SE12 THE RELATIONSHIP BETWEEN BURNOUT AND EMOTIONAL INTELLIGENCE IN AUSTRALIAN SURGEONS AND SURGICAL TRAINEES

Wellness and burnout in cardiac surgery: not black and white

PURPOSE OF REVIEW

Despite a growing emphasis on burnout in medicine, there remains a paucity of data in cardiac surgery. Herein, we summarize recent data on cardiac surgeon well being and identify factors for consideration in future burnout inquiries and management.

RECENT FINDINGS

Overall, 70-90% of cardiothoracic surgeons report job satisfaction in the United States. However, 35-60% still endorse burnout symptoms, and the specialty reports some of the highest rates of depression (35-40%) and suicidal ideation (7%). Such negative experiences are greater among early-stage and female surgeons and may be addressed through targeted, program-specific wellness policies. Canada's single-payer healthcare system might exacerbate surgeon burnout due to lower financial compensation and job autonomy.

SUMMARY

Cardiothoracic surgeons appear simultaneously burnt out and professionally fulfilled. They report a high incidence of depression and clock in the most hours, yet the majority would choose this specialty again. These findings reveal a more nuanced state of well being than previously appreciated and speak to ambiguities in how burnout is conceived and measured. A broader examination across surgical and social contexts highlights the hierarchical nature of burnout factors and potential ways forward. Collectively, these insights can inform assessments of burnout in Canadian cardiac surgery that remain absent to date.

Emotional Intelligence and Burnout in Plastic Surgery Residents: Is There a Relationship?

Background:

The specific role of emotional intelligence (EI) in the field of plastic surgery has not been investigated. We aim to investigate the relationship between EI and the individual components of burnout among plastic surgery residents in Saudi Arabia.

Methods:

In this cross-sectional study, all plastic surgery residents (n = 37) in Riyadh, Saudi Arabia, were invited to participate in a questionnaire based study in March 2018. The survey contained a validated measure of burnout (Maslach Burnout Inventory-Human Services Survey), validated measure of EI (Trait Emotional Intelligence Questionnaire-Short Form), and evaluated residents’ demographics, professional and personal risk factors, and career satisfaction.

Results:

The overall rate of high burnout was 37.9%, with 72.4% residents reporting high level of emotional exhaustion (EE), 41% reporting high depersonalization (DP) and 41% reporting low sense of personal accomplishment (PA). EI has shown to have a significant negative relationship with EE (95% confidence interval CI, −9.061 to −1.374; P = 0.010), DP (95% CI, −5.747 to −1.974; P < 0.001), and a significant positive correlation with PA (95% CI, 1.398–5.439; P = 0.002). Significant risk factors for burnout included dissatisfaction with plastic surgery as a career choice, dissatisfaction with income, and dissatisfaction with the role in the operating room (P < 0.05).

Conclusions:

We found a positive correlation between higher levels of EI and sense of personal achievement, whereas a negative correlation was observed between higher level of EI and EE and DP among the residents in this study. Plastic surgery residents who are satisfied with their salary have lower EE and DP. Residents who are satisfied with their role in the operating room have a better sense of PA.

Clinical depression: surgeons and mental illness

Surgeons are among the least likely of all medical practitioners to seek help for mental health problems. What makes them a minority within a minority?

Burnout among surgical residents in a lower-middle income country - Are we any different?

Objective

To assess the presence of burnout among surgical residents working at various public sector hospitals in Pakistan.

Design

A survey based on MBI was used to assess the presence of burnout. Residents were grouped into Group A (Burn out) or Group B (No burn out). Pearson Test was used to see any correlation between different variables and burn out. A p value of <0.05 was taken as significant.

Setting/participants

A cross sectional survey of all the surgical residents at various public sector hospitals in Lahore was done.

Results

A total of 133 residents responded to our questionnaire. 74% respondents were male and 26% were female. All residents showed a very high level of burnout. 50.4% residents had high levels of burn out on the EE category, 49.6% in the DP category and 53.4% residents had low levels on the PA scale. When assessed for overall burn out 57.9% residents had overall burnout. Males were more prone to develop burnout. Job dissatisfaction was the most prevalent reason for burn out. Owning a smartphone was significantly associated with development of burnout. Awareness regarding the burnout syndrome and having children were two factors which had a protective effect against burnout syndrome. Marriage, working hours, financial conditions, smoking and consumption of coffee/tea had no effect on development of burnout syndrome.

