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Shi H, Zhao H, He M, Ren Z, Wang S, Cui L, Zhao J, Li W, Wei Y, Zhang W, Chen Z, Liu H, Zhang X. The mediating roles of coping styles and academic burnout in the relationship between stressors and depressive symptoms among Chinese postgraduates. PeerJ 2023; 11:e16064. [PMID: 37744225 PMCID: PMC10512960 DOI: 10.7717/peerj.16064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Background Since few studies have incorporated factors like stressors, coping styles, and academic burnout into the same model to analyze their impacts on depressive symptoms, this research attempts to establish an optimal structural model to explore the direct and indirect effects of these factors on depressive symptoms. Methods A total of 266 postgraduates completed questionnaires regarding coping styles, academic burnout, stressors, and depressive symptoms. The path analysis was applied for investigating the roles of coping styles and academic burnout in mediating the relationship between stressors and depressive symptoms. Results The total and direct effects of stressors on depressive symptoms were 0.53 and 0.31, respectively. The proportion of the direct effect of stressors on depressive symptoms to its total effect amounted to 58.50%. The indirect effects of academic burnout, positive coping style, and negative coping style on the association between stressors and depressive symptoms were 0.11, 0.04, and 0.03, taking up 20.75%, 7.55%, and 5.66% of the total effect, respectively. The serial indirect effect of positive coping style and academic burnout was 0.02, accounting for 3.77% of the total effect, while that of negative coping style and academic burnout was 0.02, taking up 3.77% of the total effect. Conclusions Coping styles and academic burnout chain jointly mediate the relationship between stressors and depressive symptoms among postgraduates. Thus, encouraging postgraduates to tackle stress positively may reduce the likelihood of the development of academic burnout and further reduce depressive symptoms.
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Affiliation(s)
- Hong Shi
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Hanfang Zhao
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Shixun Wang
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Li Cui
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Jieyu Zhao
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Wenjun Li
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Yachen Wei
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Wenjing Zhang
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Ziqiang Chen
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
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Zhou W, Pu J, Zhong X, Yang W, Teng T, Fan L, Wang H, Tian L, Liu Y, Xie P. Overlap of burnout-depression symptoms among Chinese neurology graduate students in a national cross-sectional study. BMC MEDICAL EDUCATION 2021; 21:83. [PMID: 33530985 PMCID: PMC7851928 DOI: 10.1186/s12909-021-02511-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/21/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND The overlap of burnout and depression is a phenomenon that can effectively reflect the psychological state of a group. However, whether burnout is a type of depression is still debated in current research. The high incidence of burnout and depressive symptoms among medical students indicates that it is urgent to provide appropriate health services for them. However, the proportion of burnout and depression in the overlapping symptoms experienced by medical students, and the characteristics of the relative influencing factors, remain unclear. Therefore, we addressed these issues for neurology graduate students in China. METHODS Using data from a cross-sectional survey of Chinese neurology graduate students, a diagnostic model was established according to their burnout and/or depression symptoms. Burnout was assessed by using the Maslach Burnout Inventory. Depression symptoms were assessed with a two-item depression screening tool for primary care evaluation of mental disorders. Univariate analyses with chi-squared tests were conducted to assess associations between variables. Multinomial logistic regression models were used to analyze the effects of multiple factors on dependent variables. The factors included demographic information and three medical-study related problems. RESULTS In total, 32.2% of surveyed students evidenced overlapping burnout and depression symptoms. Students with depressive symptoms tended to be included in the burnout students' category. In the regression model, being unmarried, having children, and career choice regret were related to students who had only burnout, while the students with overlapping symptoms were affected by more factors such as family income, the consideration of dropping out once. CONCLUSIONS The symptoms and related factors of burnout and depression among Chinese neurology postgraduates have obvious overlap and show a significant trend. The occurrence of depressive symptoms among medical students is closely related to whether they are burned out. Students with only burnout were common, but students with only depressive symptoms were uncommon. Finally, burnout may be a pre-depression state.
