Physicians’ Perspectives About Burnout: a Systematic Review and Metasynthesis

Abstract

Background: Doctors’ burnout is a major public health issue with important harmful effects on both the healthcare system and physicians’ mental health. Qualitative studies are relevant in this context, focusing as they do on the views of the physicians of how they live and understand burnout in their own professional field. Objective: To explore physicians’ perspectives on burnout by applying a metasynthesis approach, including a systematic literature review and analysis of the qualitative studies. Data Sources: Medline, PsycINFO, EMBASE, and SSCI from the earliest available date to June 2018 Review Methods: This metasynthesis follows thematic synthesis procedures. Four databases were systematically searched for qualitative studies reporting doctors’ perspectives on burnout. Article quality was assessed with the Critical Appraisal Skills Program. Thematic analysis was used to identify key themes and synthesize them. Results: Thirty-three articles were included, covering data from more than 1589 medical doctors (68 residents and 1521 physicians). Two themes emerged from the analysis: (1) stress factors promoting burnout—ranked as organizational, then contextual and relational, and finally individual—factors and (2) protective factors, which were above all individual but also relational and organizational. Conclusions: The individual and organizational levels are abundantly described in the literature, as risk factors and interventions. Our results show that doctors identify numerous organizational factors as originators of potential burnout, but envision protecting themselves individually. Relational factors, in a mediate position, should be addressed as an original axis of protection and intervention for battling doctors’ burnout.