6.3; 95% CI: 2.2-17.8; p=0.0006) as risk factors for burnout. Outside activity (OR=0.39; 95% CI: 0.1-0.9; p=0.0406) and male gender (OR=0.2; 95% CI: 0.05-0.7; p=0.0160) emerged as protective factors. Despite a response rate of only 23% (n=441/1,900), the present study sheds light on burnout rates in French orthopedic surgeons, with 39% burnout symptoms and 10% severe burnout. Burnout impacts personal and occupational life, with increased suicidal ideation and impaired quality of life. The present results confirm the importance of screening and treatment in care-providers. Level IV, prospective descriptive transverse study without control group.

Faivre G ，Marillier G ，Nallet J ，Nezelof S ，Clment I ，Obert L ... -  《-》

Burnout syndrome in orthopaedic and trauma surgery residents in France: A nationwide survey.

Burnout syndrome is one of the manifestations of distress in healthcare workers and is characterised by emotional exhaustion (EE), depersonalisation (DP), and a sense of low personal accomplishment (PA). The surgical residency is a period of intense training that imposes major challenges on future surgeons, who may therefore be at high risk for burnout syndrome. Nevertheless, no data on burnout syndrome in orthopaedic and trauma surgery (OTS) residents in France is available. Therefore we performed a prospective survey to: (1) evaluate the prevalence of burnout syndrome among OTS residents in France, (2) and to look for factors associated with a higher or lower risk of burnout syndrome in the survey respondents. Burnout syndrome is at least as prevalent among OTS residents in France as among residents in other medical and surgical specialities. A nationwide prospective survey was conducted in France between February and April 2017 via a digital questionnaire sent by email. Burnout syndrome was evaluated using the Maslach Burnout Inventory (MBI) and symptoms of depression using the General Health Questionnaire (GHQ-12). Demographic data and information on relationships with partners and working modalities were collected. Of 480 OTS residents, 107 (22%) completed the questionnaire. Mean age was 27 years and 65% (n=70) were male. High EE was reported by 26% (n=28), high DP by 63% (n=68), and low PA by 33% (n=36) of respondents. The scores on two or all three of the MBI sub-scales were abnormal, indicating severe burnout syndrome, in 40% (n=43) of respondents. The GHQ-12 scores indicated symptoms of depression in 40% (n=43) of respondents. Furthermore, 61% (n=66) of respondents stated that they would not recommend OTS or any other area of medicine to their children as a career and 10% (n=11) reported suicidal ideation during the past year. The statistical analysis identified three risk factors for burnout syndrome: medical errors (odds ratio [OR], 8.8; 95% confidence interval [95%CI], 1.7-58.7; p=0.0121), symptoms of depression (OR, 19.3; 95%CI, 2.9-196.0; p=0.0048), and living single (OR, 4.7; 95%CI, 1.4-18.9; p=0.0173). Despite the 22% response rate, this study provides useful information on the prevalence of burnout syndrome among OTS residents in France, with severe burnout in 40% and suicidal ideation in 10%. These prevalences may be overestimations, however, as residents who felt under stress may have been more likely to respond to the survey. In published studies, burnout syndrome was associated with higher risks of medical error and suicidal behaviour. These data emphasise the importance of detecting and managing burnout syndrome in healthcare staff. Prospective descriptive cross-sectional survey with no control group.

Faivre G ，Kielwasser H ，Bourgeois M ，Panouilleres M ，Loisel F ，Obert L ... -  《-》