Occupational Burnout, Psychological Status, And Quality Of Life In Primary Care Physicians Working In Outpatient Settings

Aim To study the features of psychological status, professional burnout syndrome (PBSS), and quality of life (QOL) in therapists working in outpatient-polyclinic public health services.Material and methods A cross-sectional study was conducted on the basis of 16 randomly selected urban polyclinics in Moscow, which included general practitioners (district physicians, general practitioners, and cardiologists). After participants signed an informed consent, they filled out an individual registration card including basic socio-demographic (sex, age, education, position held) and professional characteristics (specialization, work experience, qualification category), as well as questionnaires. The degree of professional burnout was assessed by the Maslach Burnout Questionnaire (MBI-HSS), the presence of anxious and depressive symptoms was assessed by Hospital Anxiety and Depression Scale (HADS). Visual Analog Scale (VAS) with a range of values from 0 to 10 points was used to assess stress level. The World Health Organization's Brief Questionnaire for the Assessment of Quality of Life (WHOQOL-BREF) was used to study QOL in physicians.Results We included 108 doctors from 16 city polyclinics aged 24 to 70 years (mean age 44.0 +/- 13.1 years), mostly women (87.0%). Among PWS components, a high level of emotional exhaustion was detected in 50.0% of physicians, a high level of depersonalization in 34.1%, and a high level of personal achievement reduction in 37.5%. A high level of stress (=7 points on VAS) was revealed in 66.3% of physicians; anxiety and depressive symptoms of any degree of severity (=8 points on HADS-A and HADS-D subscales) were revealed in 23.8% and 22.7% of participants, respectively. The proportion of physicians who rated their QOL as less than "good" was 42.0%; the proportion of physicians who rated their state of health as less than "good" was 41.6%. Most of the factors studied had no significant differences according to participants' gender and years of service, except for emotional exhaustion (in 55.3% of women and 16.7% of men; p=0.0086) and high stress levels (in 72.2% of women and 28.6% of men; p=0.002).Conclusions A high prevalence of personal factors potentially adversely affecting the work of outpatient physicians has been revealed: high level of stress, anxious and depressive symptoms, professional burnout, unsatisfactory QOL, and low satisfaction with own health state. It is necessary to take managerial decisions and measures to create an optimal psychological climate for doctors in the workplace, to develop new strategies for the prevention and correction of psychological state of doctors, and to introduce comprehensive programs aimed at improving the professional environment in order to preserve and strengthen mental health and increase the professional prestige of the medical specialty.