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BURNOUT AMONG RESIDENTS OF GENERAL SURGERY: WORK-LIFE BALANCE, SOCIAL SUPPORT, AND BURNOUT AMONG RESIDENTS OF GENERAL SURGERY
Corresponding Author(s) : Wahida Anjum
Humanities & Social Sciences Reviews,
Vol. 9 No. 1 (2021): January
Abstract
Purpose: Postgraduate medical students or residents are candidates who gain rigorous specialized training in any field of medical science. The study attempted to explain how work-life fit and perceived social support minimize burnout in public hospital general surgery units.
Method: Explanatory, cross-sectional, and quantitative research methods were employed. A questionnaire was administered to 120 respondents using purposive sampling. Besides reliability and validity testing, inferential statistics were used to evaluate data and test hypotheses.
Principal Findings: Work-life fit and perceived social supports affect emotional tiredness in responders. However, perceived social support and emotional weariness outweigh work-family balance and emotional exhaustion. Burnout is predicted by the number of children, gender, work-life balance, work-life interference, and personal life interference.
Implications: The current study helps us understand the process that affects the professional efficacy of medical professionals. Despite their high cognitive capacity, they were victims of depersonalization, emotional tiredness, and burnout. Therefore, it is crucial to successfully address surgeon burnout to enhance patient care.
Novelty: The study has novel findings for exploring the link between work-life balance, social support, and burnout in the cultural settings of Pakistan. It was not comprehensively investigated in our traditional healthcare system which is lacking in internal and external rewards therefore a complete investigation of the matter is required. Thus, these findings will enrich scientific understanding to further study these topics.
Keywords
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- Agha, K., Azmi, F. T. & Khan, S. A. (2017). Work-Life Balance: Scale Development and Validation. In: Heras, M. L., Chinchilla, N. & Grau, M. (eds). The Work-Family Balance in Light of Globalization and Technology (pp. 109–130). Cambridge Scholars Publishing, Newcastle upon Tyne, UK.
- Balch, C. M., Shanafelt, T. D., Sloan, J., Satele, D. V., & Kuerer, H. M. (2011). Burnout and career satisfaction among surgical oncologists compared with other surgical specialities. Annals of surgical oncology, 18(1), 16-25. https://doi.org/10.1245/s10434-010-1369-5 DOI: https://doi.org/10.1245/s10434-010-1369-5
- Bandalos, D. L., & Finney, S. J. (2018). Factor analysis: Exploratory and confirmatory. In The reviewer's guide to quantitative methods in the social sciences (pp. 98-122). Routledge. https://doi.org/10.4324/9781315 755649-8 DOI: https://doi.org/10.4324/9781315755649-8
- Bono, R., Arnau, J., Alarcón, R., & Blanca, M. J. (2019). Bias, precision, and accuracy of skewness and kurtosis estimators for frequently used continuous distributions. Symmetry, 12(1), 19. https://doi.org/10.339 0/sym12010019 DOI: https://doi.org/10.3390/sym12010019
- Cook, K. S., Cheshire, C., Rice, E. R., & Nakagawa, S. (2013). Social exchange theory. In Handbook of social psychology (pp. 61-88). Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6772-0_3 DOI: https://doi.org/10.1007/978-94-007-6772-0_3
- De Campo, M. E. (2013). Contemporary Greedy Institutions: An Essay on Lewis Coser's Concept in Times of the 'Hive Mind'. Sociologický Äasopis/Czech Sociological Review, 49(06), 969-987. https://doi.org/10.130 60/00380288.2013.49.6.05 DOI: https://doi.org/10.13060/00380288.2013.49.6.05
- Drost, E. A. (2011). Validity and reliability in social science research. Education Research and perspectives, 38(1), 105-123.
- Drost, E. A. (2011). Validity and reliability in social science research. Education Research and perspectives, 38(1), 105-123.
