Published ahead of print on January 18, 2007, doi:10.1164/rccm.200608-1184OC Am. J. Respir. Crit. Care Med., Volume 175, Number 7, April 2007, 686-692 A more recent version of this article appeared on April 1, 2007
Submitted on August 21, 2006 High Level of Burnout in Intensivists: Prevalence and Associated FactorsNathalie Embriaco1,1 Medical ICU, Hopital Sainte-Marguerite Teaching Hospital, Universite de la Mediterranee, Marseille, France, 2 Medical ICU, Saint Louis Teaching Hospital, Paris, France, 3 Faculte de Medecine, Laboratoire de Sante Publique, Marseille, France, 4 Departement de Sociologie, Universite Victor Segalen, Bordeaux, France, 5 Maison des Adolescents, Cochin-Port Royal Teaching Hospital, Paris, France * To whom correspondence should be addressed. E-mail: laurent.papazian{at}ap-hm.fr.
Rationale: Professional burnout is a psychological syndrome in response to chronic interpersonal stressors on the job. There is the perception that intensivists are particularly exposed to stress since 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 unit (including interns, residents, fellows and attending physicians). Methods: A one-day national survey was conducted in adult intensive care units (ICU) in French public hospitals. Measurements: The level of burnout was evaluated using the Maslach Burnout Inventory (MBI) scale. 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 [OR=1.58 (95% CI, 1.09 to 2.30)] was independently associated with a higher MBI score. While 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 from the last non-working 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, appeared to be associated with burnout. Improving job environment and atmosphere could decrease the level of burnout. Key words: intensive care unit; organizational management; conflict
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