Theoretical Background
Culture, Burnout, and Engagement: A Meta-Analysis on National Cultural Values as Moderators in JD-R Theory
Implied research question:
To what extent, and in what specific ways, do national cultural values moderate the established relationships between job demands/resources and the outcomes of burnout/engagement as described by the Job Demands-Resources (JD-R) theory?
Key findings:
Job demands are strongly and positively linked to burnout.
Job resources are strongly and positively linked to engagement.
Five out of the six cultural dimensions from Hofstede’s framework moderated the relationships between job demand/job resource and burnout/engagement.
The Masculinity/Femininity and Tightness/Looseness dimensions only influenced relationships involving job demands.
Power Distance, Individualism/Collectivism, and Long-Term/Short-Term Orientation only influenced relationships involving job resources.
Highly Masculine and/or Tight cultures exacerbated the negative effect of job demands on burnout and decreased engagement.
High Power Distance, Collectivism, and Long-Term Orientation weakened the effects of job resources on engagement.
Many of the moderating effects were only partly stable and require further research across other national contexts.
Burnout in medical students before residency: A systematic review and meta-analysis
Implied research question:
What is the global prevalence of burnout and its constituent dimensions (emotional exhaustion, depersonalization, and low personal accomplishment) among medical students prior to their residency training?
Key findings:
Worldwide prevalence of burnout before residency is 44.2% (95% CI: 33.4%–55.0%):
Emotional Exhaustion: 40.8% (95% CI: 32.8%–48.9%).
Depersonalization: 35.1% (95% CI: 27.2%–43.0%).
Reduced Personal Accomplishment: 27.4% (95% CI: 20.5%–34.3%).
No significant gender difference in overall burnout prevalence.
Observed slight differences across various countries and continents.
Burnout syndrome among medical residents: A systematic review and meta-analysis
Implied research question:
What is the prevalence of burnout syndrome among medical residents, and how does this prevalence differ across various medical and surgical specialties?
Key findings:
The overall burnout prevalence is 35.1% across all specialties.
Three tiers of burnout prevalence based on medical specialty:
High Prevalence Group (42.5%): General surgery, anesthesiology, obstetrics/gynecology, and orthopedics.
Moderate Prevalence Group (29.4%): Internal medicine, plastic surgery, and pediatrics.
Low Prevalence Group (23.5%): Otolaryngology and neurology.
Interventions to reduce physician’s burnout
Sources:
Organizational strategies to reduce physician burnout: a systematic review and meta-analysis
Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis
Implied research question:
What is the overall effectiveness of interventions designed to reduce physician burnout, and how do organization-directed strategies compare in efficacy to individual-directed strategies?
Key findings:
Interventions are proven to cause clinically meaningful reductions in physician burnout, with a decrease in overall burnout prevalence from 54% to 44%.
Organization-directed interventions are significantly more effective at reducing burnout (Standardized Mean Difference [SMD] = -0.446) than individual-focused interventions (SMD = -0.178).
Organizational strategies were more effective at reducing depersonalization and improving feelings of personal accomplishment compared to individual strategies.
Effective intervention per approach:
Individual-focused: Mindfulness programs, stress management training, and small group curricula.
Organization-focused: Changes to workload and schedules (e.g., duty hour requirements, shift rotation) and improvements in teamwork and communication.
Resident duty hours and resident and patient outcomes: Systematic review and meta-analysis
Implied research question:
Based on evidence from randomized controlled trials, what is the impact of resident duty hour restrictions on key resident-centered outcomes (like burnout and well-being) and patient-centered outcomes (like medical errors and length of stay)?
Key findings:
Shorter resident duty hours were associated with significantly less emotional exhaustion (Standardized Mean Difference [SMD] = -0.11) and less dissatisfaction with overall well-being (Odds Ratio [OR] = 0.61).
Shorter shifts were also linked to a significant increase in sleep duration for residents.
No statistically significant association between shorter duty hours and key patient outcomes, including hospital length of stay, serious medical errors, and preventable adverse events.
A Meta-Analysis of the Relationship between Role Stress and Organizational Commitment: the Moderating Effects of Occupational Type and Culture
Implied research question:
What is the relationship between different forms of role stress (ambiguity, conflict, and overload) and the components of organizational commitment (affective and continuance), and are these relationships moderated by occupational type and culture?
Key findings:
Role ambiguity, conflict, and overload) are significantly and negatively related to affective commitment/employee’s desire to stay.
Role ambiguity, conflict, and overload) are not significantly related to continuance commitment/employee’s need to stay.
Role ambiguity has the strongest negative relationship with affective commitment (corrected correlation ρ = -0.40).
The negative relationships of role ambiguity and role conflict with affective commitment are stronger in Western cultures compared to non-Western cultures.
A systematic review including meta-analysis of work environment and burnout symptoms
Implied research question:
What are the associations between a wide range of working conditions and the development of burnout symptoms?
Key findings:
Associated with emotional exhaustion:
Low job control (OR=1.63; evidence grade 3).
Low workplace support (OR=1.81; grade 3).
High workload/demand (OR=2.53; grade 2).
Low reward (OR=1.86; grade 2).
Job insecurity (OR=1.39; grade 2).
Workplace justice (OR=0.35; grade 2; OR<1 implies that this factor is negatively associated with emotional exhaustion).
Associated with depersonalization:
Low workplace support (OR=1.59; grade 2).
Unspecified psychological demands (OR=2.37; grade 2).
High workload (OR=2.52; grade 2).
Associated with reduced personal accomplishment: Low reward (OR was not calculated because the results in the included studies were inconsistent).
