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| | {{otheruses4|the psychological term|other uses|Burnout}} |
| {{DiseaseDisorder infobox | | | {{DiseaseDisorder infobox | |
| Name = Burn-out | | | Name = Burn-out | |
| ICD10 = {{ICD10|Z|73|0|z|70}} | | | ICD10 = {{ICD10|Z|73|0|z|70}} | |
| }} | | }} |
| '''Burnout''' is a concept in [[industrial and organizational psychology]] for "an excessive stress reaction to one's occupational or professional environment. It is manifested by feelings of emotional and physical exhaustion coupled with a sense of frustration and failure".<ref name="MeSH">{{MeSH|Professional Burnout}}</ref> Burnout has three dimensions<ref name="Maslach Jackson 1981 pp. 99–113">{{cite journal | last=Maslach | first=Christina | last2=Jackson | first2=Susan E. | title=The measurement of experienced burnout | journal=Journal of Organizational Behavior | publisher=Wiley-Blackwell | volume=2 | issue=2 | year=1981 | issn=0894-3796 | doi=10.1002/job.4030020205 | pages=99–113}}</ref>: | | '''Burnout''' is a concept in [[industrial and organizational psychology]] for "an excessive stress reaction to one's occupational or professional environment. It is manifested by feelings of emotional and physical exhaustion coupled with a sense of frustration and failure". According to the [[World Health Organization]] (WHO), "Burn-out is included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon. It is not classified as a medical condition." <ref name="who">World Health Organization. Burn-Out an “Occupational Phenomenon”: International Classification of Diseases. Available online: |
| | https://www.who.int/mental_health/evidence/burn-out/en/</ref> |
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| | Burnout has three dimensions: |
| * Emotional exhaustion | | * Emotional exhaustion |
| * Depersonalization (cynicism) | | * Depersonalization (cynicism) |
| * Diminished personal accomplishment (inefficacy) | | * Diminished personal accomplishment (inefficacy) |
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| According to the [[World Health Organization]] (WHO), "Burn-out is included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon. It is not classified as a medical condition." <ref name="who">World Health Organization. Burn-Out an “Occupational Phenomenon”: International Classification of Diseases. Available online:
| | The WHO describes the three dimensions as<ref name="who"/>: |
| | |
| https://www.who.int/mental_health/evidence/burn-out/en/</ref>The WHO describes the three dimensions as<ref name="who"/>:
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| * Feelings of energy depletion or exhaustion; | | * Feelings of energy depletion or exhaustion; |
| * Increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and | | * Increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and |
| * Reduced professional efficacy | | * Reduced professional efficacy |
| | Subsequent research suggests the third dimension, personal accomplishment, better fits with the concept of professional engagement rather than with burnout. |
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| Subsequent research suggests the third dimension, personal accomplishment, better fits with the concept of professional engagement rather than with burnout.<ref name="SchaufeliBakker2016">{{cite journal|last1=Schaufeli|first1=Wilmar B.|last2=Bakker|first2=Arnold B.|last3=Salanova|first3=Marisa|title=The Measurement of Work Engagement With a Short Questionnaire|journal=Educational and Psychological Measurement|volume=66|issue=4|year=2016|pages=701–716|issn=0013-1644|doi=10.1177/0013164405282471}}</ref>
| | Burnout is due to loss of control at work, and also "burnout is mainly predicted by job demands but also by lack of job resources". |
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| Burnout is due to loss of control at work, and also "burnout is mainly predicted by job demands but also by lack of job resources"<ref nae="10.1002/job.248">Schaufeli, W. B., & Bakker, A. B. (2004). Job demands, job resources, and their relationship with burnout and engagement: A multi‐sample study. Journal of Organizational Behavior: The International Journal of Industrial, Occupational and Organizational Psychology and Behavior, 25(3), 293-315{{doi|10.1002/job.248}}</ref>. | | Burnout is now being studied in its reported antitheses, [[job satisfaction]], job engagement and thriving. Thriving may protect against burnout. Engagement is both negatively associated with burnout, but also unhealthy engagement may lead to burnout. |
