Burnout in emergency medicine physicians

Abstract

Background: Physician burnout has been a global problem that affects severely the mental status among doctors, especially in emergency medicine (EM). However, few studies have focused on emergency medicine physicians, and the published data are inconsistent. Thus, this meta-analysis is performed to systematically evaluate the prevalence of burnout among emergency medicine physicians. Methods: We systematically searched databases including PubMed, Embase, PsychINFO and the Cochrane Library from inception to September, 2019 for English-language articles. We selected all the original articles those used Maslach Burnout Inventory to assess the prevalence of burnout and its 3 dimensions emotional exhaustion (EE), depersonalization, and personal accomplishment (PA) in emergency medicine physicians. After literature screening, quality evaluation was performed for eligible studies by using the Joanna Briggs Institute (JBI) critical appraisal checklist for studies reporting prevalence data; then, Begg test and Egger test was used to assess publication bias. Pooled prevalence rates were assessed by conducting a meta-analysis using random effects models. Then sensitivity analysis followed to test the stability of the result and detected the source of heterogeneity. Results: A total of 1943 EM physicians provided burnout data. The pooled prevalence rates of high levels of emotional exhaustion, high levels of depersonalization and low levels of PA were 40% (95% CI: 26%–55%; I 2 = 97.4%), 41% (95% CI: 30%–52%; I 2 = 94.5%) and 35% (95% CI: 19%–52%; I 2 = 99.0%), respectively. The mean burnout scores were 23.95 (SD = 11.88) for emotional exhaustion, 11.63 (SD = 6.85) for depersonalization, and 34.69 (SD = 7.71) for PA. Conclusions: This meta-analysis demonstrate a high level of burnout prevalent in EM physicians that approximately 40% experience high levels of EE and depersonalization. Our findings also suggest that EM physicians are more susceptible to burnout compared with physicians in other departments and other medical staffs in EM. More attention should be payed to mental status of EM physicians and further investigation concerning how to reduce burnout would be beneficial for EM physicians. Registration: INPLASY202060060 in inplasy.com (doi.org/10.37766/inplasy2020.6.0060)

Experiences and management of physician psychological symptoms during infectious disease outbreaks: a rapid review

“…The most common psychological symptoms measured with surveys or validated questionnaires reported included anxiety ( n = 103), depression ( n = 73), stress ( n = 68), fear ( n = 61), burnout ( n = 25), mental distress/health ( n = 21), and post-traumatic stress disorder (PTSD) ( n = 14) (Additional File 3 ). Most COVID-19 studies reported on physicians from USA ( n = 23) [ 41 , 52 , 66 , 70 , 77 , 90 – 107 ], China ( n = 22) [ 15 , 49 , 54 – 56 , 65 , 68 , 73 , 86 , 89 , 102 , 108 – 118 ] followed by India ( n = 21) [ 40 , 50 , 58 , 63 , 67 , 71 , 102 , 119 – 132 ] [ 41 , 52 , 66 , 70 , 77 ], Italy ( n = 10) [ 32 , 94 , 102 , 125 , 133 – 138 ], and Turkey ( n = 11) [ 35 , 44 , 94 , 139 – 146 ] [ 28 , 30 , 32 , 34 , 36 , 37 , 42 , 45 , 47 , 48 , 59 , 60 , 62 , 80 , 87 ]. .Sixtee...…”

“…Physicians working more days, with higher patient volumes, or with increased duties than before than pandemic also had an increased prevalence of psychological symptoms [ 96 , 101 , 122 , 128 , 149 , 187 , 192 , 195 , 198 ]. Eighteen studies reported on insomnia [ 32 , 35 , 36 , 54 , 65 , 69 , 88 , 114 , 128 , 145 , 149 , 163 , 175 , 177 , 181 , 188 , 192 , 194 ], which is associated with psychiatric disorders and is a risk factor for depression and anxiety [ 15 , 32 , 54 , 65 , 69 , 199 , 200 ]. During the SARS outbreak, physicians of Asian descent felt more stigmatized than their Caucasian colleagues (Canada) [ 15 , 32 , 35 , 36 , 46 , 54 , 65 , 69 , 88 , 114 , 128 , 145 , 149 , 163 , 175 , 177 , 181 , 188 , 192 , 194 , 199 , 200 ].…”

“…Prior to the COVID-19 pandemic, studies reported that physicians experienced unprecedented levels of burnout [ 10 – 15 ]. Burnout among physicians is reported to be as high as 70% [ 16 ], and has been reported to be higher than registered nurses (RNs) and respiratory therapists [ 17 , 18 ].…”

The Burden of Burnout among Healthcare Professionals of Intensive Care Units and Emergency Departments during the COVID-19 Pandemic: A Systematic Review

“…Indeed, several systematic reviews explored this issue, reporting the lowest values of burnout prevalence from 6% [34] to 25.4% [36] and the highest from 41% [19] to 71.4% [36]. Moreover, considering the different dimensions of burnout, the prepandemic prevalence of highly burned-out ICU/ED professionals was remarkable, being approximately around 40% for high emotional exhaustion, high depersonalization, and low personal accomplishment [37,38]. Thus, although it seems clear that a great percentage of ICU/ED staff is currently suffering from burnout, this population has presented a high prevalence of this condition for a long time, and there is not sufficient evidence to understand if such prevalence increased due to the pandemic.…”

Prevalence of burnout among intensivists in mainland China: a nationwide cross-sectional survey

“…The prevalence observed here is also higher than that in previous Chinese studies [ 19 – 21 ], but those studies were limited to specific regions or cities. Nevertheless, a recent meta-analysis reveals that 40% emergency medicine physicians have high levels of EE and DP [ 26 ]. The differences might be due to fundamental differences in the medical systems between China and the West.…”