Emotionally exhausting factors in general practitioners’ work

Abstract

Background. Emotional exhaustion is central in burnout syndrome and signals its development. General practitioners’ (GP) work is emotionally challenging but research on these aspects is lacking. Objective. To study the prevalence of emotional exhaustion among GPs and to evaluate how their characteristics and work experiences are associated with emotional exhaustion. Design and methods. A questionnaire survey was carried out among GPs in Finland in 2011 in which questions were posed regarding their experience of emotional exhaustion and items related to their work experiences and professional identity. A statement “I feel burnt out from my job” (never, seldom, sometimes, quite often, or often) enquired about emotional exhaustion. Those responding quite often or often were categorized as emotionally exhausted. Results. Among the GPs, 68% responded (165/244). Of the respondents, 18% were emotionally exhausted. Emotional exhaustion was associated with older age, longer working history, experiences of having too much work, fear and reports of having committed a medical error, low tolerance of uncertainty in their work, and feeling alone at work. No differences in positive work experiences were found. In logistic regression analysis working experience > 5 years (OR 4.1, 95% CI 1.6–10.8; p = 0.0036) and feeling alone at work (OR 2.9, 95% CI 1.2–7.1; p = 0.020) predicted emotional exhaustion, having committed a medical error in the past three months predicted it marginally significantly (OR 2.4, 95% CI 1.0–5.9, p = 0.057), whereas tolerating uncertainty well protected against it (OR 0.2, 95% CI 0.09–0.7; p = 0.0098). Conclusions. Emotional exhaustion among GPs was common and associated with longer working history, having committed a medical error, and feelings of isolation at work. GPs should receive more support throughout their careers.

Tolerance of ambiguity and psychological well‐being in medical training: A systematic review

“…In 10/11 studies, previously validated scales (either the complete scales or a selected component) were used and in the remaining study a new ad hoc single‐item self‐reported questionnaire was used . The Physicians’ Reactions to Uncertainty (PRU) Scale, which evaluates physicians’ ‘affective’ response to uncertainty, was most frequently used (six studies).…”

“…In eight of the studies, level of tolerance of ambiguity or uncertainty was treated as a continuous variable, with a ‘score’ for tolerance of ambiguity or uncertainty being calculated based on scale responses. In three of the studies, level of tolerance of ambiguity or uncertainty was treated as an ordinal variable . In one of these studies scores above the midpoint were considered to represent a positive interpretation bias towards ambiguous situations, whereas in another participants were only considered to be tolerant of uncertainty if participants scored above the 75th centile.…”

“…Self‐reported burnout was assessed in seven of the studies. Variations of the Maslach Burnout Inventory were used in five of the seven studies . This is a self‐reported measure of burnout that defines burnout as emotional exhaustion, depersonalisation and reduced personal accomplishment.…”

“…In all studies where self‐reported burnout was assessed an association was demonstrated with lower levels of tolerance of ambiguity or uncertainty. Only one study measuring burnout evaluated levels of tolerance of ambiguity .…”

Family physician experiences with and needs for clinical supervision: Associations between work experiences, professional issues and social support at work

“…Many FPs have an unmet need for CS [6][7][8]. Research suggests that distress at work, emotional exhaustion and even burnout may indirectly indicate a need for CS [8][9][10]. However, few studies have explored which factors predict the need for CS.…”