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| The prevalence of burnout in the general, employed population of the United States, aged is<ref name="pmid24448053">{{cite journal| author=Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J et al.| title=Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. | journal=Acad Med | year= 2014 | volume= 89 | issue= 3 | pages= 443-51 | pmid=24448053 | doi=10.1097/ACM.0000000000000134 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24448053 }} </ref><ref name="pmid22911330">{{cite journal| author=Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D et al.| title=Burnout and satisfaction with work-life balance among US physicians relative to the general US population. | journal=Arch Intern Med | year= 2012 | volume= 172 | issue= 18 | pages= 1377-85 | pmid=22911330 | doi=10.1001/archinternmed.2012.3199 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22911330 }} </ref><ref name="pmid26653297">{{cite journal| author=Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J et al.| title=Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. | journal=Mayo Clin Proc | year= 2015 | volume= 90 | issue= 12 | pages= 1600-13 | pmid=26653297 | doi=10.1016/j.mayocp.2015.08.023 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26653297 }} </ref>:
| | Engagement may not simply be the opposite of burnout. |
| * General, employed U.S. population
| |
| ** (2010): aged 31-47 30%<ref name="pmid24448053"/>, aged 29-65 29%<ref name="pmid22911330"/>
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| ** (2014): aged 31-65 28%<ref name="pmid26653297"/>
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| ** (2017): aged 29-65 28%<ref name="ShanafeltWest2019">{{cite journal|last1=Shanafelt|first1=Tait D.|last2=West|first2=Colin P.|last3=Sinsky|first3=Christine|last4=Trockel|first4=Mickey|last5=Tutty|first5=Michael|last6=Satele|first6=Daniel V.|last7=Carlasare|first7=Lindsey E.|last8=Dyrbye|first8=Lotte N.|title=Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017|journal=Mayo Clinic Proceedings|year=2019|issn=00256196|doi=10.1016/j.mayocp.2018.10.023}}</ref>
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| * College graduates 2010: aged 31-47 36%<ref name="pmid24448053"/>
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| Burnout is now being studied in its reported antitheses, [[job satisfaction]], job engagement and thriving. Thriving may protect against burnout<ref name="Porath2012">Porath, Christine, et al. "Thriving at work: Toward its measurement, construct validation, and theoretical refinement." Journal of Organizational Behavior 33.2 (2012): 250-275. {{doi|10.1002/job.756}}</ref><ref name="pmid27631555">{{cite journal| author=Hildenbrand K, Sacramento CA, Binnewies C| title=Transformational Leadership and Burnout: The Role of Thriving and Followers' Openness to Experience. | journal=J Occup Health Psychol | year= 2016 | volume= | issue= | pages= | pmid=27631555 | doi=10.1037/ocp0000051 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27631555 }} </ref>. Engagement is both negatively associated with burnout<ref nae="10.1002/job.248">Schaufeli, W. B., & Bakker, A. B. (2004). Job demands, job resources, and their relationship with burnout and engagement: A multi‐sample study. Journal of Organizational Behavior: The International Journal of Industrial, Occupational and Organizational Psychology and Behavior, 25(3), 293-315{{doi|10.1002/job.248}}</ref>, but also unhealthy engagement may lead to burnout.<ref name="pmid17470184">{{cite journal| author=Vinje HF, Mittelmark MB| title=Job engagement's paradoxical role in nurse burnout. | journal=Nurs Health Sci | year= 2007 | volume= 9 | issue= 2 | pages= 107-11 | pmid=17470184 | doi=10.1111/j.1442-2018.2007.00310.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17470184 }} </ref>
| | ==Prevalence== |
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| ==Health care workers==
| | The prevalence of burnout in the general, employed population of the United States, aged is: |
| | | * General, employed U.S. population |
| As of 2017, 44% of physicians have have burnout<ref name="ShanafeltWest2019">{{cite journal|last1=Shanafelt|first1=Tait D.|last2=West|first2=Colin P.|last3=Sinsky|first3=Christine|last4=Trockel|first4=Mickey|last5=Tutty|first5=Michael|last6=Satele|first6=Daniel V.|last7=Carlasare|first7=Lindsey E.|last8=Dyrbye|first8=Lotte N.|title=Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017|journal=Mayo Clinic Proceedings|year=2019|issn=00256196|doi=10.1016/j.mayocp.2018.10.023}}</ref>. Previously, in 2014, as many as 50% of physicians in practice may have burnout.<ref name="pmid26653297">{{cite journal| author=Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J et al.| title=Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. | journal=Mayo Clin Proc | year= 2015 | volume= 90 | issue= 12 | pages= 1600-13 | pmid=26653297 | doi=10.1016/j.mayocp.2015.08.023 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26653297 }} </ref> [[General practitioner]]s seem to have low job control and the highest proportion of burnout cases<ref name="pmid16512316">{{cite journal| author=Taris TW, Stoffelsen J, Bakker AB, Schaufeli WB, van Dierendonck D| title=Job control and burnout across occupations. | journal=Psychol Rep | year= 2005 | volume= 97 | issue= 3 | pages= 955-61 | pmid=16512316 | doi=10.2466/pr0.97.3.955-961 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16512316 }} </ref>.
