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Occupational Medicine Advance Access published online on September 16, 2008
Occupational Medicine, doi:10.1093/occmed/kqn122
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Burnout and patient care in junior doctors in Mexico City

Rodrigo Toral-Villanueva1, Guadalupe Aguilar-Madrid2 and Cuauhtémoc Arturo Juárez-Pérez2

1 Coordinación de Salud en el Trabajo, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, D. F., México
2 Unidad de Investigación en Salud en el Trabajo, IMSS, Ciudad de México, D. F., México

Background Burnout is known to occur in public service workers leading to a reduction in effectiveness at work.

Aim To estimate the prevalence of burnout in junior doctors and its impact on patient care.

Methods A cross-sectional study of junior doctors at three hospitals in Mexico City was conducted. Measures used included the Maslach Burnout Inventory (MBI), measuring depersonalization (DP), emotional exhaustion (EE) and personal achievement (PA), a questionnaire about patient care practices and attitudes and one on sociodemographic characteristics. Logistic regression analysis was used to assess the association between burnout and suspected risk factors.

Results A total of 312 junior doctors participated (response rate 65%). In total, 57% were male and the average age was 28. Average scores in MBI subscales were EE: 18.2, DP: 6.9 and PA: 37.6. Burnout prevalence was 40% (126). Junior doctors with burnout were more likely to report suboptimal patient care practices occurring monthly (OR 5.5; 95% CI 2.7–11.2) and weekly (OR 5.2; 95% CI 1.6–16.3). The logistic regression model for burnout included shifts lasting >12 h, current depression, former major depression, first- or second-year junior doctors, male gender and single status.

Conclusions Burnout was most strongly associated with shifts >12 h and with both current and previous depression. Reported suboptimal patient care was also associated with working shifts of ≥12 h. Burnout may be adversely affecting junior doctors’ health and their patients’ care.

Keywords      Attitudes; burnout; junior doctors; patient care; practices; work shift

Correspondence to: Rodrigo Toral-Villanueva, Coordinación de Salud en el Trabajo, IMSS, Av. Cuauhtémoc 330, Edif. C, 4° Piso, Col. Doctores, Del. Cuauhtémoc, C. P. 06725, Ciudad de México, D. F., México. Tel: +52 (55) 56 27 69 00 x 21838; fax: +52 (55) 55 19 50 52; e-mail: rodrigo.toral{at}imss.gob.mx


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