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Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Explaining burnout and the intention to leave the profession among health professionals – a cross-sectional study in a hospital setting in Switzerland

Author: Oliver Hämmig

Published in: BMC Health Services Research | Issue 1/2018

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Abstract

Background

Burnout and the intention to leave the profession are frequently studied outcomes in healthcare settings that have not been investigated together and across different health professions before. This study aimed to examine work-related explanatory factors or predictors of burnout and the intention to leave the profession among health professionals in general, and nurses and physicians in particular.

Methods

Cross-sectional survey data of 1840 employees of six public hospitals and rehabilitation clinics recorded in 2015/16 in German-speaking Switzerland were used. Multiple logistic and stepwise linear regression analyses were performed to estimate the relative risks (odds ratios) and standardized effects (beta coefficients) of different workloads and work-related stressors on these outcomes and to study any possible mediation between them.

Results

On average, one in twelve health professionals showed increased burnout symptoms and every sixth one thought frequently of leaving the profession. Temporal, physical, emotional and mental workloads and job stresses were strongly and positively associated with burnout symptoms and thoughts of leaving the profession. However, the relative risks of increased burnout symptoms and frequent thoughts of leaving the profession were highest in the case of effort-reward and work-life imbalances. In fact, these two work-related stress measures partly or even largely mediated the relationships between exposures (workloads, job stresses) and outcomes and were found to be the strongest predictors of all. Whereas a work-life imbalance most strongly predicted burnout symptoms among health professionals (β = .35), and particularly physicians (β = .48), an effort-reward imbalance most strongly predicted thoughts of leaving the profession (β = .31–36). A substantial part of the variance was explained in the fully specified regression models across both major health professions and both outcomes. However, explained variance was most pronounced for burnout symptoms of physicians (43.3%) and for frequent thoughts of leaving the profession among nurses and midwives (28.7%).

Conclusions

Reducing workload and job stress, and particularly reward frustration at work, as well as the difficulties in combining work and private lives among health professionals, may help to prevent them from developing burnout and/or leaving the profession and consequently also to reduce turnover, early retirement, career endings and understaffing in healthcare settings.
Literature
2.
go back to reference Virtanen P, Oksanen T, Kivimäki M, Virtanen M, Pentti J, Vahtera J. Work stress and health in primary health care physicians and hospital physicians. Occup Environ Med. 2008;65(5):364–6.CrossRef Virtanen P, Oksanen T, Kivimäki M, Virtanen M, Pentti J, Vahtera J. Work stress and health in primary health care physicians and hospital physicians. Occup Environ Med. 2008;65(5):364–6.CrossRef
3.
go back to reference Weinberg A, Creed F. Stress and psychiatric disorder in healthcare professionals and hospital staff. Lancet. 2000;355(9203):533–7.CrossRef Weinberg A, Creed F. Stress and psychiatric disorder in healthcare professionals and hospital staff. Lancet. 2000;355(9203):533–7.CrossRef
4.
go back to reference Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.
5.
go back to reference Maslach C, Goldberg J. Prevention of burnout: new perspectives. Appl Prev Psychol. 1998;7:63–74.CrossRef Maslach C, Goldberg J. Prevention of burnout: new perspectives. Appl Prev Psychol. 1998;7:63–74.CrossRef
12.
go back to reference Pantenburg B, Luppa M, König HH, Riedel-Heller SG. Überlegungen junger Ärztinnen und Ärzte aus der Patientenversorgung auszusteigen – Ergebnisse eines surveys in Sachsen [young physicians’ thoughts about leaving patient care – results of a survey in Saxony, Germany]. Gesundheitswesen. 2014;76(7):406–12. https://doi.org/10.1055/s-0034-1381986.CrossRefPubMed Pantenburg B, Luppa M, König HH, Riedel-Heller SG. Überlegungen junger Ärztinnen und Ärzte aus der Patientenversorgung auszusteigen – Ergebnisse eines surveys in Sachsen [young physicians’ thoughts about leaving patient care – results of a survey in Saxony, Germany]. Gesundheitswesen. 2014;76(7):406–12. https://​doi.​org/​10.​1055/​s-0034-1381986.CrossRefPubMed
16.
go back to reference Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377–85.CrossRef Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377–85.CrossRef
17.
go back to reference Bagaajav A, Myagmarjav S, Nanjid K, Otgon S, Chae YM. Burnout and job stress among Mongolian doctors and nurses. Ind Health. 2011;49(5):582–8.CrossRef Bagaajav A, Myagmarjav S, Nanjid K, Otgon S, Chae YM. Burnout and job stress among Mongolian doctors and nurses. Ind Health. 2011;49(5):582–8.CrossRef
22.
go back to reference Bakker AB, Killmer CH, Siegrist J, Schaufeli WB. Effort-reward imbalance and burnout among nurses. J Adv Nurs. 2000;31(4):884–91.CrossRef Bakker AB, Killmer CH, Siegrist J, Schaufeli WB. Effort-reward imbalance and burnout among nurses. J Adv Nurs. 2000;31(4):884–91.CrossRef
23.
go back to reference Grassi L, Magnani K. Psychiatric morbidity and burnout in the medical profession: an Italian study of general practitioners and hospital physicians. Psychother Psychosom. 2000;69(6):329–34.CrossRef Grassi L, Magnani K. Psychiatric morbidity and burnout in the medical profession: an Italian study of general practitioners and hospital physicians. Psychother Psychosom. 2000;69(6):329–34.CrossRef
26.
go back to reference Siegrist J, Starke D, Chandola T, Godin I, Marmot M, Niedhammer I, et al. The measurement of effort-reward imbalance at work: European comparisons. Soc Sci Med. 2004;58(8):1483–99.CrossRef Siegrist J, Starke D, Chandola T, Godin I, Marmot M, Niedhammer I, et al. The measurement of effort-reward imbalance at work: European comparisons. Soc Sci Med. 2004;58(8):1483–99.CrossRef
27.
go back to reference Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996;1(1):27–41.CrossRef Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996;1(1):27–41.CrossRef
28.
go back to reference Netemeyer RG, Boles JS, McMurrian R. Development and validation of work-family conflict and family-work conflict scales. J Appl Psychol. 1996;81(4):400–10.CrossRef Netemeyer RG, Boles JS, McMurrian R. Development and validation of work-family conflict and family-work conflict scales. J Appl Psychol. 1996;81(4):400–10.CrossRef
30.
go back to reference Borritz M, Rugulies R, Bjorner JB, Villadsen E, Mikkelsen OA, Kristensen TS. Burnout among employees in human service work: design and baseline findings of the PUMA study. Scand J Public Health. 2006;34(1):49–58.CrossRef Borritz M, Rugulies R, Bjorner JB, Villadsen E, Mikkelsen OA, Kristensen TS. Burnout among employees in human service work: design and baseline findings of the PUMA study. Scand J Public Health. 2006;34(1):49–58.CrossRef
Metadata
Title
Explaining burnout and the intention to leave the profession among health professionals – a cross-sectional study in a hospital setting in Switzerland
Author
Oliver Hämmig
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3556-1

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