| | ** (2010): aged 31-47 30% |
| | |
| Burnout is more common in larger practices suggesting that practice level autonomy may be important<ref name="EdwardsMarino2018">{{cite journal|last1=Edwards|first1=Samuel T.|last2=Marino|first2=Miguel|last3=Balasubramanian|first3=Bijal A.|last4=Solberg|first4=Leif I.|last5=Valenzuela|first5=Steele|last6=Springer|first6=Rachel|last7=Stange|first7=Kurt C.|last8=Miller|first8=William L.|last9=Kottke|first9=Thomas E.|last10=Perry|first10=Cynthia K.|last11=Ono|first11=Sarah|last12=Cohen|first12=Deborah J.|title=Burnout Among Physicians, Advanced Practice Clinicians and Staff in Smaller Primary Care Practices|journal=Journal of General Internal Medicine|volume=33|issue=12|year=2018|pages=2138–2146|issn=0884-8734|doi=10.1007/s11606-018-4679-0}}</ref>.
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| For physicians in training, rates of burnout (emotional exhaustion) for students, residents and fellows is about 50% while the rate is 36% in similarly aged college graduates.<ref name="pmid24448053">{{cite journal| author=Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J et al.| title=Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. | journal=Acad Med | year= 2014 | volume= 89 | issue= 3 | pages= 443-51 | pmid=24448053 | doi=10.1097/ACM.0000000000000134 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24448053 }} </ref> Burnout in physicians in training is associated with perceived harassment<ref name="pmid24667503">{{cite journal| author=Cook AF, Arora VM, Rasinski KA, Curlin FA, Yoon JD| title=The prevalence of medical student mistreatment and its association with burnout. | journal=Acad Med | year= 2014 | volume= 89 | issue= 5 | pages= 749-54 | pmid=24667503 | doi=10.1097/ACM.0000000000000204 | pmc=4401419 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24667503 }} </ref>. In one survey of 24 American medical schools, harassment occurring at least one time was reported by 83% of students<ref name="pmid24667503"/>. In this study, harassment was more commonly reported being perpetrated by residents<ref name="pmid24667503"/>. The rates of burnout among students responding to the survey were<ref name="pmid24667503"/>:
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| * All students 34% | |
| * Those reporting recurrent harassment by faculty 57% | |
| * Those ''not'' reporting recurrent harassment by faculty 32%
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| According to the yearly survey of recent medical school graduates by the Association of American Medical Colleges, the following are reported <ref>Association of American Medical Colleges. [https://www.aamc.org/data/gq/allschoolsreports/ Medical School Graduation Questionnaire: All Schools Summary Report]. Association of American Medical Colleges; Washington, DC</ref>:
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| * Occasional public embarrassment 20%
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| * Occasional public humiliation 8%
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| ==Measurement==
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| Several burnout inventories are available including the Maslach, Copenhagen, and Oldenburg<ref>Dyrbye L et al (2018). [https://nam.edu/a-pragmatic-approach-for-organizations-to-measure-health-care-professional-well-being/ A Pragmatic Approach for Organizations to Measure Health Care Professional Well-Being]. National Academy of Medicine</ref>.
