Physician burnout and patient care practices in Sierra Leone

Abstract

Background: Burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, can negatively impact patient care. While well-studied in developed countries, burnout in resource-limited settings like Sierra Leone is under-researched. We aimed to determine the prevalence of burnout among public sector physicians in Sierra Leone and assess its association with self-reported patient care practices. Methods: We conducted a cross-sectional study of 139 physicians randomly selected from major government hospitals across Sierra Leone. Burnout was assessed using the Maslach Burnout Inventory, and self-reported patient care practices were evaluated using an adapted version of Shanafelt et al.'s 2002 questionnaire. Statistical analyses included chi-square and fisher's exact test to compare demographic variables, and patient care practices between burnout and non-burnout physicians. Results: Of 139 physicians surveyed (30% female), 23.7% met criteria for burnout, defined by two of the three criteria: high emotional exhaustion, high depersonalization scores and low personal accomplishment. Most respondents were aged 26–35 years. Burnout prevalence did not significantly differ by gender, age group, marital status, region, or practice level. Physicians with burnout reported high emotional exhaustion (32%), depersonalization (22%), and low personal accomplishment (39%). Physicians with burnout showed suboptimal patient care practices, including avoiding necessary diagnostic tests due to cost concerns, expediting discharges, and prescribing without adequate patient evaluation. Conclusion: Physician burnout is prevalent in Sierra Leone and is correlated with compromised patient care practices. Addressing burnout necessitates multifaceted interventions at individual, organizational, and systemic levels. Implementing support systems and promoting well-being among physicians may improve patient care outcomes.