Institutional factors in the medical burnout epidemic

Hauck, Simone; Gabbard, Glen O.

doi:10.1590/1516-4446-2018-0340

Cited by 9 publications

(13 citation statements)

References 7 publications

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“…As pointed out by several authors, institutional factors must be addressed and the instrument developed in this study can contribute to further research investigating these factors. 2,4,5 Limitations of this study include the fact that it was conducted in a specific population (psychiatry residents from Rio Grande do Sul, Brazil). Therefore, studies…”

Section: Discussionmentioning

confidence: 99%

“…Some authors argue that this may be because efforts to reduce burnout are typically focused on increasing resilience and wellness, rather than combating problematic changes in how medicine is practiced by physicians in the current era, or the roots of the problem that involve institutional factors and culture. 2,4,5 With respect to medical education, many studies report rates of burnout and other mental diseases that are much higher than those in the general population. 6,7 The prevalence of burnout in residents is generally about 25-75%, varying by specialty, country, and measurement method.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, institutional factors are as yet poorly investigated and understood. 4,11 Medical students and residents spend a great proportion of their time immersed in the institutional environment and are in constant contact with professors, assistants, colleagues, patients, and the institutional staff and culture. The nature of this contact and also the beliefs and values common to the members of the institution may play a fundamental role in development of burnout, especially if they are not compatible with one's own beliefs.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, contemporary physicians are faced with the challenge of delivering increasingly patient-centered care, at the same time that they are continually exposed to ongoing economic, technological, and regulatory changes, posing unrealistic expectations of physician availability. 4 The consequences of burnout can be devastating, for both personal and professional life, leading to increased reports of medical errors, suboptimal patient care, reduced empathy in general, reduced quality of life, and development of mental disorders like depression. 8,12,13 It is both crucial and urgent to elucidate the role played by the work environment in this phenomenon.…”

Section: Introductionmentioning

confidence: 99%

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Work Environment Evaluation Instrument (WEEI): development, validation, and association with burnout

Monteiro

Baeza

Hauck

2020

Trends Psychiatry Psychother.

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Introduction: Physician burnout is considered an epidemic. In 2019, 44% of U.S. physicians reported feeling burned out. The work environment is a central risk factor for this. The aim of this study is to develop and test an instrument to evaluate work environment factors in medical training courses. Method: After focus groups, an initial pool of 14 items was generated and tested in a pilot study (n = 66). Face validity was verified, and small adjustments were made. The resulting version was administered to a sample of 115 psychiatry residents. Eleven items were selected based on the correlations between them, principal component analysis, and theoretical reasons, and then tested for internal and construct validity. Results: The final version had high reliability (Cronbach's alpha = 0.898) and comprised three dimensions: relations with the institution; with colleagues; and with preceptors. Both total scores and dimensions correlated significantly with burnout scores (p < 0.01). Cutoffs defining the environment as healthy (>32 points); risky (23-31 points); or toxic (<22 points) were suggested and related to the risk of burnout. Conclusion: Several authors have emphasized the importance of approaching institutional factors as an effective strategy for coping with the increased prevalence of burnout. This instrument should contribute to these efforts.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Work Environment Evaluation Instrument (WEEI): development, validation, and association with burnout

Monteiro

Baeza

Hauck

2020

Trends Psychiatry Psychother.

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“…Several authors have observed that health professionals as a group have been intensely affected by changes in the administrative structure of hospitals and the decline of physician autonomy in the current culture of health institutions. [5][6][7] In fact, a recent meta-analysis revealed a significantly smaller effect of interventions aimed at the individual level compared to those geared to the institutional level. 8,9 Rates of exhaustion and mental health concerns are currently affecting 30-60% of all doctors and physicians in training in North America.…”

Section: Introductionmentioning

confidence: 99%

Factor Structure, Reliability and Validity of the Institutional Culture Assessment Scale (ICAS)

Monteiro

Moser

Oliveira

et al. 2020

Preprint

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Introduction: Work environment can affect the employees, fostering well-being versus emotional burden. The aim of this study was to develop the Institutional Culture Assessment Scale (ICAS), and evaluate its Factor Structure, Reliability and Validity in a Brazilian sample of medical students and physicians in different settings and phases of the medical career. Method: 2537 individuals were evaluated by an online questionnaire. The sample was split in half for independent testing of Exploratory Factor Analysis and Confirmatory Factor Analysis. We then used Confirmatory Factor Analysis (CFA) to test the best solutions in the second half of the sample. Then, considering a unidimensional model solution, an item response theory (IRT) analysis was conducted. Simple linear regression analysis was performed to investigate associations between ICAS factor scores and internal validators (burnout scores), using again the second half of the sample. Result: Parallel analysis revealed two factors. The first factor encompassed items involving the institution and supervisors. The second factor encompassed items involving peers. We decided to performed the next analysis with a unidimensional construct based solely on institution/supervisor items. A unidimensional model including the remaining seven items from the ICAS instrument revealed an excellent fit with the data. All items loaded significantly on the unidimensional latent trait with factor loadings ranging from 0.583 to 0.869. McDonalds Omega was 0.89, showing a high internal consistency. Conclusion: This study presents a valid and reliable scale to assess aspects of institutional culture connected to the relationships with superiors/supervisors and to the relation to the institutions themselves.

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