Job Strain, Burnout, and Suicidal Ideation in Tenured University Hospital Faculty Staff in France in 2021

Abstract

ImportanceThe ability to attract and retain university hospital faculty staff is in jeopardy because of the high levels of mental symptoms in this professional group.ObjectiveTo examine the prevalence and determinants of symptoms of severe burnout, job strain, and suicidal ideation in tenured associate and full professors in university hospitals.Design, Setting, and ParticipantsThis nationwide cross-sectional study offered online surveys to 5332 tenured university hospital faculty members in France from October 25, 2021, to December 20, 2021.ExposuresBurnout and job strain.Main Outcomes and MeasuresParticipants completed the 22-item Maslach Burnout Inventory and a 12-item job strain assessment tool, reported suicidal ideation, and used visual analog scales to evaluate unidimensional parameters. The primary outcome was presence of severe burnout symptoms. Factors associated with mental health symptoms were identified by multivariable logistic regression.ResultsCompleted questionnaires were returned by 2390 of 5332 faculty members (response rate, 45%; range, 43%-46%). Tenured associate professors were a median of 40 (IQR, 37-45) years old with a sex ratio of 1:1, whereas tenured full professors were a median of 53 (IQR, 46-60) years old with a sex ratio of 1:5. Of 2390 respondents, 952 (40%) reported symptoms of severe burnout. Symptoms of job strain (296 professors [12%]) and suicidal ideation (343 professors [14%]) were also reported. Compared with full professors, significantly more associate professors reported feeling overwhelmed at work (496 [73%] vs 972 [57%]; P < .001), considering resignation (365 [54%] vs 834 [49%]; P = .004), or considering a career change (277 [41%] vs 496 [29%]; P < .001). Factors independently associated with less burnout were a longer time being a professor (adjusted odds ratio [aOR], 0.97; 95% CI, 0.96-0.98 per year of age), sleeping well (aOR, 0.88; 95% CI, 0.83-0.92), feeling valued by colleagues (aOR, 0.91; 95% CI, 0.86-0.95 per visual analog scale point) or the public (aOR, 0.92; 95% CI, 0.88-0.96 per visual analog scale point), and accepting more tasks (aOR, 0.82; 95% CI, 0.72-0.93). Factors independently associated with more burnout were having a nonclinical position (OR, 2.48; 95% CI, 1.96-3.16), reporting work encroachment on private life (OR, 1.17; 95% CI, 1.10-1.25), feeling the need to constantly put on a brave face (OR, 1.82; 95% CI, 1.32-2.52), considering a career change (OR, 1.53; 95% CI, 1.22-1.92), and having experienced harassment (OR, 1.52; 95% CI, 1.22-1.88).Conclusions and RelevanceThese findings suggest that the psychological burden on tenured university hospital faculty staff in France is considerable. Hospital administrators and health care authorities should urgently develop strategies for burden prevention and alleviation and for attraction of the next generation.

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“…This result is particularly worrying, considering that mental health problems impact doctors of all categories and all ages in France. In a recent study involving 2,390 French teaching hospital physicians, almost 40% of respondents reported severe burnout, and 12% experienced job strain ( Dres et al, 2023 ). A 2019 meta-analysis estimated the prevalence of burnout at 49% among French doctors, and at 52% among residents ( Kansoun et al, 2019 ).…”

“…Thus, the impact of psycho-social risk factors, workplace stress and violence, has been identified as crucial determinants of psychological wellbeing ( Rugulies et al, 2023 ) in particular in the healthcare sector ( Hu et al, 2019 ; Kansoun et al, 2019 ; Dres et al, 2023 ). The overall proportion of healthcare workers who report experiencing violence at work has been estimated to reach nearly 80% ( Rossi et al, 2023 ).…”

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