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Mental health
Original research
Associations between job demands, job resources and patient-related burnout among physicians: results from a multicentre observational study
  1. Renée Scheepers1,2,
  2. Milou Silkens3,
  3. Joost van den Berg4,
  4. Kiki Lombarts2
  1. 1Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
  2. 2Medical Psychology, Amsterdam University Medical Centres, Amsterdam, Noord-Holland, The Netherlands
  3. 3Research Department of Medical Education, University College London, London, UK
  4. 4Internal Medicine, Amsterdam University Medical Centres, Amsterdam, Noord-Holland, The Netherlands
  1. Correspondence to Dr Renée Scheepers; scheepers{at}eshpm.eur.nl

Abstract

Objectives To investigate associations of job demands and resources with patient-related burnout among physicians.

Design Multicentre observational study.

Setting Fifty medical departments at 14 (academic and non-academic) hospitals in the Netherlands.

Participants Four hundred sixty-five physicians (71.6% response rate), comprising 385 (82.8%) medical specialists and 80 (17.2%) residents.

Main outcome measures Job demands (workload and bureaucratic demands), job resources (participation in decision making, development opportunities, leader’s inspiration, relationships with colleagues and patients)—measured with the validated Questionnaire of Experience and Evaluation of Work and Physician Worklife Survey—and patient-related burnout, measured using the validated Copenhagen Burnout Inventory.

Results Patient-related burnout was positively associated with workload (b=0.36; 95% CI, 0.25 to 0.48; p<0.001) and negatively associated with development opportunities (b=–0.18; 95% CI, –0.27 to –0.08; p<0.001) and relationships with patients (b=–0.12; 95% CI, –0.22 to –0.03; p=0.01). Relationships with patients moderated the association between bureaucratic demands and patient-related burnout (b=–0.15; 95% CI, –0.27 to –0.04; p=0.01).

Conclusions Physicians with high workloads and few development opportunities reported higher levels of patient-related burnout. Those with positive patient relationships were less likely to experience patient-related burnout, even in the presence of excessive bureaucracy. Therefore, positive physician–patient relationships may be supported to reduce the likelihood of physicians’ patient-related burnout. However, the specific support needed to effectively reduce patient-related burnout may vary per healthcare context and thus requires intensified research across healthcare systems and settings.

  • health policy
  • human resource management
  • quality in health care
  • medical education & training
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

http://dx.doi.org/10.1136/bmjopen-2020-038466

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    Footnotes

    • Contributors RS conceptualised and designed the study; acquired and interpreted study data; drafted the article; and gave final approval of the version to be published. MS contributed to the design of the study; analysed and interpreted study data; drafted the article; and gave final approval of the version to be published. JvdB contributed to the design of the study; interpreted study data; critically revised the article; and gave final approval of the version to be published. KL conceptualised and designed the study; acquired and interpreted study data; critically revised the article; and gave final approval of the version to be published. All authors agree to be accountable for all aspects of the study in ensuring that questions related to the accuracy or integrity of any part of the study are appropriately investigated and resolved.

    • Funding The study was funded by the Dutch Ministry of Social Affairs and Employment.

    • Disclaimer This Ministry had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. All authors confirm their independence from funders and had full access to all of study data and take responsibility for the integrity of the data and the accuracy of the data analysis is also required.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval Ethical approval was waived by the Medical Ethics Committee of the Amsterdam University Medical Centre (ID XT4-118). All participants gave informed consent before taking part.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data may be obtained from a third party and are not publicly available. No additional data available, as data are protected under contract with participating medical centres. Nonetheless, inquiries about potential research collaboration can be directed to Professor Kiki Lombarts (m.j.lombarts@amsterdamumc.nl).