Physician burnout, associated factors, and their effects on work performance throughout first-year internships during the COVID-19 pandemic in Thailand: a cross-sectional study

泰国新冠疫情期间第一年实习医生倦怠、相关因素及其对工作表现的影响:一项横断面研究

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Abstract

BACKGROUND: Burnout has become a significant occupational concern for physicians who have recently graduated, attributed to their prolonged exposure to workplace stressors, poor work-life balance, and limited patient care experience. These challenges posed during the COVID-19 pandemic, placed unprecedented stress on healthcare systems and first-year interns navigating their careers. This study aimed to assess the prevalence of burnout among first-year intern physicians (1st IPs), investigate the factors contributing to burnout, and explore potential correlations between burnout and work performance. METHODS: This cross-sectional study was carried out between June and July 2022, enrolling 412 1st IPs in Thailand. These participants completed a questionnaire through an online web-based platform. The questionnaire included the Maslach Burnout Inventory-Human Services Survey for Medical Personnel to assess burnout, as well as items addressing factors related to working conditions. These factors included colleague support, academic counselling, professional satisfaction, income and workload balance, medical errors, work performance, resignation thoughts, and suicidal ideation. Data were analysed using multivariable logistic regression. RESULTS: Among the participants, 58.5% were female, with an average age of 25.59 years (SD 2.18). A significant proportion (81.2%) worked more than 80 h per week. Nearly half, 48.1% experienced burnout, characterized by high levels of emotional exhaustion (83.5%), depersonalization (74.8%), and low personal accomplishment (66.5%). In the adjusted model, physicians lacking support from their colleagues had higher levels of burnout (adjusted odds ratio [aOR] 2.56, 95% CI 1.18 to 5.58). Those dissatisfied with their professional life were more likely to experience burnout compared to those who were satisfied (aOR 4.52, 95% CI 2.31 to 8.84). Burnout was also significantly associated with poor work performance (aOR 2.14, 95% CI 1.08 to 4.21), while no association was found between burnout and suicidal ideation. CONCLUSIONS: Our findings revealed a significantly high prevalence of burnout among 1st IPs in Thailand. This burnout was associated with inadequate colleague support and professional dissatisfaction, ultimately resulting in poor work performance. To address these issues, mentorship programs and buddy support systems, along with adherence to recommended work-hour guidelines, are crucial to mitigate burnout and improve work performance.

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