Abstract:Background
The COVID-19 pandemic has increased the burden on resident physicians. They may use different coping strategies to manage those burdens, which partly determine their mental health outcomes, including burnout syndrome. This study explores the relationship between coping strategies and burnout among resident physicians during the COVID-19 pandemic in an Indonesian tertiary referral hospital.
Methods
This online cross-sectional study was conducted from June to August 2020, involving nine residency pr… Show more
“…Encouragingly, the most frequently reported coping strategies by doctors in Ireland were adaptive rather than maladaptive , and this finding was consistent across grades and sexes. This is in keeping with several international studies12 28 29 but is in contrast to a UK study 3…”
Section: Discussionsupporting
confidence: 91%
“…A study of doctors in the UK3 found that the most frequently reported coping mechanism was the maladaptive strategy of self-distraction (ie, drawing one’s thoughts or attention away from the problem or stressor). In contrast, recent studies of Italian healthcare workers12 and residents in Indonesia28 found that the most commonly reported coping strategies were adaptive . Similarly, a cross-cultural study found that the most commonly reported coping strategies by German and Australian doctors were the adaptive strategies of active coping, planning and positive reframing 29…”
ObjectivesTo measure coping strategies and associated psychological distress, burnout and work ability in hospital doctors in Ireland.DesignNational cross-sectional study of randomised sample of trainee and consultant hospital doctors.SettingIrish publicly funded hospitals and residential institutions.Participants1749 doctors returned surveys (55% response rate).Outcome measuresDependent variables were psychological distress (measured using 12-item General Health Questionnaire), burnout (Maslach Burnout Inventory) and work ability (single-item measure). Adaptive and maladaptive coping strategies (Brief Coping Orientation to Problems Experienced) were covariates.ResultsThe coping mechanism most frequently reported by this cohort was the adaptive strategy of active planning. Increased mean hours worked (MHW) (OR 1.02; 95% CI 1.01 to 1.03), a low Work Ability Score (OR 3.23; 95% CI 2.47 to 4.23) and maladaptive coping strategies (OR 1.26; 95% CI 1.22 to 1.31) were significantly associated with psychological distress. Adaptive coping was associated with decreased psychological distress (OR 0.98; 95% CI 0.97 to 1.00). Increased MHW (OR 0.98; 95% CI 0.97 to 0.99), insufficient work ability (OR 0.62; 95% CI 0.48 to 0.80) and maladaptive coping (OR 0.87; 95% CI 0.85 to 0.89) were significantly associated with burnout. Increased MHW (OR 0.99; 95% CI 0.98 to 1.00) and maladaptive coping (OR 0.90, 95% CI 0.88 to 0.92) were significantly associated with insufficient work ability.ConclusionsAdaptive coping is associated with decreased psychological distress but does not mitigate the effect of increased work hours, which are associated with burnout, distress and insufficient work ability, regardless of a doctor’s coping style. The burden of psychological distress on doctors cannot be mitigated meaningfully unless workplace factors are addressed.
“…Encouragingly, the most frequently reported coping strategies by doctors in Ireland were adaptive rather than maladaptive , and this finding was consistent across grades and sexes. This is in keeping with several international studies12 28 29 but is in contrast to a UK study 3…”
Section: Discussionsupporting
confidence: 91%
“…A study of doctors in the UK3 found that the most frequently reported coping mechanism was the maladaptive strategy of self-distraction (ie, drawing one’s thoughts or attention away from the problem or stressor). In contrast, recent studies of Italian healthcare workers12 and residents in Indonesia28 found that the most commonly reported coping strategies were adaptive . Similarly, a cross-cultural study found that the most commonly reported coping strategies by German and Australian doctors were the adaptive strategies of active coping, planning and positive reframing 29…”
ObjectivesTo measure coping strategies and associated psychological distress, burnout and work ability in hospital doctors in Ireland.DesignNational cross-sectional study of randomised sample of trainee and consultant hospital doctors.SettingIrish publicly funded hospitals and residential institutions.Participants1749 doctors returned surveys (55% response rate).Outcome measuresDependent variables were psychological distress (measured using 12-item General Health Questionnaire), burnout (Maslach Burnout Inventory) and work ability (single-item measure). Adaptive and maladaptive coping strategies (Brief Coping Orientation to Problems Experienced) were covariates.ResultsThe coping mechanism most frequently reported by this cohort was the adaptive strategy of active planning. Increased mean hours worked (MHW) (OR 1.02; 95% CI 1.01 to 1.03), a low Work Ability Score (OR 3.23; 95% CI 2.47 to 4.23) and maladaptive coping strategies (OR 1.26; 95% CI 1.22 to 1.31) were significantly associated with psychological distress. Adaptive coping was associated with decreased psychological distress (OR 0.98; 95% CI 0.97 to 1.00). Increased MHW (OR 0.98; 95% CI 0.97 to 0.99), insufficient work ability (OR 0.62; 95% CI 0.48 to 0.80) and maladaptive coping (OR 0.87; 95% CI 0.85 to 0.89) were significantly associated with burnout. Increased MHW (OR 0.99; 95% CI 0.98 to 1.00) and maladaptive coping (OR 0.90, 95% CI 0.88 to 0.92) were significantly associated with insufficient work ability.ConclusionsAdaptive coping is associated with decreased psychological distress but does not mitigate the effect of increased work hours, which are associated with burnout, distress and insufficient work ability, regardless of a doctor’s coping style. The burden of psychological distress on doctors cannot be mitigated meaningfully unless workplace factors are addressed.
