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Psychosocial work characteristics, burnout, psychological morbidity symptoms and early retirement intentions: a cross-sectional study of NHS consultants in the UK
  1. Atir Khan1,
  2. Kevin RH Teoh2,
  3. Saiful Islam3,
  4. Juliet Hassard4
  1. 1 Diabetes Centre, Glangwili Hospital, Hywel Dda University Health Board, Carmarthen, UK
  2. 2 Department of Organizational Psychology, Birkbeck University of London, London, UK
  3. 3 Swansea Trials Unit, College of Medicine, Swansea University, Swansea, UK
  4. 4 Centre for Organisational Health and Development, Institute of Mental Health, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
  1. Correspondence to Dr Atir Khan; atir.khan45{at}


Objectives The objectives of this study are twofold. First, to examine the direct effect of psychosocial work characteristics (as measured by job autonomy and work-related pressure) in relation to self-reported psychological morbidity symptoms and early retirement intentions among a sample of hospital consultants in the National Health Service (NHS). Second, to investigate burnout as mediating variable (ie, indirect effect) of these postulated associations.

Design A cross-sectional observational study.

Participants 593 NHS consultants (male=63.1%) from hospitals in England, Scotland and Wales.

Measures Self-reported online questionnaires on work-related pressure and job autonomy (Job Demands-Resources Questionnaire); emotional exhaustion and depersonalisation (Maslach Burnout Inventory); depressive and anxiety symptoms (State Trait Personality Inventory) and a single-item on early retirement intention.

Results This study observed high prevalence rates across all adverse health measures: emotional exhaustion (38.7%), depersonalisation (20.7%), anxiety symptoms (43.1%) and depressive symptoms (36.1%). Multiple linear regressions examined the postulated direct and indirect effects. Job autonomy had significant negative direct effects on the frequency of NHS consultants’ anxiety and depressive symptoms, and their intention to retire early. Both emotional exhaustion and depersonalisation mediated the relationships that work-related pressure (full mediation) and job autonomy (partial mediation) had with self-reported symptoms of psychological morbidities. Only emotional exhaustion mediated the relationships where early retirement intention was the outcome. In terms of sociodemographic factors, age and years’ experience predicted both burnout dimensions and psychological morbidity.

Conclusions This is the first study to observe job autonomy to be associated with the number of self-reported psychological morbidity symptoms and early retirement intentions in a sample of NHS consultants. Burnout dimensions mediated these relationships, indicating that interventions need to focus on enhancing working conditions and addressing burnout among NHS consultants before more severe symptoms of psychological morbidity are reported. This study has implications for NHS policy makers and senior leadership.

  • psychological morbidity
  • autonomy
  • burnout
  • working conditions
  • retirement intentions

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  • Contributors AK and JH conceived the study concept and design. AK and KT drafted the first version of the manuscript. KT and JH provided critical revision of the manuscript as it went through the revision process. SI and KT did the data management and statistical analyses. All authors contributed to the content and critical revision of the report, and agreed to submit the report for publication.

  • Funding This study was funded by a study grant from the Research & Development Department Hywel Dda University Health Board. Publication costs were supported by Hywel Dda University Health Board R&D Department

  • Competing interests None declared.

  • Patient consent Not reqired.

  • Ethics approval The study received ethical approval from Birkbeck University of London.

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

  • Data sharing statement Individual participant data collected under this study were deidentified which are reported in the form of tables. The original proposal of the study will be available on request. Deidentified data will be shared for non-commercial research purpose given the consent of the lead author after the publications as per guidelines of the BMJ Open.

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