- Elmore, L. C., Jaffe, D. B., Jin, L., Awad, M. M., & Turnbull, I. R. (2016). A national survey of burnout among US general surgery residents. Journal of the American College of Surgeons, 223(3), 440-451. https://doi.org/10.1136/bmjopen-2016-013897 DOI: https://doi.org/10.1016/j.jamcollsurg.2016.05.014
- Field, A. (2018). Discovering statistics using IBM SPSS statistics 5th ed.
- Field, J. C., & Chan, X. W. (2018). Contemporary knowledge workers and the boundaryless work-life interface: Implications for the human resource management of the knowledge workforce. Frontiers in Psychology, 9, 2414. https://doi.org/10.3389/fpsyg.2018.02414 DOI: https://doi.org/10.3389/fpsyg.2018.02414
- Fiske, D.W., (1982). Convergent-discriminant validation in measurements and research strategies. N. Dir. Methodol. Social Behavioural Science. 12, 77-92.
- Greenhaus, J. H., & Allen, T. D. (2011). Work-family balance: A review and extension of the literature. In J. C. Quick & L. E. Tetrick (Eds.), Handbook of occupational health psychology (2nd ed.). (pp. 165-183). Washington, DC US: American Psychological Association. https://doi.org/10.2307/j.ctv1chs29w.14 DOI: https://doi.org/10.2307/j.ctv1chs29w.14
- Han, S., Shanafelt, T. D., Sinsky, C. A., Awad, K. M., Dyrbye, L. N., Fiscus, L. C., ... & Goh, J. (2019). Estimating the attributable cost of physician burnout in the United States. Annals of internal medicine, 170(11), 784-790. https://doi.org/10.7326/M18-1422 DOI: https://doi.org/10.7326/M18-1422
- Holmgreen, L., Tirone, V., Gerhart, J., & Hobfoll, S. E. (2017). Conservation of resources theory. The Handbook of stress and health: A guide to research and practice, 2(7), 443-457. https://doi.org/10.1002/9 781118993811.ch27 DOI: https://doi.org/10.1002/9781118993811.ch27
- Holzer, E., Tschan, F., Kottwitz, M. U., Beldi, G., Businger, A. P., & Semmer, N. K. (2019). The workday of hospital surgeons: what they do, what makes them satisfied, and the role of core tasks and administrative tasks; a diary study. BMC surgery, 19(1), 1-9. https://doi.org/10.1186/s12893-019-0570-0 DOI: https://doi.org/10.1186/s12893-019-0570-0
- Hsu, Y. Y., Bai, C. H., Yang, C. M., Huang, Y. C., Lin, T. T., & Lin, C. H. (2019). Long hours' effects on work-life balance and satisfaction. BioMed research international, 2019. https://doi.org/10.1155/2019/5046934 DOI: https://doi.org/10.1155/2019/5046934
- https://doi.org/10.1080/00223891.1990.9674095
- Hulland, J., Baumgartner, H., Smith, K.M., (2018). Marketing survey research best practices: evidence and recommendations from a review of JAMS articles. Journal of the Academy of Marketing Science, 46(1), 92-108. https://doi.org/10.1007/s11747-017-0532-y DOI: https://doi.org/10.1007/s11747-017-0532-y
- Hyman, L., Lamb, J., Bulmer, M.(2006). The use of pre-existing survey questions: implications for data quality. Paper presented at the. In: Proceedings of the European Conference on Quality in Survey Statistics.
