Mindfulness, Resilience, and Burnout Subtypes in Primary Care Physicians: The Possible Mediating Role of Positive and Negative Affect

Abstract

Purpose: Primary care health professionals suffer from high levels of burnout. The aim of the present study was to evaluate the associations of mindfulness and resilience with the features of the burnout types (overload, lack of development, neglect) in primary care physicians, taking into account the potential mediating role of negative and positive affect.Methods: A cross-sectional design was used. Six hundred and twenty-two Spanish primary care physicians were recruited from an online survey. The Mindful Attention Awareness Scale (MAAS), Connor-Davidson Resilience Scale (CD-RISC), Positive and Negative Affect Schedule (PANAS), and Burnout Clinical Subtype Questionnaire (BCSQ-12) questionnaires were administered. Polychoric correlation matrices were calculated. The unweighted least squares (ULS) method was used for developing structural equation modeling.Results: Mindfulness and resilience presented moderately high associations (φ = 0.46). Links were found between mindfulness and overload (γ = −0.25); resilience and neglect (γ = −0.44); mindfulness and resilience, and negative affect (γ = −0.30 and γ = −0.35, respectively); resilience and positive affect (γ = 0.70); negative affect and overload (β = 0.36); positive affect and lack of development (β = −0.16). The links between the burnout types reached high and positive values between overload and lack of development (β = 0.64), and lack of development and neglect (β = 0.52). The model was a very good fit to the data (GFI = 0.96; AGFI = 0.96; RMSR = 0.06; NFI = 0.95; RFI = 0.95; PRATIO = 0.96).Conclusions: Interventions addressing both mindfulness and resilience can influence burnout subtypes, but their impact may occur in different ways, potentially mediated by positive and negative affect. Both sorts of trainings could constitute possible tools against burnout; however, while mindfulness seems a suitable intervention for preventing its initial stages, resilience may be more effective for treating its advanced stages.

Frenetic, under-Challenged, and Worn-out Burnout Subtypes among Brazilian Primary Care Personnel: Validation of the Brazilian “Burnout Clinical Subtype Questionnaire” (BCSQ-36/BCSQ-12)

“…The under-challenged subtype seems to be a very affected profile that could be using cynicism as a dysfunctional coping strategy based on cognitive avoidance [39], leading to depersonalized attitudes, as it has been observed in physicians and nurses in other works [78,79]. The distance from obligations and detachment from tasks, workmates, and patients this attitude entails might reduce the adaptive ability at work, eroding possible positive affectivity derived from a job well done and from positive relationships, promoting negative affectivity, and exacerbating a lack of development, as has been previously proposed in PC physicians [80].…”

Trait mindfulness may buffer against the deleterious effects of childhood abuse in recurrent depression: A retrospective exploratory study

“…Results from longitudinal studies suggest that this characteristic is stable over time (Black, Sussman, Johnson, & Milam, ). Researchers have also found that mindfulness is a strong predictor of resilience among clinical and general population samples (Keye & Pidgeon, ; Montero‐Martin et al, ; Pidgeon & Keye, ). Indeed, some investigators now conceptualise mindfulness as an essential component of resilience, especially resilience against trauma (Thompson, Arnkoff, & Glass, ).…”

The effects of Compassion Cultivation Training (CCT) on health‐care workers

“…Previous research suggests that LKM is linked to increased mindfulness and self‐compassion (Galante, Galante, Bekkers, & Gallacher, ). In addition, mindfulness and self‐compassion scores appear to be negatively correlated to burnout (Barnard & Curry, ; Luken & Sammons, ; Montero‐Marin et al, , ). Given these findings, burnout resilience was operationalised as increased scores on mindfulness and self‐compassion outcomes.…”