Department of Psychiatry, Sainte-Marguerite University Hospital, Marseille, France.
EA 3279-Public Health, Chronic Diseases and Quality of Life-Research Unit, Aix-Marseille University, 13005 Marseille, France.
J Affect Disord. 2019 Mar 1;246:132-147. doi: 10.1016/j.jad.2018.12.056. Epub 2018 Dec 18.
Burnout syndrome is the consequence of chronic work-related stress exposure and is 2-3 times higher than in physicians than in other professions. Many studies exploring burnout in French physicians have been published with inconsistent data regarding its prevalence and associated factors.
To assess the prevalence of burnout and associated factors in French physicians in a systematic review and meta-analysis.
Studies assessing the prevalence of French physician's burnout and its three dimensions emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA) were selected in the following databases from 2000 to April 2017: MEDLINE, BIOSIS WEB OF SCIENCE, PASCAL ET FRANCIS, SCIENCES DIRECT, PSYCHinfo, and BDSP. Burnout was defined by one abnormal score in one or more of the 3 dimensions of the MBI scale (EE, DP or PA). Severe burnout was defined by the association of high scores of EE and DP, and low score of PA. High EE was defined by an EE score ≥27. High DP was defined by a score ≥10. Low PA was defined by a score ≤33.
A total of 37 studies and 15,183 French physicians were included in the present meta-analysis. The random effects pooled prevalence estimate was 49% (95% CI 45%-53%, P < 0.001, I = 93.1%) for burnout, 5% (95% CI 4-7, P < 0.001, I= 92.7%) for severe burnout, 21% (95% CI 19-24, P < 0.001, I = 94.7%) for high EE, 29% (95% CI 25-33, P < 0.001, I = 96.7%) for high DP, and 29% (95% CI 24-34, P < 0.001, I = 97.7%) for low PA. Emergency physicians were found to have a trend to higher rates of burnout (P = 0.051), and significantly more severe burnout compared to other physicians (b = 0.05, se[b] = 0.02, P = 0.019). Junior residents were found to have higher rates of DP; junior residents, sample size, and monthly number of night shifts were associated with lower PA; and anesthesiologists were found to have lower rates of high EE and high DP.
Burnout is highly prevalent in French physicians. Some recommendations may be suggested to reduce this rate, including reducing the number or duration of night shifts to increase personal accomplishment and targeting emergency physicians and junior residents in priority. Other specialties should be explored in future studies.
burnout 综合征是慢性工作相关压力暴露的结果，其发生率比其他职业高 2-3 倍。许多研究探索了法国医生的 burnout 问题，但关于其患病率和相关因素的数据并不一致。
通过系统综述和荟萃分析评估法国医生 burnout 及其三个维度（情绪衰竭、去人格化和个人成就感）的患病率和相关因素。
从 2000 年至 2017 年 4 月，在以下数据库中检索评估法国医生 burnout 及其三个维度（情绪衰竭、去人格化和个人成就感）患病率的研究：MEDLINE、BIOSIS WEB OF SCIENCE、PASCAL ET FRANCIS、SCIENCES DIRECT、PSYCHinfo 和 BDSP。 burnout 由 MBI 量表三个维度中的一个或多个维度的一个异常得分定义（情绪衰竭、去人格化或个人成就感）。严重 burnout 定义为情绪衰竭和去人格化得分高，个人成就感得分低。情绪衰竭高定义为情绪衰竭得分≥27。去人格化高定义为去人格化得分≥10。个人成就感低定义为个人成就感得分≤33。
本荟萃分析共纳入 37 项研究和 15183 名法国医生。随机效应汇总患病率估计值为 49%（95%CI 45%-53%，P<0.001，I=93.1%）为 burnout，5%（95%CI 4-7%，P<0.001，I=92.7%）为严重 burnout，21%（95%CI 19-24%，P<0.001，I=94.7%）为情绪衰竭高，29%（95%CI 25-33%，P<0.001，I=96.7%）为去人格化高，29%（95%CI 24-34%，P<0.001，I=97.7%）为个人成就感低。急诊医生的 burnout 发生率较高（P=0.051），与其他医生相比，严重 burnout 的发生率显著更高（b=0.05，se[b]=0.02，P=0.019）。初级住院医师的去人格化发生率较高；初级住院医师、样本量和每月夜班次数与个人成就感较低有关；麻醉师的情绪衰竭高和去人格化高发生率较低。
法国医生 burnout 的发生率很高。为降低这一比率，可能需要提出一些建议，包括减少夜班次数或缩短夜班时间，以提高个人成就感，并优先针对急诊医生和初级住院医师。未来的研究应探索其他专业。