- Hyman, S. A., Shotwell, M. S., Michaels, D. R., Han, X., Card, E. B., Morse, J. L., & Weinger, M. B. (2017). A survey evaluating burnout, health status, depression, reported alcohol and substance use, and social support of anesthesiologists. Anesthesia & Analgesia, 125(6), 2009-2018. https://doi.org/10.1213/ANE.0000000000 002298 DOI: https://doi.org/10.1213/ANE.0000000000002298
- Kahneman, D., & Deaton, A. (2010). High income improves evaluations of life but not emotional well-being. Proceedings of the national academy of sciences, 107(38), 16489-16493. https://doi.org/10.1073/pnas.10114 92107 DOI: https://doi.org/10.1073/pnas.1011492107
- Kelliher, C., Richardson, J., & Boiarintseva, G. (2019). All of the work? All of life? Reconceptualizing workâ€life balance for the 21st century. Human Resource Management Journal, 29(2), 97-112. https://doi.org/10.1111/1748-8583.12215 DOI: https://doi.org/10.1111/1748-8583.12215
- Kingsbury, N., & Scanzoni, J. (2009). Structural-functionalism. In Sourcebook of family theories and methods (pp. 195-221). Springer, Boston, MA. https://doi.org/10.1007/978-0-387-85764-0_9 DOI: https://doi.org/10.1007/978-0-387-85764-0_9
- Low, Z. X., Yeo, K. A., Sharma, V. K., Leung, G. K., McIntyre, R. S., Guerrero, A., ... & Ho, R. C. (2019). Prevalence of burnout in medical and surgical residents: a meta-analysis. International journal of environmental research and public health, 16(9), 1479. https://doi.org/10.3390/ijerph16091479 DOI: https://doi.org/10.3390/ijerph16091479
- Maslach, C., & Leiter, M. P. (2008). Early predictors of job burnout and engagement. Journal of applied psychology, 93(3), 498. https://doi.org/10.1037/0021-9010.93.3.498 DOI: https://doi.org/10.1037/0021-9010.93.3.498
- Maslach, C., Jackson, S. E., & Leiter, M. P. (1997). Maslach burnout inventory. Scarecrow Education.
- Nepogodiev, D., Martin, J., Biccard, B., Makeup, A., Bhangu, A., Ademuyiwa, A., ... & Morton, D. G. (2019). Global burden of postoperative death. The Lancet, 393(10170), 401. https://doi.org/10.1016/S0140-6736(18)33139-8 DOI: https://doi.org/10.1016/S0140-6736(18)33139-8
- Nippert-Eng, C. (1996). Calendars and keys: The classification of "home" and "work". In Sociological Forum (Vol. 11, No. 3, pp. 563-582). Kluwer Academic Publishers-Plenum Publishers. https://doi.org/10.1007/BF02 408393 DOI: https://doi.org/10.1007/BF02408393
- Parsons, T. (2017). The present status of "structural-functional" theory in sociology. In The idea of social structure (pp. 67-84). Routledge. https://doi.org/10.4324/9781315132563-5 DOI: https://doi.org/10.4324/9781315132563-5
- Rotenstein, L. S., Torre, M., Ramos, M. A., Rosales, R. C., Guille, C., Sen, S., & Mata, D. A. (2018). Prevalence of burnout among physicians: a systematic review. Jama, 320(11), 1131-1150. https://doi.org/1 0.1001/jama.2018.12777 DOI: https://doi.org/10.1001/jama.2018.12777
- Shanafelt, T. D., Balch, C. M., Bechamps, G., Russell, T., Dyrbye, L., Satele, D., ... & Freischlag, J. (2010). Burnout and medical errors among American surgeons. Annals of surgery, 251(6), 995-1000. https://doi.org/10. 1097/SLA.0b013e3181bfdab3 DOI: https://doi.org/10.1097/SLA.0b013e3181bfdab3
- Shanafelt, T. D., Balch, C. M., Dyrbye, L., Beauchamp, G., Russell, T., Satele, D., ... & Oreskovich, M. R. (2011). Special report: suicidal ideation among American surgeons. Archives of surgery, 146(1), 54-62. DOI: https://doi.org/10.1001/archsurg.2010.292
- Shanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015, December). Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. In Mayo clinic proceedings (Vol. 90, No. 12, pp. 1600-1613). Elsevier. https://doi.org/10.1016/j.mayocp.2015.08.023 DOI: https://doi.org/10.1016/j.mayocp.2015.08.023
- Tafa, M., & Baiocco, R. (2009). Addictive behavior and family functioning during adolescence. The American Journal of Family Therapy, 37(5), 388-395. https://doi.org/10.1080/01926180902754745 DOI: https://doi.org/10.1080/01926180902754745
- Waxman, B. P. (2011). Caring and sharing: strategies for recognizing and surviving burnout in surgeons. ANZ Journal of Surgery, 7(81), 493-494. https://doi.org/10.1111/j.1445-2197.2011.05803.x DOI: https://doi.org/10.1111/j.1445-2197.2011.05803.x
- Wong, K.K.-K. (2013). Partial least squares structural equation modelling (PLS-SEM) techniques using SmartPLS. Market. Bull. 24(1), 1-32
- Zimet, G. D., Powell, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric characteristics of the multidimensional scale of perceived social support. Journal of personality assessment, 55(3-4), 610-617. DOI: https://doi.org/10.1080/00223891.1990.9674095
- Zubairi, A. J., & Noordin, S. (2016). Factors associated with burnout among residents in a developing country. Annals of medicine and surgery, 6, 60-63. https://doi.org/10.1016/j.amsu.2016.01.090 DOI: https://doi.org/10.1016/j.amsu.2016.01.090
References
Agha, K., Azmi, F. T. & Khan, S. A. (2017). Work-Life Balance: Scale Development and Validation. In: Heras, M. L., Chinchilla, N. & Grau, M. (eds). The Work-Family Balance in Light of Globalization and Technology (pp. 109–130). Cambridge Scholars Publishing, Newcastle upon Tyne, UK.
