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Medline ® Abstract for Reference 94

of 'Palliative care: Issues in the intensive care unit in adults'

High level of burnout in intensivists: prevalence and associated factors.
Embriaco N, Azoulay E, Barrau K, Kentish N, Pochard F, Loundou A, Papazian L
Am J Respir Crit Care Med. 2007 Apr;175(7):686-92. Epub 2007 Jan 18.
RATIONALE: Professional burnout is a psychological syndrome arising in response to chronic interpersonal stressors on the job. There is the perception that intensivists are particularly exposed to stress because lives are literally in their hands.
OBJECTIVE: To evaluate the prevalence and associated factors (patients or organization) of burnout among physicians working in intensive care units (ICUs) (including interns, residents, fellows, and attending physicians).
METHODS: A 1-day national survey was conducted in adult ICUs in French public hospitals.
MEASUREMENTS: The level of burnout was evaluated on the basis of the Maslach Burnout Inventory (MBI).
MAIN RESULTS: A total of 189 ICUs participated and 978 surveys were returned (82.3% response rate). A high level of burnout was identified in 46.5% of the respondents. Ordinal logistic regression showed that female sex (odds ratio, 1.58; 95% confidence interval, 1.09 to 2.30) was independently associated with a higher MBI score. Whereas no factor related to the severity of illness of patients was retained by the model, organizational factors were strongly associated with a higher MBI score. Workload (the number of night shifts per month, a long period of time from the last nonworking week, night shift the day before the survey) and impaired relationships (such as conflict with another colleague intensivist, and/or with a nurse) were the variables independently associated with a higher MBI score. In contrast, the quality of the relationships with chief nurses and nurses was associated with a lower MBI score.
CONCLUSIONS: Approximately one-half of the intensivists presented a high level of burnout. Organizational factors, but not factors related to the patients, appeared to be associated with burnout.
Medical Intensive Care Unit, Hôpital Sainte-Marguerite Teaching Hospital, Universitéde la Méditerranée, Marseille 13009, France.