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Prevalence and severity of burnout in Hong Kong doctors up to 20 years post-graduation: a cross-sectional study.

ABSTRACT: OBJECTIVE:To estimate the prevalence and severity of burnout and explore the factors associated with burnout among Hong Kong medical graduates up to 20 years post-graduation. DESIGN:Cross-sectional survey. SETTING:Hong Kong. PARTICIPANTS:Doctors who graduated from the University of Hong Kong between 1995 and 2014. PRIMARY AND SECONDARY OUTCOME MEASURES:Burnout as measured by the Copenhagen Burnout Inventory (CBI), alcohol consumption as measured by the Alcohol Use Disorders Identification Test Version C, lifestyle behaviours (hours of sleep and work, exercise, smoking, substance use), career satisfaction and sociodemographic characteristics were obtained using paper or online questionnaires. RESULTS:Response rate was 30.9% (496/1607). Prevalence of CBI burnout was 63.1% (personal), 55.9% (work-related) and 35.4% (patient-related). The mean CBI subscale scores were 57.4±21.4 (personal), 48.9±7.4 (work-related) and 41.5±21.8 (client-related). Factors associated with personal and patient-related burnout included age (coeff -0.437, 95%?CI -0.779 to -0.095 and coeff -0.596, 95%?CI -0.965 to -0.228, respectively), practice setting (coeff -5.759, 95%?CI -10.665 to -0.853 and coeff -5.317, 95%?CI -10.602 to -0.032, respectively) and regular exercise (coeff -6.855, 95%?CI -11.102 to -2.608 and coeff -6.769, 95%?CI -11.333 to -2.205, respectively). Gender (coeff 5.1, 95%?CI 1.382 to 8.818), average hours of sleep per night (coeff -5.200, 95%?CI -7.139 to -3.262) and work hours per week (coeff 0.226, 95%?CI 0.099 to 0.353) were associated with personal burnout only. No factors were significantly associated with work-related burnout. CONCLUSION:Burnout is highly prevalent among Hong Kong medical graduates. Younger doctors, women and those working in the public sector appear to be at higher risk for burnout and may benefit from targeted interventions. Policymakers and healthcare authorities should consider measures to help reduce burnout by enabling adequate sleep, reducing work hours and encouraging exercise.

SUBMITTER: Ng APP

PROVIDER: S-EPMC7592302 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Prevalence and severity of burnout in Hong Kong doctors up to 20 years post-graduation: a cross-sectional study.

Ng Amy Pui Pui APP Chin Weng Yee WY Wan Eric Yuk Fai EYF Chen Julie J Lau Chak Sing CS

BMJ open 20201027 10

<h4>Objective</h4>To estimate the prevalence and severity of burnout and explore the factors associated with burnout among Hong Kong medical graduates up to 20 years post-graduation.<h4>Design</h4>Cross-sectional survey.<h4>Setting</h4>Hong Kong.<h4>Participants</h4>Doctors who graduated from the University of Hong Kong between 1995 and 2014.<h4>Primary and secondary outcome measures</h4>Burnout as measured by the Copenhagen Burnout Inventory (CBI), alcohol consumption as measured by the Alcohol ...[more]

PMID: 33109674

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Project description:BackgroundBurnout causes personal suffering and adverse professional consequences. It is prevalent among medical students, although the relationship between burnout and lifestyle factors are understudied in Chinese medical students. Thus, this study aims to (i) estimate the prevalence of burnout among medical students in Hong Kong (HK) and (ii) delineate the relationship between burnout and various lifestyle factors.Method1,341 students were invited to complete a questionnaire from September to December 2017. Burnout was measured by the Maslach Burnout Inventory. Lifestyle factors including drinking habit, sleep habit and quality, and exercise level were assessed by validated instruments, including Alcohol Use Disorder Identification Test (AUDIT-C), Pittsburgh Sleep Quality Index (PSQI), and Godin-Shephard Leisure-Time Physical Activity (GSLTPA), respectively. Smoking status and use of self-medications were also inquired into, while demographic data was self-reported. Prevalence of burnout with confidence intervals was calculated. Difference in lifestyle and demographic data in students with or without burnout, were compared by t-test and Chi-square/Fisher's exact test. From this, all associations with significant p-value at p<0.1 were entered into the multiple logistic regression model.Results731 students (55.6%) responded to the questionnaire. Prevalence of burnout was 27.9% (95%CI: 24.6%-31.5%). Only 3 students in the whole sample smoked; and 6.6% of students drank weekly but rarely drank more than 2 drinks per week. 6.3% and 2.3% self-medicated themselves with medications to improve their sleep and concentration, respectively. Using a multiple logistic regression model, only sleep quality and exercise level were significantly associated with the presence of burnout.ConclusionAround a quarter of medical students in HK suffered from burnout. Burnout was found to be significantly associated with sleep quality and physical exercise. The study also highlighted that HK medical students lived very different lifestyles from those from other countries. More research is needed to design and establish the effectiveness of lifestyle interventional programs that enhance exercise level and sleep quality.

Project description:BackgroundHypertension is the most common chronic disease and is the leading cause of morbidity and mortality. Its screening, diagnosis, and management depend heavily on accurate blood pressure (BP) measurement. It is recommended that the diagnosis of hypertension should be confirmed or corroborated by out-of-office BP values, measured using ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM). When office BP is used, automated office BP (AOBP) measurement method, which automatically provides an average of 3-5 BP readings, should be preferred. This study aimed to describe the BP measurement methods commonly used by doctors in primary care in Hong Kong, to screen, diagnose, and manage hypertensive patients.MethodsIn this cross-sectional survey, all doctors registered in the Hong Kong "Primary Care Directory" were mailed a questionnaire, asking their preferred BP-measuring methods to screen, diagnose, and manage hypertensive patients. Furthermore, we also elicited information on the usual number of office BP or HBPM readings obtained, to diagnose or manage hypertension.ResultsOf the 1738 doctors included from the directory, 445 responded. Manual measurement using a mercury or aneroid device was found to be the commonest method to screen (63.1%), diagnose (56.4%), and manage (72.4%) hypertension. There was a significant underutilisation of ABPM, with only 1.6% doctors using this method to diagnose hypertension. HBPM was used by 22.2% and 56.8% of the respondents to diagnose and manage hypertension, respectively. A quarter (26.7%) of the respondents reported using only one in-office BP reading, while around 40% participants reported using ≥12 HBPM readings. Doctors with specialist qualification in family medicine were more likely to use AOBP in clinics and to obtain the recommended number of office BP readings for diagnosis and management of hypertension.ConclusionPrimary Care doctors in Hong Kong prefer to use manual office BP values, measured using mercury or aneroid devices, to screen, diagnose, and manage hypertension, highlighting a marked underutilisation of AOBP and out-of-office BP measuring techniques, especially that of ABPM. Further studies are indicated to understand the underlying reasons and to minimise the gap between real-life clinical practice and those recommended, based on scientific advances.Trial registrationClinicaltrial.gov; ref. no.: NCT03926897.

Dataset Information

Prevalence and severity of burnout in Hong Kong doctors up to 20 years post-graduation: a cross-sectional study.

Publications

Prevalence and severity of burnout in Hong Kong doctors up to 20 years post-graduation: a cross-sectional study.

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