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| Eckleberry-Hunt in 2017 raised the question that burnout is being over-reported by deeming burnout present if ''either'' emotional exhaustion ''or'' depersonalization are present.<ref name="pmid28817432">{{cite journal| author=Eckleberry-Hunt J, Kirkpatrick H, Barbera T| title=The Problems With Burnout Research. | journal=Acad Med | year= 2017 | volume= | issue= | pages= | pmid=28817432 | doi=10.1097/ACM.0000000000001890 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28817432 }} </ref>
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| ===Maslach Burnout Inventory===
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| The Maslach Burnout Inventory is the earliest and most well-studied measurement of burnout. Maslach and her colleague Jackson first identified the construct "burnout" in the 1970s, and developed a measure that weighs the effects of on three scales<ref name="Maslach Jackson 1981 pp. 99–113">{{cite journal | last=Maslach | first=Christina | last2=Jackson | first2=Susan E. | title=The measurement of experienced burnout | journal=Journal of Organizational Behavior | publisher=Wiley-Blackwell | volume=2 | issue=2 | year=1981 | issn=0894-3796 | doi=10.1002/job.4030020205 | pages=99–113}}</ref>:
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| * Emotional exhaustion (nine items)
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| * Depersonalization (five items)
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| * Personal accomplishment (eight items)
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| ===2 item burnout Inventory===
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| In this survey, abnormal is defined as symptoms weekly or more on either item.<ref name="pmid21900135">{{cite journal| author=West CP, Shanafelt TD, Kolars JC| title=Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. | journal=JAMA | year= 2011 | volume= 306 | issue= 9 | pages= 952-60 | pmid=21900135 | doi=10.1001/jama.2011.1247 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21900135 }} </ref><ref name="pmid22362127">{{cite journal| author=West CP, Dyrbye LN, Satele DV, Sloan JA, Shanafelt TD| title=Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. | journal=J Gen Intern Med | year= 2012 | volume= 27 | issue= 11 | pages= 1445-52 | pmid=22362127 | doi=10.1007/s11606-012-2015-7 | pmc=3475833 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22362127 }} </ref> The first item correlates with emotional exhaustion.
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| 1. ''I feel burned out from my work''<ref name="pmid22362127"/> or ''How often do you feel burned out from your work?''<ref name="pmid21900135"/>
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| * Never
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| * A few times a year or less
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| * Once a month
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| * A few times a month
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| * Once a week
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| * A few times a week
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| * Every day
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| 2. ''I have become more callous toward people since I took this job''<ref name="pmid22362127"/> or ''How often do you feel you’ve become more callous toward people since you started your residency?''<ref name="pmid21900135"/>
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| * Never
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| * A few times a year or less
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| * Once a month
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| * A few times a month
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| * Once a week
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| * A few times a week
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| * Every day
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| The two item format has been used in national surveys in 2011<ref name="pmid22911330">{{cite journal| author=Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D et al.| title=Burnout and satisfaction with work-life balance among US physicians relative to the general US population. | journal=Arch Intern Med | year= 2012 | volume= 172 | issue= 18 | pages= 1377-85 | pmid=22911330 | doi=10.1001/archinternmed.2012.3199 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22911330 }} </ref> and its follow-up survey in 2014<ref name="pmid26653297">{{cite journal| author=Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J et al.| title=Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. | journal=Mayo Clin Proc | year= 2015 | volume= 90 | issue= 12 | pages= 1600-13 | pmid=26653297 | doi=10.1016/j.mayocp.2015.08.023 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26653297 }} </ref>.
