Explaining and addressing the limitations in usefulness of available estimated prevalence figures relating to burnout in family doctors: Evidence from a systematic scoping literature review

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Abstract

Burnout in family doctors (FDs) affects their well-being, patient care, and healthcare organizations, and is considered common worldwide. However, its measurement has been so inconsistent that whether the widely divergent prevalence figures can be meaningfully interpreted has been questioned. Our aim was to go further than previous systematic reviews to explore the meaning contribution and usefulness of FD-burnout prevalence estimates. Worldwide literature was systematically reviewed using Levac's scoping framework, with 249 papers undergoing full-text review. Of 176 studies measuring burnout, 78% used the Maslach Burnout Inventory (MBI), which measures burnout as now defined by the World Health Organization. We, therefore, concentrated on the MBI. Its burnout measurement was markedly inconsistent, with prevalence estimates ranging from 2.8% to 85.7%. Researchers made prevalence claims relating to burnout severity and implied diagnoses based on participants' MBI scores, even though the MBI has not been validated as a clinical or diagnostic tool. Except when comparisons were possible between certain studies, prevalence figures provided limited meaning and added little to the understanding of burnout in FDs. Our review revealed a lack of research-supported meaningful information about the prevalence of FD burnout and that care is required to avoid drawing unsubstantiated conclusions from prevalence results. This paper's overall purpose is to propose how obtaining meaningful prevalence estimates can begin, which are recognized as key to developing improved prevention policies and interventions. Researchers must adopt a consistent means to measure burnout, use the MBI as its authors intended, and explore making progress through quantitative and qualitative collaboration.
Original languageEnglish
Pages (from-to)261-272
Number of pages12
JournalJournal of Psychiatric Research
Volume158
Early online date13 Dec 2022
DOIs
Publication statusPublished (in print/issue) - 28 Feb 2023

Bibliographical note

Role of the funding source
The funding for conduct of the research and preparation of the article was provided solely by the co-authors.

Declaration of competing interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.


Funding Information:
Dr Derek McLaughlin, Queens University Belfast, School of Nursing and Midwifery, for his invaluable contribution during conceptualization and supervision, and his general support and encouragement. Professor Marlene Sinclair, Ulster University, Midwifery Research, School of Nursing, for her always helpful critical review of our work, and her subsequent advice and encouragement. Ulster University Jordanstown library staff and subject librarians, Mary Rose Holman and Kelly McCoo. Professor Shanafelt and his colleagues who were frequently cited in our paper because of their series of robust cross-sectional studies. We hope that our paper can also make a contribution to the future of physician-burnout research. Professor Michael Leiter for his helpful and authoritative responses to our emails.

Publisher Copyright:
© 2022 The Authors

Funding Information:
Dr Derek McLaughlin, Queens University Belfast, School of Nursing and Midwifery, for his invaluable contribution during conceptualization and supervision, and his general support and encouragement. Professor Marlene Sinclair, Ulster University, Midwifery Research, School of Nursing, for her always helpful critical review of our work, and her subsequent advice and encouragement. Ulster University Jordanstown library staff and subject librarians, Mary Rose Holman and Kelly McCoo. Professor Shanafelt and his colleagues who were frequently cited in our paper because of their series of robust cross-sectional studies. We hope that our paper can also make a contribution to the future of physician-burnout research. Professor Michael Leiter for his helpful and authoritative responses to our emails.

Publisher Copyright:
© 2022 The Authors

Keywords

  • Burnout
  • Professional
  • stress
  • fatigue
  • General Practitioner
  • family physician
  • family practice
  • prevalence
  • Maslach Burnout Inventory
  • Prevalence
  • General practitioner
  • Family physician
  • Maslach burnout inventory
  • Family practice

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