Balch, C. M., Shanafelt, T. D., Sloan, J., Satele, D. V., & Kuerer, H. M. (2011). Burnout and career satisfaction among surgical oncologists compared with other surgical specialities. Annals of surgical oncology, 18(1), 16-25. https://doi.org/10.1245/s10434-010-1369-5 DOI: https://doi.org/10.1245/s10434-010-1369-5
Bandalos, D. L., & Finney, S. J. (2018). Factor analysis: Exploratory and confirmatory. In The reviewer's guide to quantitative methods in the social sciences (pp. 98-122). Routledge. https://doi.org/10.4324/9781315 755649-8 DOI: https://doi.org/10.4324/9781315755649-8
Bono, R., Arnau, J., Alarcón, R., & Blanca, M. J. (2019). Bias, precision, and accuracy of skewness and kurtosis estimators for frequently used continuous distributions. Symmetry, 12(1), 19. https://doi.org/10.339 0/sym12010019 DOI: https://doi.org/10.3390/sym12010019
Cook, K. S., Cheshire, C., Rice, E. R., & Nakagawa, S. (2013). Social exchange theory. In Handbook of social psychology (pp. 61-88). Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6772-0_3 DOI: https://doi.org/10.1007/978-94-007-6772-0_3
De Campo, M. E. (2013). Contemporary Greedy Institutions: An Essay on Lewis Coser's Concept in Times of the 'Hive Mind'. Sociologický Äasopis/Czech Sociological Review, 49(06), 969-987. https://doi.org/10.130 60/00380288.2013.49.6.05 DOI: https://doi.org/10.13060/00380288.2013.49.6.05
Drost, E. A. (2011). Validity and reliability in social science research. Education Research and perspectives, 38(1), 105-123.
Drost, E. A. (2011). Validity and reliability in social science research. Education Research and perspectives, 38(1), 105-123.
Elmore, L. C., Jaffe, D. B., Jin, L., Awad, M. M., & Turnbull, I. R. (2016). A national survey of burnout among US general surgery residents. Journal of the American College of Surgeons, 223(3), 440-451. https://doi.org/10.1136/bmjopen-2016-013897 DOI: https://doi.org/10.1016/j.jamcollsurg.2016.05.014
Field, A. (2018). Discovering statistics using IBM SPSS statistics 5th ed.
Field, J. C., & Chan, X. W. (2018). Contemporary knowledge workers and the boundaryless work-life interface: Implications for the human resource management of the knowledge workforce. Frontiers in Psychology, 9, 2414. https://doi.org/10.3389/fpsyg.2018.02414 DOI: https://doi.org/10.3389/fpsyg.2018.02414
Fiske, D.W., (1982). Convergent-discriminant validation in measurements and research strategies. N. Dir. Methodol. Social Behavioural Science. 12, 77-92.
