Original Article
Burnout syndrome in critical care team members: A monocentric cross sectional survey

https://doi.org/10.1016/j.accpm.2016.06.011Get rights and content

Abstract

Introduction

There has been a growing interest in evaluating the occurrence of burnout syndrome (BOS) among intensive care units (ICU) team over recent years. The aims of this study were to determine the prevalence of BOS among staff working in the Amiens University Hospital and to assess associated factors.

Patients and methods

Prospective observational study based on self-administered questionnaires filled in by physicians and non-physicians working in 3 ICUs. Demographic data, well-being assessment, work relationships, level of BOS and depressive symptoms were investigated. Logistic regression analysis was performed to identify variables independently associated with BOS.

Results

One hundred and sixty-one questionnaires were analysed. Participation rate was 90%. Thirty-two respondents were physicians and 129 were non-physicians. The prevalence of BOS was 51% and was not significantly different between physicians and non-physicians (56% versus 50%; P = 0.501). Respondents who reported BOS less frequently had regular leisure activities (54 [66%] versus 70 [87%], P = 0.001). In the BOS group, well-being was significantly lower (4.8 ± 2.5/10 versus 6 ± 2/10, P = 0.001), a desire to leave the job was more frequently expressed (50 [61%] versus 32 [40%], P = 0.009) and depressive symptoms were significantly more frequent (41 [50%] versus 21 [27%], P = 0.002). Factors independently associated with BOS were regular leisure activities (OR 0.24 [0.1–0.59]; P = 0.002), the presence of depressive symptoms (OR 2.71 [1.26–5.84]; P = 0.011) and a well-being visual analogue scale  5 (OR 0.40 [0.18–0.89]; P = 0.024).

Conclusions

BOS affects all ICU workers and is determined by multiple factors. Leisure activities and measures designed to improve well-being should be promoted.

Introduction

Critical care staffs are required to deal with death, pain, family emotions, withholding and withdrawal of life support [1], all of which require considerable technical and human resources. These stressful situations and their emotional impact require a large capacity for adaptation [2].

Burnout syndrome (BOS) was first identified in non-medical occupations, especially in large companies, in which the high incidence of suicide has recently raised concern [3]. This syndrome refers to the fact that individual is “consumed by his/her work” and specifically affects all individuals who have chosen to devote themselves to others in their job [4]. It is characterized by the appearance of non-specific somatic and psychological disorders in a previously healthy individual [5]. In 1981, Maslach et al. [6] described three components of BOS: emotional exhaustion, depersonalisation and low personal accomplishment.

There has been a growing interest in evaluating the occurrence of BOS among critical care workers since Embriaco et al. [7], [8] demonstrated in 2007 that 46.5% of critical care physicians, mostly women, and 30% of critical care nurses were affected by BOS. Numerous factors associated with BOS have been identified, such as age, organisational factors, quality of working relationships and the number of decisions to withhold life-sustaining treatments. BOS is also associated with a three-fold higher risk of an expressed desire to leave one's job in 5 European countries [9]. These studies mostly included doctors or nurses but we noticed the lack of studies regarding BOS among all ICU professionals including physicians, nurses, nursing assistants and residents [10].

The aims of this study were to determine the current prevalence of BOS among critical care staff working in the Amiens University Hospital intensive care units (ICU) and to assess the factors associated with BOS.

Section snippets

Study design

A single-centre, prospective, observational study was performed based on self-administered questionnaires filled in by critical care nurses, nursing assistants and physicians (consultants, fellows and residents) working in three ICUs at the Amiens University Hospital. Questionnaires were delivered to the medical and surgical ICUs, the cardiothoracic and vascular ICUs and the neurosurgical ICU. Anonymous responses were required. All respondents agreed to fill in the questionnaire and to

The respondent population

One hundred and sixty-one questionnaires from 177 care workers were filled in and analysed, corresponding to a participation rate of 90%. Participating ICUs (medical and surgical ICUs, cardiothoracic and vascular ICUs and the neurosurgical ICU) comprised a total of 48 beds: the mean SAPS2 score was 43 ± 5; the mean number of admissions was 628 ± 150 per year, and the mean duration of mechanical ventilation was 6 ± 3 days.

Thirty-two respondents were physicians (19 [11.8%] senior intensivists, 13 [8%]

Discussion

This study revealed a high prevalence of BOS among all critical care staff members. Similar results were reported several years ago in the study by Mion et al. [14], in which 62.3% of respondents experienced BOS. Nevertheless, in this very large French national survey, most respondents were anaesthetics physicians or nurses, and only 15% of respondents were intensivists; intensive care staffs other than physicians were not included. In another large survey conducted by Embriaco et al. [16]

Conclusion

Although BOS was identified almost 10 years ago, its prevalence remains high and it affects all ICU workers and is determined by a subjective feeling of non-well-being at work. The improvement of working conditions constitutes a priority. Psychological support for ICU workers could constitute one approach to improvement, but would not be feasible in the current context of hiring restrictions. Valuing the work of each team member by managers could improve personal accomplishment. Finally, the

Authors’ contributions

SM designed and coordinated the study, interpreted data and drafted the manuscript. YM helped draft the manuscript. AM collected and analysed data. EZ, AS and MG contributed to data collection. HD supervised the study and helped to draft the manuscript. All authors read and approved the final manuscript.

Disclosure of interest

The authors declare that they have no competing interest.

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