Job stressors in relation to burnout and compromised sleep among academic physicians in India

BACKGROUND: Burnout among physicians, especially in the academic setting, is an urgent concern, with adequate sleep one of the key focal points. OBJECTIVE: To identify job stressors contributing to burnout and compromised sleep among academic physicians, using a comprehensive, theory-based instrument, the Occupational Stressor Index (OSI), whose specific form was created ‘for physicians by physicians’. METHODS: This parallel mixed-methods cross-sectional investigation was conducted among 109 physicians employed in a public teaching hospital, Jodhpur, India. Work conditions were evaluated by the physician-specific OSI (part I). The Copenhagen Burnout Index and Pittsburgh Sleep Quality Index (PSQI) were the outcome instruments (part II). Seventy-six physicians completed parts I and II. RESULTS: The physicians were from wide-ranging specialties, and 82% of the cohort were residents. Mean total OSI scores were 87.4±8.1, with unit-change yielding adjusted odds-ratios (95% confidence-intervals) for personal (1.10 (1.02–1.18)) and work-related burnout (1.12 (1.04–1.22)), and PSQI (1.09 (1.01–1.17)). Significant multivariable associations with burnout and/or sleep indices included: working 7 days/week, lacking work-free vacation, insufficient rest breaks, interruptions, many patients in intensive-care, no separate time for non-clinical duties, pressure to publish, injury/suicide attempts of colleagues/staff, performing pointless tasks. The latter were described as administrative/clerical. Lacking genuine rest breaks was mainly patient-related, further compromised by emergency work and lacking separate time for non-clinical duties. Long workhours and exhausting schedule were cited as most difficult parts of work, while reducing workhours, improving work schedule, and hiring more staff most frequently recommended. CONCLUSION: Specific working conditions potentially contributory to burnout and compromised sleep among physicians working in academic medicine are identified using a methodologically-rigorous, in-depth approach. These findings inform evidence-based interventions aimed at preserving physician mental health and work capacity.

Complete, it is entirely up to me.0.5) To a large extent, I mainly decide on my work schedule.1.5)A little, but mainly my schedule depends on others, or is decided by others.
2) Not at all.No acute hazards 13 11.9 OVAOIT HAZARDOUS TASK PERFORMANCE  1) It is sometimes impossible to complete everything, even with maximal effort.
2) It is often objectively impossible to complete everything, even with maximal effort.0) Excellent, we all get along very well together and misunderstanding are very rare.0.5) Good, most the time we get along well, with few misunderstandings and tensions.1) Fair, we have our ups-and-downs, and sometimes there are misunderstandings and tensions.
2) Poor, there is a great deal of tension and conflict.0) The atmosphere is constructive and conducive to growth and learning 0.5) There is some tension.Oversights and/or lack of knowledge will be noticed and commented upon.If these are of major importance, there may be adverse consequences for me. 1) These occasions are highly unpleasant.Even the slightest oversight or lack of knowledge inevitably becomes a point of ridicule and/or chastisement.2) I must care for all the patients whom I admit during a given shift.1.5)I must care for some of the patients whom I admit during a given shift.0) The patients whom I admit are nearly always transferred fairly rapidly to other colleagues.
is always possible to complete everything.0.5 G3 It is usually possible to complete everything. 1 G3 It is sometimes impossible to complete everything, even with maximal effort.2 G3 It is often objectively impossible to complete everything, even with maximal effort.Add 0.5 points for J14 =no special time set aside for non-clinical tasks, J7= cares for newly admitted patients during shift, to max. of patients under your care/ outpatient scheduling H2.Which clinical tasks or procedures you perform H3.Whether and how much you will take on other, non-clinical duties H4.Which colleagues and staff you work with H5.Planning and policy of your institution (including those regarding indications for medical procedures and for hospital admissions) H1: Influence over number of patients under your care/outpatient scheduling --------------------------------------------LACKS HELP WITH CLINICAL DIFFICULTIES Can you get help for difficult cases and/or clinical dilemmas?0) Yes, I can almost always count on such help.1.5)I can't really count on getting such help.0.5) Yes, more often than not 2) Rarely or never do I get the help, which I need.-------------------------------I2: Social climate: In general, how is the social climate at your workplace?