Greenhaus, J. H., & Allen, T. D. (2011). Work-family balance: A review and extension of the literature. In J. C. Quick & L. E. Tetrick (Eds.), Handbook of occupational health psychology (2nd ed.). (pp. 165-183). Washington, DC US: American Psychological Association. https://doi.org/10.2307/j.ctv1chs29w.14 DOI: https://doi.org/10.2307/j.ctv1chs29w.14
Han, S., Shanafelt, T. D., Sinsky, C. A., Awad, K. M., Dyrbye, L. N., Fiscus, L. C., ... & Goh, J. (2019). Estimating the attributable cost of physician burnout in the United States. Annals of internal medicine, 170(11), 784-790. https://doi.org/10.7326/M18-1422 DOI: https://doi.org/10.7326/M18-1422
Holmgreen, L., Tirone, V., Gerhart, J., & Hobfoll, S. E. (2017). Conservation of resources theory. The Handbook of stress and health: A guide to research and practice, 2(7), 443-457. https://doi.org/10.1002/9 781118993811.ch27 DOI: https://doi.org/10.1002/9781118993811.ch27
Holzer, E., Tschan, F., Kottwitz, M. U., Beldi, G., Businger, A. P., & Semmer, N. K. (2019). The workday of hospital surgeons: what they do, what makes them satisfied, and the role of core tasks and administrative tasks; a diary study. BMC surgery, 19(1), 1-9. https://doi.org/10.1186/s12893-019-0570-0 DOI: https://doi.org/10.1186/s12893-019-0570-0
Hsu, Y. Y., Bai, C. H., Yang, C. M., Huang, Y. C., Lin, T. T., & Lin, C. H. (2019). Long hours' effects on work-life balance and satisfaction. BioMed research international, 2019. https://doi.org/10.1155/2019/5046934 DOI: https://doi.org/10.1155/2019/5046934
https://doi.org/10.1080/00223891.1990.9674095
Hulland, J., Baumgartner, H., Smith, K.M., (2018). Marketing survey research best practices: evidence and recommendations from a review of JAMS articles. Journal of the Academy of Marketing Science, 46(1), 92-108. https://doi.org/10.1007/s11747-017-0532-y DOI: https://doi.org/10.1007/s11747-017-0532-y
Hyman, L., Lamb, J., Bulmer, M.(2006). The use of pre-existing survey questions: implications for data quality. Paper presented at the. In: Proceedings of the European Conference on Quality in Survey Statistics.
Hyman, S. A., Shotwell, M. S., Michaels, D. R., Han, X., Card, E. B., Morse, J. L., & Weinger, M. B. (2017). A survey evaluating burnout, health status, depression, reported alcohol and substance use, and social support of anesthesiologists. Anesthesia & Analgesia, 125(6), 2009-2018. https://doi.org/10.1213/ANE.0000000000 002298 DOI: https://doi.org/10.1213/ANE.0000000000002298
Kahneman, D., & Deaton, A. (2010). High income improves evaluations of life but not emotional well-being. Proceedings of the national academy of sciences, 107(38), 16489-16493. https://doi.org/10.1073/pnas.10114 92107 DOI: https://doi.org/10.1073/pnas.1011492107
Kelliher, C., Richardson, J., & Boiarintseva, G. (2019). All of the work? All of life? Reconceptualizing workâ€life balance for the 21st century. Human Resource Management Journal, 29(2), 97-112. https://doi.org/10.1111/1748-8583.12215 DOI: https://doi.org/10.1111/1748-8583.12215
Kingsbury, N., & Scanzoni, J. (2009). Structural-functionalism. In Sourcebook of family theories and methods (pp. 195-221). Springer, Boston, MA. https://doi.org/10.1007/978-0-387-85764-0_9 DOI: https://doi.org/10.1007/978-0-387-85764-0_9
Low, Z. X., Yeo, K. A., Sharma, V. K., Leung, G. K., McIntyre, R. S., Guerrero, A., ... & Ho, R. C. (2019). Prevalence of burnout in medical and surgical residents: a meta-analysis. International journal of environmental research and public health, 16(9), 1479. https://doi.org/10.3390/ijerph16091479 DOI: https://doi.org/10.3390/ijerph16091479
Maslach, C., & Leiter, M. P. (2008). Early predictors of job burnout and engagement. Journal of applied psychology, 93(3), 498. https://doi.org/10.1037/0021-9010.93.3.498 DOI: https://doi.org/10.1037/0021-9010.93.3.498
Maslach, C., Jackson, S. E., & Leiter, M. P. (1997). Maslach burnout inventory. Scarecrow Education.