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| ===Mini Z===
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| The 10‑item Zero Burnout Program survey, or called the Mini Z<ref name="pmid27138425">{{cite journal| author=Linzer M, Poplau S, Babbott S, Collins T, Guzman-Corrales L, Menk J et al.| title=Worklife and Wellness in Academic General Internal Medicine: Results from a National Survey. | journal=J Gen Intern Med | year= 2016 | volume= 31 | issue= 9 | pages= 1004-10 | pmid=27138425 | doi=10.1007/s11606-016-3720-4 | pmc=4978678 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27138425 }} </ref>, was adapted from earlier work by Rohland<ref name="RohlandKruse2004">{{cite journal|last1=Rohland|first1=Barbara M.|last2=Kruse|first2=Gina R.|last3=Rohrer|first3=James E.|title=Validation of a single-item measure of burnout against the Maslach Burnout Inventory among physicians|journal=Stress and Health|volume=20|issue=2|year=2004|pages=75–79|issn=1532-3005|doi=10.1002/smi.1002}}</ref> and Schmoldt<ref>Schmoldt RA, Freeborn DK, Klevit HD. Physician burnout: recommendations for HMO managers. HMO Pract. 1994 Jun;8(2):58-63. PMID: [https://pubmed.gov/1013526 1013526]</ref> and the Physician Worklife Survey<ref name="pmid10549620">{{cite journal| author=Konrad TR, Williams ES, Linzer M, McMurray J, Pathman DE, Gerrity M et al.| title=Measuring physician job satisfaction in a changing workplace and a challenging environment. SGIM Career Satisfaction Study Group. Society of General Internal Medicine. | journal=Med Care | year= 1999 | volume= 37 | issue= 11 | pages= 1174-82 | pmid=10549620 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10549620 }} </ref>. The Mini Z is a single item (burnout is defined as answers c, d, or e) that correlates with the emotional exhaustion scale of the Maslach<ref name="RohlandKruse2004"/>:
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| 1. ''Using your own definition of “burnout,” please circle one of the answers below'':
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| a. I enjoy my work. I have no symptoms of burnout.
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| b. I am under stress, and don’t always have as much energy as I did, but I don’t feel burned out.
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| c. I am definitely burning out and have one or more symptoms of burnout, e.g., emotional exhaustion.
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| d. The symptoms of burnout that I am experiencing won’t go away. I think about work frustrations a lot.
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| e. I feel completely burned out. I am at the point where I may need to seek help.
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| The Mini Z is promoted by the [[American Medical Association]]'s [https://www.stepsforward.org/modules/physician-burnout Steps Forward] campaign.<ref>{{Cite web| last1 = Linzer| first1 = Mark| last2 = Guzman-Corrales| first2 = Laura| last3 = Poplau| first3 = Sara| title = Preventing physician burnout - STEPS Forward| work = STEPSforward.org| accessdate = 2017-05-24| url = https://www.stepsforward.org/modules/physician-burnout}}</ref>
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| The Mini Z may report lower prevalence of burnout than when measured by the full Maslach Burnout Inventory (MBI).<ref name="pmid28379818">{{cite journal| author=Linzer M, Poplau S| title=Building a Sustainable Primary Care Workforce: Where Do We Go from Here? | journal=J Am Board Fam Med | year= 2017 | volume= 30 | issue= 2 | pages= 127-129 | pmid=28379818 | doi=10.3122/jabfm.2017.02.170014 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28379818 }} </ref>
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| ===Copenhagen Burnout Inventory===
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| The Copenhagen Burnout Inventory is another scale and was developed in 2005.<ref>CKristensen T, Borritz M, Villadsen E, Christensen KB. The Copenhagen Burnout Inventory: a new tool for the assessment of burnout. Work Stress. 2005;19(3):192–207 {{doi|10.1080/02678370500297720}}</ref>
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| ===Physician Well-Being Index (PWBI)===
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| The PWBI contains 7 items, one of which queries burnout in a yes/no response format. Its development<ref>Dyrbye LN, Satele D, Sloan J, Shanafelt TD. Utility of a brief screening tool to identify physicians in distress. J Gen Intern Med. 2013 Mar;28(3):421-7. doi: {{doi|10.1007/s11606-012-2252-9}}. PMID: {{PMID|23129161}}</ref> and application<ref>Dyrbye LN, Satele D, Shanafelt T. Ability of a 9-Item Well-Being Index to Identify Distress and Stratify Quality of Life in US Workers. J Occup Environ Med. 2016 Aug;58(8):810-7. doi: {{doi|10.1097/JOM.0000000000000798}}. PMID: {{PMID|27294444}}</ref> have been reported.