Conclusion

There is high prevalence of burnout among the surgical residents in our hospitals. Unsatisfactory training is the number one reason for development of this syndrome.

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A cross sectional survey of surgical residents revealed very high levels of burnout among them.

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Males were most commonly affected.

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Job dissatisfaction and owning a smart phone were high risk factors for developing burn out.

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Having children and having some knowledge of burn out syndrome were protective against it.

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Working hours, financial constraints, smoking and consumption of coffee had no effect.

Surgeons' Emotional Experience of Their Everyday Practice - A Qualitative Study

Background

Physicians’ emotions affect both patient care and personal well-being. Surgeons appear at particularly high risk, as evidenced by the high rate of burnout and the alarming consequences in both their personal lives and professional behavior. The aim of this qualitative study is to explore the emotional experiences of surgeons and their impact on their surgical practice.

Methods and Findings

27 purposively selected liver and pancreatic surgeons from 10 teaching hospitals (23 men, 4 women) participated. Inclusion took place until data saturation was reached. Data were collected through individual interviews and thematically analyzed independently by 3 researchers (a psychologist, a psychiatrist, and a surgeon). 7 themes emerged from the analysis, categorized in 3 main or superordinate themes, which described surgeons’ emotional experience before, during, and after surgery. Burdensome emotions are present throughout all 3 periods (and invade life outside the hospital)—surgeons’ own emotions, their perception of patients’ emotions, and their entwinement. The interviewees described the range of emotional situations they face (with patients, families, colleagues), the influence of the institutional framework (time pressure and fatigue, cultural pressure to satisfy the ideal image of a surgeon), as well as the emotions they feel (including especially anxiety, fear, distress, guilt, and accountability).

Conclusions

Emotions are ubiquitous in surgeons’ experience, and their exposure to stress is chronic rather than acute. Considering emotions only in terms of their relations to operative errors (as previous studies have done) is limiting. Although complications are quite rare events, the concern for possible complications is an oppressive experience, regardless of whether or not they actually occur.

The experience of burnout across different surgical specialties in the United Kingdom: a cross-sectional survey

BACKGROUND

We used a cross-sectional e-mail survey to assess the prevalence of psychological morbidity across different surgical specialties and identify predictor variables of burnout in surgeons.

METHOD

The survey was sent to 1971 surgeons from 127 National Health Service (NHS) hospital trusts across the United Kingdom. Burnout prevalence and mood were assessed using the Maslach Burnout Inventory-General Survey and Profile of Mood States (POMS), respectively. Demographic and POMS factors were investigated as predictors of burnout using linear and stepwise regression analyses.

RESULTS

Responses to the survey were received from 342 surgeons (17% response rate). One-third of 313 respondents showed high mean levels of burnout on exhaustion (2.32; standard deviation [SD], 1.62) and cynicism (2.34; SD, 1.44) subscales. Some specialties worked significantly more hours per week (F[8, 252] = 2.89; P = .004), but burnout prevalence did not differ significantly between specialty, grade, age, gender, hours worked per week, or years spent in post. The number of years in specialty (β = -0.17; P = .003) independently predicted surgeons' scores on exhaustion. POMS factors significantly predicted burnout, where fatigue (β = 0.58; P < .001) was the best predictor of exhaustion scores, depression (β = 0.28; P < .001) the best predictor of cynicism, and vigor (β = 0.29; P < .001) the best predictor of professional efficacy. Management issues were cited as contributing to psychological morbidity.

CONCLUSION

UK surgeons show high levels of cynicism and exhaustion burnout irrespective of their specialty, grade, or hours worked per week. Surgeons' mood profiles significantly predicted burnout, indicating the POMS could be used as part of an assessment for preventive interventions. NHS management and infrastructure are highlighted as influences on surgeons' psychological health.