Burnout syndrome among orthopedic surgeons: a systematic review and meta-analysis of worldwide data
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20242996Keywords:
Burnout syndrome, Orthopedic surgery, Meta-analysisAbstract
Burnout syndrome has been associated with serious consequences for healthcare providers and healthcare systems. Orthopedic surgeons, as professionals in a specialty that is physically and mentally demanding, commonly experience high-stress work circumstances. We aimed to identify and assess the burden of burnout syndrome among orthopedic surgeons. This study was conducted in accordance with the guidelines and recommendations of the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020. Studies were shortlisted by searching PubMed, EBSCO, Scopus, Web of Science through Clarivate, and Google Scholar using keywords and medical subject headings terms related to burnout syndrome and orthopedics. Rayyan-intelligent systematic reviews were used to manage citations and remove duplicates. We used review manager 5.4 for quantitative data synthesis. Our meta-analysis included data from 16 studies on 2,564 orthopedic physicians, and quantitative data synthesis revealed that the pooled prevalence of high emotional exhaustion (EE) was 34% (95% CI: 27%, 40%), that of high depersonalization (DP) was 39% (95% CI: 29%, 50%), that of low sense of personal accomplishment (PA) was 24% (95% CI: 17%, 31%), and that of overall burnout was 43% (95% CI: 33%, 53%). There was significant heterogeneity in all analyses. In conclusion, burnout syndrome shows varying prevalence across different countries. The development of preventive measures may be necessary to alleviate the high rates of burnout among orthopedic surgeons.
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References
Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatr. 2016;15(2):103-11.
Balch CM. Stress and Burnout Among Surgeons. Arch Surg. 2009;144(4):371.
Balch CM, Shanafelt T. Combating Stress and Burnout in Surgical Practice: A Review. Adv Surg. 2010;44(1):29-47.
Dewa CS, Loong D, Bonato S, Trojanowski L, Rea M. The relationship between resident burnout and safety-related and acceptability-related quality of healthcare: a systematic literature review. BMC Med Educ. 2017;17(1):195.
Dimou FM, Eckelbarger D, Riall TS. Surgeon Burnout: A Systematic Review. J Am Coll Surg. 2016;222(6):1230-9.
Grover S, Sahoo S, Bhalla A, Avasthi A. Psychological problems and burnout among medical professionals of a tertiary care hospital of North India: A cross-sectional study. Indian J Psychiatry. 2018;60(2):175.
Hall LH, Johnson J, Heyhoe J, Watt I, Anderson K, O’Connor DB. Exploring the Impact of Primary Care Physician Burnout and Well-Being on Patient Care: A Focus Group Study. J Patient Saf. 2020;16(4):e278-83.
Gouveia PA da C, Ribeiro Neta MHC, Aschoff CA de M, Gomes DP, Silva NAF da, Cavalcanti HAF. Factors associated with burnout syndrome in medical residents of a university hospital. Rev Assoc Med Bras. 2017;63(6):504-11.
Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB. Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. Harris F, editor. PLoS One. 2016;11(7):e0159015.
Panagioti M, Geraghty K, Johnson J, Zhou A, Panagopoulou E, Chew-Graham C, et al. Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction. JAMA Intern Med. 2018;178(10):1317.
Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103-11.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
Maslach C, Jackson SE, Leiter M. Maslach Burnout Inventory. Consult Psychol Press. 1986;191-218.
Arora M, Diwan AD, Harris IA. Prevalence and Factors of Burnout among Australian Orthopaedic Trainees: A Cross-Sectional Study. J Orthop Surg. 2014;22(3):374-7.
Balch CM, Shanafelt TD, Sloan JA, Satele DV, Freischlag JA. Distress and Career Satisfaction Among 14 Surgical Specialties, Comparing Academic and Private Practice Settings. Ann Surg. 2011;254(4):558-68.
Simons BS, Foltz PA, Chalupa RL, Hylden CM, Dowd TC, Johnson AE. Burnout in U.S. Military Orthopaedic Residents and Staff Physicians. Mil Med. 2016;181(8):835-9.