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| ===Professional Quality of Life (ProQOL) ===
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| The ProQOL has three scales<ref name="pmid28383935">{{cite journal| author=De La Rosa GM, Webb-Murphy JA, Fesperman SF, Johnston SL| title=Professional quality of life normative benchmarks. | journal=Psychol Trauma | year= 2018 | volume= 10 | issue= 2 | pages= 225-228 | pmid=28383935 | doi=10.1037/tra0000263 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28383935 }} </ref>:
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| * Compassion satisfaction (CS)
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| * Burnout (BO)
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| * Compassion fatigue (CF)
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| ==Causes==
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| Leiter and Maslach found the following antecedents from the Areas of Worklife Survey (AWS) using factor analysis:<ref name="Leite20093">Leiter, Michael P., and Christina Maslach. "Areas of worklife: A structured approach to organizational predictors of job burnout." Emotional and physiological processes and positive intervention strategies. Emerald Group Publishing Limited, 2003. 91-134. {{doi|10.1016/S1479-3555(03)03003-8}}</ref>
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| * Workload
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| * Fairness
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| * Control
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| * Community
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| * Values
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| * Rewards
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| Of these causes, workload is the strongest correlate of emotional exhaustion<ref name="Leite20093"/> but loss of control may be the initial factor. Perceived control or autonomy and fairness correlate with cynicism.<ref name="Leite20093"/><ref name="Fernet Austin Trépanier Dussault 2013 pp. 123–137">{{cite journal | last=Fernet | first=Claude | last2=Austin | first2=Stéphanie | last3=Trépanier | first3=Sarah-Geneviève | last4=Dussault | first4=Marc | title=How do job characteristics contribute to burnout? Exploring the distinct mediating roles of perceived autonomy, competence, and relatedness | journal=European Journal of Work and Organizational Psychology | publisher=Informa UK Limited | volume=22 | issue=2 | year=2013 | issn=1359-432X | doi=10.1080/1359432x.2011.632161 | pages=123–137}}</ref>
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| * 16% of burnout is attributed to perceived control at the worksite.<ref>Taris, Toon W., et al. "Job control and burnout across occupations." Psychological Reports 97.3 (2005): 955-961. {{doi|10.2466/pr0.97.3.955-961}}</ref>
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| These findings, specifically workload, are reflected in the job demands-resources model of burnout<ref name="pmid11419809">{{cite journal| author=Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB| title=The job demands-resources model of burnout. | journal=J Appl Psychol | year= 2001 | volume= 86 | issue= 3 | pages= 499-512 | pmid=11419809 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11419809 }} </ref>.
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| These findings are reflected in the Demand-Control theory of job stress.
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| <ref name="Karasek 1990 p. ">{{cite book | last=Karasek | first=Robert | title=Healthy work : stress, productivity, and the reconstruction of working life | publisher=Basic Books | publication-place=New York | year=1990 | isbn=0-465-02897-7 | page=}}</ref>
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| ==Prevention==
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| Thriving<ref name="Porath2012">Porath, Christine, et al. "Thriving at work: Toward its measurement, construct validation, and theoretical refinement." Journal of Organizational Behavior 33.2 (2012): 250-275. {{doi|10.1002/job.756}}</ref><ref name="pmid27631555">{{cite journal| author=Hildenbrand K, Sacramento CA, Binnewies C| title=Transformational Leadership and Burnout: The Role of Thriving and Followers' Openness to Experience. | journal=J Occup Health Psychol | year= 2016 | volume= | issue= | pages= | pmid=27631555 | doi=10.1037/ocp0000051 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27631555 }} </ref> and engagement<ref name="pmid24895952">{{cite journal| author=Mason VM, Leslie G, Clark K, Lyons P, Walke E, Butler C et al.| title=Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study. | journal=Dimens Crit Care Nurs | year= 2014 | volume= 33 | issue= 4 | pages= 215-25 | pmid=24895952 | doi=10.1097/DCC.0000000000000056 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24895952 }} </ref><ref name="SchaufeliBakker2016">{{cite journal|last1=Schaufeli|first1=Wilmar B.