地域医療と健康教育

抽象的な

Professional Risk Factors for Burnout among Medical Residents

Deschamps F, Castanon J, Laraqui O, Manar N, Laraqui C, Gregoris M and Dramé M

Study background: We aimed to identify professional risk factors for burnout among residents in medicine and surgery.
Materials and methods: Epidemiological, observational, and cross-sectional study among trainee physicians working in the Champagne-Ardenne region, from 31 March to 3 May 2015. Burnout was assessed using the Maslach Burnout Inventory (MBI). Variables recorded included the location of the residency, the type of unit (hospitalisation ward, emergency department, consultations), workload, and exposure to patients’ suffering. Karasek’s Job Content Questionnaire was also administered. For each component of the MBI, univariate and binary logistic regression was performed to identify risk factors.
Results: In total, 191 out of 644 eligible residents (29.7%) completed the survey. The majority were working in conditions likely to pose a risk to their health: 42.4% were exposed to job strain, and 19.9% had iso-strain. Overall, 62.8% of residents presented at least one component of burnout as assessed by the MBI. By multivariate analysis, risk factors for emotional exhaustion were high psychological demands (Odds Ratio (OR) 1.16; 95% confidence interval (95% CI) 1.05-1.29) and iso-strain (OR 3.25; 95% CI 1.29-8.22), while high psychological demands were also a risk factor for depersonalization (OR 1.14; 95% CI 1.07-1.22). Working in a hospitalisation unit (OR 3.66; 95% CI 1.30-10.3) and not meeting patients’ families (OR 11.7; 95% CI 3.08-44.4) were risk factors for a feeling of low personal accomplishment, whereas increased decision latitude had a protective effect (OR 0.95; 95% CI 0.91-0.99).
Conclusion: This study identifies occupational risk factors for burnout among residents in training, and provides a useful basis for preventive measures aimed at changing the organisational structure in the hospital setting with a view to improving mental health among trainee physicians.