Sochacki KR, Dong D, Peterson L, McCulloch PC, Harris JD. The Measurement of Orthopaedic Surgeon Burnout Using a Validated Wearable Device. Arthrosc Sport Med Rehabil. 2019;1(2):e115-21.
Somerson JS, Patton A, Ahmed AA, Ramey S, Holliday EB. Burnout Among United States Orthopaedic Surgery Residents. J Surg Educ. 2020;77(4):961-8.
Terrones-Rodríguez JF, Cisneros-Pérez V, Arreola-Rocha JJ. Burnout syndrome in medical residents at the General Hospital of Durango, México. Rev Med Inst Mex Seguro Soc. 2016;54(2):242-8.
Van Vendeloo SN, Brand PLP, Verheyen CCPM. Burnout and quality of life among orthopaedic trainees in a modern educational programme. Bone Joint J. 2014;96-B(8):1133-8.
Zheng H, Shao H, Zhou Y. Burnout Among Chinese Adult Reconstructive Surgeons: Incidence, Risk Factors, and Relationship With Intraoperative Irritability. J Arthroplasty. 2018;33(4):1253-7.
Faivre G, Kielwasser H, Bourgeois M, Panouilleres M, Loisel F, Obert L. Burnout syndrome in orthopaedic and trauma surgery residents in France: A nationwide survey. Orthop Traumatol Surg Res. 2018;104(8):1291-5.
Ghoraishian M, Zare Mehrjardi H, Askari J, Abrisham SMJ, Sobhan MR. The Frequency of Burnout among Iranian Orthopedic Surgeons and Residents. Arch bone Jt Surg. 2022;10(1):78-84.
Hwang JS, Ippolito JA, Beebe KS, Benevenia J, Berberian WS. Dealing with the loss of a resident: An analysis of burnout rates in a reduced complement training program. Work. 2018;60(4):567-71.
Lesic ARA, Petrovic-Stefanovic N, Perunicic I, Milenkovic P, Lecic-Tosevski D, Bumbasirevic MZ. Burnout in Belgrade orthopaedic surgeons and general practitioners: A preliminary report. Acta Chir Iugosl. 2009;56(2):53-9.
Oladeji LO, Ponce BA, Worley JR, Keeney JA. Mentorship in Orthopedics: A National Survey of Orthopedic Surgery Residents. J Surg Educ. 2018;75(6):1606-14.
Sadat-Ali M, Al-Habdan IM, Al-Dakheel DA, Shriyan D. Are orthopedic surgeons prone to burnout? Saudi Med J. 2005;26(8):1180-2.
Saleh KJ, Quick JC, Conaway M, Sime WE, Martin W, Hurwitz S, et al. The Prevalence and Severity of Burnout Among Academic Orthopaedic Departmental Leaders. J Bone Jt Surg. 2007;89(4):896-903.
Sargent MC, Sotile W, Sotile MO, Rubash H, Barrack RL. Quality of Life During Orthopaedic Training and Academic Practice. J Bone Jt Surgery-American Vol. 2009;91(10):2395-405.
Ramirez A, Graham J, Richards M, Gregory W, Cull A. Mental health of hospital consultants: the effects of stress and satisfaction at work. Lancet. 1996;347(9003):724-8.
Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population. Arch Intern Med. 2012;172(18):1377.
Shanafelt TD, Sloan JA, Habermann TM. The well-being of physicians. Am J Med. 2003;114(6):513-9.
Campbell DA, Sonnad SS, Eckhauser FE, Campbell KK, Greenfield LJ. Burnout among American surgeons. Surgery. 2001;130(4):696-705.
Kollias CM, Okoro T, Tufescu T V, Wadey V. Distress in orthopedic trainees and attending surgeons: a Canadian national survey. Can J Surg. 2020;63(3):E190-5.
Benson S, Truskett PG, Findlay B. SE12 the relationship between burnout and emotional intelligence in australian surgeons and surgical trainees. ANZ J Surg. 2007;77(s1).
Benson S, Sammour T, Neuhaus SJ, Findlay B, Hill AG. Burnout in Australasian Younger Fellows. ANZ J Surg. 2009;79(9):590-7.