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High Level of Burnout in Intensivists

Prevalence and Associated Factors

¹ Medical Intensive Care Unit, Hôpital Sainte-Marguerite Teaching Hospital, Université de la Méditerranée, Marseille, France; ² Medical Intensive Care Unit, Saint Louis Teaching Hospital, Paris, France; ³ Laboratoire de Santé Publique, Faculté de Médecine, Marseille, France; ⁴ Département de Sociologie, Université Victor Segalen, Bordeaux, France; and ⁵ Maison des Adolescents, Cochin-Port Royal Teaching Hospital, Paris, France

Correspondence and requests for reprints should be addressed to Laurent Papazian, M.D., Ph.D., Medical Intensive Care Unit, Hôpital Sainte-Marguerite Teaching Hospital, Université de la Méditerranée, Marseille 13009, France. E-mail address: laurent.papazian{at}ap-hm.fr

Rationale: Professional burnout is a psychological syndrome arising in response to chronic interpersonal stressors on the job. There is the perception that intensivists are particularly exposed to stress because lives are literally in their hands.

Objective: To evaluate the prevalence and associated factors (patients or organization) of burnout among physicians working in intensive care units (ICUs) (including interns, residents, fellows, and attending physicians).

Methods: A 1-day national survey was conducted in adult ICUs in French public hospitals.

Measurements: The level of burnout was evaluated on the basis of the Maslach Burnout Inventory (MBI).

Main Results: A total of 189 ICUs participated and 978 surveys were returned (82.3% response rate). A high level of burnout was identified in 46.5% of the respondents. Ordinal logistic regression showed that female sex (odds ratio, 1.58; 95% confidence interval, 1.09 to 2.30) was independently associated with a higher MBI score. Whereas no factor related to the severity of illness of patients was retained by the model, organizational factors were strongly associated with a higher MBI score. Workload (the number of night shifts per month, a long period of time from the last nonworking week, night shift the day before the survey) and impaired relationships (such as conflict with another colleague intensivist, and/or with a nurse) were the variables independently associated with a higher MBI score. In contrast, the quality of the relationships with chief nurses and nurses was associated with a lower MBI score.

Conclusions: Approximately one-half of the intensivists presented a high level of burnout. Organizational factors, but not factors related to the patients, appeared to be associated with burnout.

Key Words: intensive care unit • organizational management • conflict

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject Little is known about burnout in intensivists (including both juniors and seniors). Associated factors have not been identified. What This Study Adds to the Field The present study suggests that a high level of burnout is present in about 50% of intensivists. Organizational factors, but not factors related to patients, appear to be associated with burnout.

 

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