Nepogodiev, D., Martin, J., Biccard, B., Makeup, A., Bhangu, A., Ademuyiwa, A., ... & Morton, D. G. (2019). Global burden of postoperative death. The Lancet, 393(10170), 401. https://doi.org/10.1016/S0140-6736(18)33139-8 DOI: https://doi.org/10.1016/S0140-6736(18)33139-8
Nippert-Eng, C. (1996). Calendars and keys: The classification of "home" and "work". In Sociological Forum (Vol. 11, No. 3, pp. 563-582). Kluwer Academic Publishers-Plenum Publishers. https://doi.org/10.1007/BF02 408393 DOI: https://doi.org/10.1007/BF02408393
Parsons, T. (2017). The present status of "structural-functional" theory in sociology. In The idea of social structure (pp. 67-84). Routledge. https://doi.org/10.4324/9781315132563-5 DOI: https://doi.org/10.4324/9781315132563-5
Rotenstein, L. S., Torre, M., Ramos, M. A., Rosales, R. C., Guille, C., Sen, S., & Mata, D. A. (2018). Prevalence of burnout among physicians: a systematic review. Jama, 320(11), 1131-1150. https://doi.org/1 0.1001/jama.2018.12777 DOI: https://doi.org/10.1001/jama.2018.12777
Shanafelt, T. D., Balch, C. M., Bechamps, G., Russell, T., Dyrbye, L., Satele, D., ... & Freischlag, J. (2010). Burnout and medical errors among American surgeons. Annals of surgery, 251(6), 995-1000. https://doi.org/10. 1097/SLA.0b013e3181bfdab3 DOI: https://doi.org/10.1097/SLA.0b013e3181bfdab3
Shanafelt, T. D., Balch, C. M., Dyrbye, L., Beauchamp, G., Russell, T., Satele, D., ... & Oreskovich, M. R. (2011). Special report: suicidal ideation among American surgeons. Archives of surgery, 146(1), 54-62. DOI: https://doi.org/10.1001/archsurg.2010.292
Shanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015, December). Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. In Mayo clinic proceedings (Vol. 90, No. 12, pp. 1600-1613). Elsevier. https://doi.org/10.1016/j.mayocp.2015.08.023 DOI: https://doi.org/10.1016/j.mayocp.2015.08.023
Tafa, M., & Baiocco, R. (2009). Addictive behavior and family functioning during adolescence. The American Journal of Family Therapy, 37(5), 388-395. https://doi.org/10.1080/01926180902754745 DOI: https://doi.org/10.1080/01926180902754745
Waxman, B. P. (2011). Caring and sharing: strategies for recognizing and surviving burnout in surgeons. ANZ Journal of Surgery, 7(81), 493-494. https://doi.org/10.1111/j.1445-2197.2011.05803.x DOI: https://doi.org/10.1111/j.1445-2197.2011.05803.x
Wong, K.K.-K. (2013). Partial least squares structural equation modelling (PLS-SEM) techniques using SmartPLS. Market. Bull. 24(1), 1-32
Zimet, G. D., Powell, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric characteristics of the multidimensional scale of perceived social support. Journal of personality assessment, 55(3-4), 610-617. DOI: https://doi.org/10.1080/00223891.1990.9674095
Zubairi, A. J., & Noordin, S. (2016). Factors associated with burnout among residents in a developing country. Annals of medicine and surgery, 6, 60-63. https://doi.org/10.1016/j.amsu.2016.01.090 DOI: https://doi.org/10.1016/j.amsu.2016.01.090