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Affiliation(s)
- Wei Zhou
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Juncai Pu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xiaogang Zhong
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Wensong Yang
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Teng Teng
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Li Fan
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Haiyang Wang
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
- Stomatological Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Lu Tian
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Yiyun Liu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Peng Xie
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China.
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
- China Neurologist Association of Chinese Medical Doctor Association, Beijing, 100010, China.
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Nishimura Y, Miyoshi T, Obika M, Ogawa H, Kataoka H, Otsuka F. Factors related to burnout in resident physicians in Japan. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2019; 10:129-135. [PMID: 31272084 PMCID: PMC6766397 DOI: 10.5116/ijme.5caf.53ad] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 04/11/2019] [Indexed: 06/01/2023]
Abstract
OBJECTIVES We explore the prevalence and characteristics of burnout among Japanese resident physicians and identifies factors associated with burnout. METHODS A cross-sectional study was conducted three times between April 2017 and March 2018 at a Japanese teaching hospital. Resident physicians were invited to answer an online survey that included existing valid instruments related to burnout, depression, and empathy. Demographic, background, occupational, and socioeconomic data were also collected. Participants were prompted to report the average daily work hours and the specialty they wish to pursue. RESULTS Overall, 39/76 (51%), 27/76 (36%), and 21/76 (28%) resident physicians responded to surveys in April 2017, October 2017, and March 2018, respectively. The percentages of participants with burnout for surveys in April 2017, October 2017, and March 2018 were 7/39 (18%), 6/27 (22%), and 7/21 (33.3%). Emotional exhaustion (EE) was the only burnout component strongly correlated with the severity of depression (r = .615, p < .001; r = .706, p < .001; r = .601, p < .01). EE and depersonalization (DP) had no significant correlation with average daily working hours (β = .156, p = .343 for EE; β = .061, p = .711 for DP). CONCLUSIONS The results suggest that capping working hours alone may not be effective in reducing burnout in Japanese resident physicians. Medical educators might need to consider not only working hours but also individual job quality and satisfaction to address burnout. Future studies may need to incorporate qualitative methods to explore the characteristics of burnout.
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Affiliation(s)
- Yoshito Nishimura
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tomoko Miyoshi
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Mikako Obika
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroko Ogawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hitomi Kataoka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Care for Dying Children and Their Families in the PICU: Promoting Clinician Education, Support, and Resilience. Pediatr Crit Care Med 2018; 19:S79-S85. [PMID: 30080815 DOI: 10.1097/pcc.0000000000001594] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe the consequences of workplace stressors on healthcare clinicians in PICU, and strategies for personal well-being, and professional effectiveness in providing high-quality end-of-life care. DATA SOURCES Literature review, clinical experience, and expert opinion. STUDY SELECTION A sampling of foundational and current evidence was accessed. DATA SYNTHESIS Narrative review and experiential reflection. CONCLUSIONS The well-being of healthcare clinicians in the PICU influences the day-to-day quality and effectiveness of patient care, team functioning, and the retention of skilled individuals in the PICU workforce. End-of-life care, including decision making, can be complicated. Both are major stressors for PICU staff that can lead to adverse personal and professional consequences. Overresponsiveness to routine stressors may be seen in those with moral distress, and underresponsiveness may be seen in those with compassion fatigue or burnout. Ideally, all healthcare professionals in PICU can rise to the day-to-day workplace challenges-responding in an adaptive, effective manner. Strategies to proactively increase resilience and well-being include self-awareness, self-care, situational awareness, and education to increase confidence and skills for providing end-of-life care. Reactive strategies include case conferences, prebriefings in ongoing preidentified situations, debriefings, and other postevent meetings. Nurturing a culture of practice that acknowledges the emotional impacts of pediatric critical care work and celebrates the shared experiences of families and clinicians to build resilient, effective, and professionally fulfilled healthcare professionals thus enabling the provision of high-quality end-of-life care for children and their families.
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