“…Interventions should focus on promoting healthier coping mechanisms to prevent and alleviate burnout. Existing literature support these findings, as studies in other settings have demonstrated similar associations between dysfunctional coping and elevated burnout levels among healthcare professionals ( 26 ). However, it would be valuable to explore dissenting views or alternative coping strategies to ensure a comprehensive understanding of the relationship between coping mechanisms and burnout in this specific context.…”
BackgroundThe escalating global prevalence of burnout among healthcare professionals poses a serious health concern. Recent studies focus on prevalence and predictors of burnout among healthcare providers, emphasizing the need for well-being interventions. This study investigates burnout and coping mechanisms among healthcare professionals in central Uganda, addressing the dearth of knowledge about coping strategies specific to the region.MethodsAn analytical facility cross-sectional study was conducted in five healthcare facilities in central Uganda between June to July 2023. Participants included physicians, nurses, and technicians actively engaged in direct patient care. Data were collected using socio-demographic surveys, the Professional Quality of Life (ProQOL-5), and the Brief-COPE tools.ResultsThe study revealed a high prevalence of burnout, with 39.8% of participants experiencing significant levels. Active coping, positive reframing, and denial were negatively correlated with low burnout levels. Dysfunctional coping, specifically self-distraction and denial, showed positive correlations with average and high burnout levels. Emotion-focused coping mechanisms were not employed across burnout levels.ConclusionsThe results emphasize the demanding nature of healthcare roles in the region and highlight the need for comprehensive, context-specific interventions to address burnout globally. While some healthcare professionals utilized adaptive strategies such as seeking social support, engaging in self-care activities, and utilizing problem-solving skills, others resorted to maladaptive coping mechanisms such as substance use and avoidance behaviors. This dichotomy highlights the need for targeted interventions to promote adaptive coping strategies and mitigate the negative impact of maladaptive behaviors on individual well-being and patient care.
“…Using self- distraction as a coping mechanism has been reported as one of the most used coping strategies among medical residents globally and is considered a maladaptive approach. 27 , 28 Studies have also suggested that residency training is a time of heightened vulnerability associated with mental exhaustion and suppressed emotions. 12 A study looking at the impact of emotional regulation on burnout reported that emotional suppression was associated with higher burnout and depersonalization and was also considered maladaptive.…”
Purpose
Burnout is an occupational stress syndrome that gives rise to emotional exhaustion (EE) depersonalization (DP) and reduced personal accomplishment (PA). Increasing rates of burnout among health care professionals has been reported globally. Saudi Arabia appears to be among the highest in prevalence with reports of higher than 70%. Medical residents in training are the highest group at risk. The literature has repeatedly linked burnout among residents with poor academic performance on training exams, impaired quality of life, career choice regret and intentions to abandon medicine. In this study, we explore the factors that contribute to resident burnout, their experiences with burnout and how they choose to mitigate it.
Methods
A qualitative design was used to conduct this study in the city of Riyadh, Saudi Arabia. A total of 14 residents from surgical and non-surgical programs were interviewed through in-depth interviews. Interpretive thematic analysis was used in coding and generated coding templates. Categories were repetitively reviewed and revised, expanding to include new data as it emerged and collapsing to remove redundant codes. Categories were organized into the final themes and sub-themes.
Results
All participants demonstrated a shared thread of shame in reaching the level of burnout. Three main interlinked themes were identified: Burnout stigma cycle, amalgamated causes of burnout and self-coping with burnout. One of the concerning findings in our study is the participants’ pursuit of self-coping strategies and the avoidance of formal help, creating a cycle of suffering in silence.
Conclusion
The literature has repeatedly reported high levels of burnout among residents in training. This study has added another dimension to those findings through the exploration of residents actual accounts and appears to link burnout with suboptimal training and working conditions. We have highlighted the pivotal role stigma and shame play in completely preventing residents from seeking professional help.
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