A systematic review of burnout among doctors in China: a cultural perspective

Abstract

BackgroundNumerous studies around the world has already suggested that burnout among doctors is a global phenomenon. However, studies for burnout in doctors are relatively limited in Chinese communities when compared to the West. As risk factors, barriers to intervention and strategies combatting burnout in different parts of the world can vary a lot due to different social culture and healthcare system, study with a focus at doctors in China from a cultural perspective is a worthful endeavor.MethodsSystematic searches of databases were conducted for papers published in peer-reviewed journals from 2006 to 2016. Selection criteria included practicing doctors in Mainland China and publications written in English or Chinese. Keywords searched including “burnout”, “doctors” and “China” in 3 electronic databases has been undergone. Traditional understanding of “work attitude” and “doctors’ humanity” from ancient Chinese literature has also been retrieved.ResultsEleven full papers, including 9302 participants, were included in this review. The overall prevalence of burnout symptoms among doctors in China ranged from 66.5 to 87.8%. The review suggested that negative impact of burnout include association with anxiety symptoms and low job satisfaction at the individual doctors’ level, and prone to committing medical mistakes affecting patient safety and higher turnover intention at the society/organizational level. Burnout was higher among doctors who worked over 40 h/week, working in tertiary hospitals, on younger age group within the profession (at age 30-40), and with negative individual perception to work and life.Conclusions and implicationsThe overall prevalence and adverse impact of burnout among doctors in China echo with the findings from Western studies. Young doctors and doctors working in tertiary hospitals are more at risk of burnout, probably related to shift of social culture related to the loss of medical humanities and a weak primary healthcare system. Potential strategies of managing burnout in Chinese doctors should therefore take consideration from the Chinese cultural perspective, with renaissance of medical humanities and strengthening the primary healthcare system in China.

The influence of job satisfaction, resilience and work engagement on turnover intention among village doctors in China: a cross-sectional study

“…Village doctors have been changed from self-employed to public service providers, playing a basic net role in China's rural health care system. They are responsible for providing rural residents with life-cycle care involving prevention, treatment, health protection and rehabilitation, as well as two-way referral between village clinics and urban general hospitals, so that village doctors are the indispensable gatekeepers of health for the vast majority of rural residents in China [1]. With a rural population over 900 million, village doctors in China conduct a much broader scope of work compared to other countries.…”

“…Recently, China's Henan province witnessed two serious cases of village doctors' collective turnover, one involving 36 doctors and the other 28 doctors. As an important part of China's medical and health service team, when village doctors leave collectively, rural medical institutions may face a "stall" and rural residents may be trapped in incurable difficulties, resulting in more serious social consequences [1,8].…”

A Randomized Controlled Trial of Balint Groups to Prevent Burnout Among Residents in China

“…A recent survey of U.S. physicians revealed that 54.4% of respondents reported at least one symptom of burnout (3). In China, the overall prevalence of physician burnout was reported as between 66.5% to 87.8% (4). Variation in reported physician burnout rate was attributed to differences in specialty, work setting, and years of training (4).…”

“…In China, the overall prevalence of physician burnout was reported as between 66.5% to 87.8% (4). Variation in reported physician burnout rate was attributed to differences in specialty, work setting, and years of training (4). From these studies, it is evident that physicians internationally are at a high risk of burnout.…”

“…They have overloaded schedules, low income, feel disrespected by patients and senior physicians, and battle a growing distrust among healthcare providers and patients in China (8). Young doctors in China, especially those younger than 40 years old, have higher burnout rates than older physicians in China (4). The most recent studies on burnout rates for Chinese physicians demonstrate a range of 54.99% to 78.2% (9,10).…”