Burnout among family physicians and its associated factors
Aim: Aim of this study was to determine the rate of burnout among family physicians and to identify the contributing factors behind it.
Material-Methods: This descriptive study was conducted among family physicians working in the city center of Kayseri in 2013.
All 280 family physicians who worked in the city center were included in the study and 143 of them participated (51.1%). Physicians were given a questionnaire containing 24 questions and Maslach Burnout Inventory. Study has been approved by the ethics committee of Erciyes University. p<0.05 was considered statistically significant.
Results: The mean working year of the family physicians was 19.0±5.4 years. Out of 143 physicians, 83.9% were working in family practice since family practitioner scheme was introduced. 53.2% of them stated that being a family physician was very suitable/suitable for them. The mean emotional exhaustion score, depersonalization score and personal accomplishment score were 16.1±7.2, 4.3±3.2 and 21.0±3.7. There were no differences between the burnout scores according to gender, marital status and the presence of a diagnosed health problem (p>0.05).
The emotional exhaustion (p<0.001), depersonalization (p<0.05) and total exhaustion (p<0.001) scores of the physicians who stated their work load and work stress increased and who were not satisfied with their working place were higher than the others.
The emotional burnout scores were lower for the physicians who stated that family medicine was appropriate for them (p=0,004), they were glad to be in the family practice (p<0.001) and their expectations were met (p<0.001). There was no correlation between the total professional years and any burnout score (p>0.05). A low positive correlation was found between the duration of working in the family practice and emotional and total burnout scores (p<0.05). Fulfillment of expectations and workload was found as the two most important factors affecting motional and total burnout scores.
Conclusion: The majority of family physicians have been thinking that family practice has increased the rival between physicians, the work load stress, and ethical degeneration, decreased the time spared for their social life and professional development. A positive correlation has been found between the duration of working in family practice and the emotional and total burnout scores.
Burnout syndrome of family practitioners and related factors
Background and Aim: Burnout syndrome is a social state that affects the individual, his/her workplace and environment. Various factors effect burnout syndrome, including the changes in workplace environment. In Turkey since 2005, there has been grate changes in health care system, especially in primary care, under the name of health reforms. Studies show that burnout syndrome leads to serious problems such as unemployment, various social problems and even psychiatric diseases. This study aims to understand the burnout level of family physicians and related factors.
Method: A descriptive study was planned among the 280 family physicians who work in central Kayseri in 2013. In the survey there were 24 questions that covered the socio-demographic traits of the participants and the situation that has progressed since the health reforms regulations. In order to identify the burnout level, Maslach exhaustion scale was used. The ethical approval was given by the Erciyes University Ethics Committee. For the analysis of the data, two independent sample t tests, one way variant analysis and Kruskal-Wallis test were made; and in order to determine variables that affect the emotional and total burnout measures, a multiple linear regression analysis was used. p<0.05 is accepted as statistically significant.
Results: 143 of 280 family practitioners who worked in central Kayseri have participated in the study (respond rate 51.1%). The average working years were 19.0±5.4 years. %83.9 of the physicians have been in the practice since the last primary care regulation. %53.2 has stated that family practice was suitable/ very suitable for them. According to participants, the most significant positive change since the beginning of primary care regulations was the increase of the income (%67.4). The increase of workload, stress and the daily working hours as well as the decrease of the time that physicians can allocate for themselves, for their families and for professional development were noted as negative changes. Three out of four of the physicians have thought that the competition among physicians and ethical corruption have increased (78% and 73.9% respectively). Three out of five physicians (67.4%) have stated that their levels of burnout syndrome have increased. The contentment level was higher for 16.2% of the physicians, not changed for 22.4% and, decreased for 61.3%, considering the beginning of the health reforms in primary care.
The mean score of emotional burnout was 16.1±7.2, mean desensitization score was 4.3±3.2 and mean personal success score was 21.0±3.7. There were no statistical differences between burnout scores according genders, marital statuses or any diagnosed health issues (p>0.005). Emotional burnout (p<0.001), desensitization (p<0.05) and total burn out (p<0.001) scores were higher with the physicians who have stated that the workload and the stress have increased and were no longer content with the workplace. The ones who have stated that family practice was suitable for them (p=0.004), who were happy to be in the practice (p<0.001) and who were satisfied with their expectations (p<0.001) had lower burnout scores. No correlation was determined between total employment time and burnout points (p>0.05). There was weak positive correlation between the time spent as family physician, emotional burnout and total burnout scores (p<0.05). The most significant factors that affect emotional and total burnout scores were: the meeting of expectations and workload.
Conclusion: A large portion of family physicians think that primary care regulation has increased competition among physicians, workload, ethical corruption and work stress; and half of them think that it decreased the time they can spend on social life and professional development. Also half of their contentment has decayed over time. A positive correlation has been found out between time employed in primary care and, emotional and total burn out scores. This situation might enable the increase and widespread of burnout syndrome among physicians over time.