Is Burnout in Family Physicians in Croatia Related to Interpersonal Quality of Care?

Abstract

The impact of physician burnout on the quality of patient care is unclear. This cross-sectional study aimed to investigate the prevalence of burnout in family physicians in Croatia and its association with physician and practice characteristics, and patient enablement as a consultation outcome measure. Hundred and twenty-fi ve out of 350 family physicians responded to our invitation to participate in the study. They were asked to collect data from 50 consecutive consultations with their adult patients who had to provide information on patient enablement (Patient Enablement Instrument). Physicians themselves provided their demographic and professional data, including workload, job satisfaction, consultation length, and burnout [Maslach Burnout Inventory -Human Services Survey (MBI-HSS )]. MBI-HSS scores were analysed in three dimensions: emotional exhaustion (EE), depersonalisation (DP), and personal accomplishment (PA). Of the responding physicians, 42.4 % scored high for EE burnout, 16.0 % for DP, and 15.2 % for PA. Multiple regression analysis showed that low job satisfaction and more patients per day predicted high EE scores. Low job satisfaction, working more years at a current workplace, and younger age predicted high DP scores. Lack of engagement in education and academic work, shorter consultations, and working more years at current workplace predicted low PA scores, respectively (P<0.05 for each). Burnout is common among family physicians in Croatia yet burnout in our physicians was not associated with patient enablement, suggesting that it did not affect the quality of interpersonal care. Job satisfaction, participation in educational or academic activities and suffi cient consultation time seem to reduce the likelihood of burnout. KEY WORDS: family practice, patient enablement, quality of health careOžvačić Adžić Z, et al. Arh Hig Rada Toksikol 2013;64:255-264 Burnout is a psychological syndrome developed in response to exposure to continuing interpersonal stressors, usually in jobs involving intense interaction with people. Burnout is characterised by feelings of emotional exhaustion (emotional overextension and d e p l e t i o n o f o w n e m o t i o n a l r e s o u r c e s ) , depersonalisation (negative feelings and attitudes toward clients) and reduced sense of personal accomplishment (negative self-evaluation in terms of productivity at work) (1, 2). It is a personal experience related more to situational factors (e.g. workload, time Unauthenticated Download Date | 5/12/18 1:44 AM BURNOUT AND INTERPERSONAL QUALITY OF CARE IN FAMILY MEDICINE IN CROATIA

Empathy and burnout in Slovenian family medicine doctors: The first presentation of jefferson scale of empathy results

“…The correlation between workload and emotional exhaustion ( Table 2 ), supported by the findings highlighting difficult working conditions in Slovenian primary health care, with 90% of physicians dealing with at least 40 patients and 20% with at least 60 patients per day ( Table 2 ), is concordant with a previous Slovenian study of family medicine trainees and Croatian FMDs ( 21 , 37 ). An additional burden was demonstrated in those working in rural family medicine clinics ( Table 3 ), which is concordant with the study in which those working in rural settings scored higher on the MBI ( 28 ).…”

“…In this study, organisational issues are shown to be a high risk factor for burnout ( Table 2 ), high workload being an issue in Slovenia as well as in other developed countries ( 3 , 15 , 37 ). The situation in the country, with an aging population, the lack of physicians working in primary care, a decrease in interest in family medicine residencies, and shortage of time for the patient ( 48 ), suggests an urgent need for psychological help and support for FMDs, taking into consideration empathic attitude, which is associated with the feeling of personal accomplishment.…”

Coping better with health problems after a visit to the family physician: associations with patients and physicians characteristics

“…However to our knowledge, the relationship between family physician job stress factors and patient coping with health trouble has never been investigated. One study has explored potential links between patient enablement and FP burnout and reported negative results [ 17 ].…”

Mental well-being and job satisfaction in general practitioners in Denmark and their patients’ change of general practitioner: a cohort study combining survey data and register data

“…Other studies found that GPs with lower sense of personal accomplishment used less affective communication and were less patient-centred35 and that patients listed with more depersonalised and emotionally exhausted GPs were less satisfied with the consultations with their GP 36. However, other studies found no indications that burnout or job dissatisfaction impaired the quality of interpersonal care 37–39. Some of these differences may be attributable to different burnout definitions.…”

“…Moreover, high conscientiousness could be a risk factor for burnout. Thus, emotionally exhausted GPs may exhibit high levels of thoroughness and attentiveness to patients’ needs in clinical encounters, and hence their patients may experience excellent care 3 38 42. In later stages of burnout, carelessness and disengagement may become more dominant.…”