|last2=Bakker|first2=Arnold B.|last3=Salanova|first3=Marisa|title=The Measurement of Work Engagement With a Short Questionnaire|journal=Educational and Psychological Measurement|volume=66|issue=4|year=2016|pages=701–716|issn=0013-1644|doi=10.1177/0013164405282471}}</ref> are negatively correlated with, and thus may be protective, against burnout. However, unhealthy engagement may lead to burnout.<ref name="pmid17470184">{{cite journal| author=Vinje HF, Mittelmark MB| title=Job engagement's paradoxical role in nurse burnout. | journal=Nurs Health Sci | year= 2007 | volume= 9 | issue= 2 | pages= 107-11 | pmid=17470184 | doi=10.1111/j.1442-2018.2007.00310.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17470184 }} </ref>
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| Perceived control or autonomy and fairness correlate with cynicism.<ref name="Leite20093"/><ref name="Fernet Austin Trépanier Dussault 2013 pp. 123–137">{{cite journal | last=Fernet | first=Claude | last2=Austin | first2=Stéphanie | last3=Trépanier | first3=Sarah-Geneviève | last4=Dussault | first4=Marc | title=How do job characteristics contribute to burnout? Exploring the distinct mediating roles of perceived autonomy, competence, and relatedness | journal=European Journal of Work and Organizational Psychology | publisher=Informa UK Limited | volume=22 | issue=2 | year=2013 | issn=1359-432X | doi=10.1080/1359432x.2011.632161 | pages=123–137}}</ref>
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| ==Consequences==
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| Burnout may be associated with operating margins<ref name="pmid29969540">{{cite journal| author=Muller IR, Eldakar-Hein ST, Ames SE, Rosen LD, Urman RD, Tsai MH| title=Potential Association Between Physician Burnout Rates and Operating Margins: Specialty-Specific Analysis. | journal=J Med Pract Manage | year= 2017 | volume= 32 | issue= 4 | pages= 233-238 | pmid=29969540 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29969540 }} </ref>.
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| ==Treatment==
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| Institutional and individual strategies to reduce burnout have been reviewed<ref name="pmid27692469">{{cite journal| author=West CP, Dyrbye LN, Erwin PJ, Shanafelt TD| title=Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. | journal=Lancet | year= 2016 | volume= 388 | issue= 10057 | pages= 2272-2281 | pmid=27692469 | doi=10.1016/S0140-6736(16)31279-X | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27692469 }} </ref>.
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| Physicians may not be aware that they are burned out and providing awareness may increase engagement with addressing burnout<ref name="pmid23979287">{{cite journal| author=Shanafelt TD, Kaups KL, Nelson H, Satele DV, Sloan JA, Oreskovich MR et al.| title=An interactive individualized intervention to promote behavioral change to increase personal well-being in US surgeons. | journal=Ann Surg | year= 2014 | volume= 259 | issue= 1 | pages= 82-8 | pmid=23979287 | doi=10.1097/SLA.0b013e3182a58fa4 | pmc=4333681 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23979287 }} </ref>.
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| == See also ==
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| * [[Job satisfaction]]
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| * [[Stress (medicine)]]
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| * [[Compassion fatigue]]
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| * The poetry of [[Edna St. Vincent Millay]]: "My candle burns at both ends/It will not last the night."
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| == References ==
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| <references/>
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| *”Sources of Management of Excessive Job Stress and Burnout”, In P. Warr (Ed.), ''Psychology at Work'' Fourth Edition. Penguin.
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| * “Tailoring treatment strategies for different types of burnout” Farber, B. A. (1998). Paper presented at the ''Annual Convention of the American Psychological Association'', 106th, San Francisco California, August 14-18. ED 424 517
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| * “Staff burnout”, Freudenberger, H. J. (1974). ''Journal of Social Issues'', 30(1), 159-165.
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| * “Authentic leaders creating healthy work environments for nursing practice”, Shirey MR. ''American Journal of Critical Care'' May 2006. Vol. 15, Iss. 3; p. 256
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| * “Taming burnout's flame”, Krista Gregoria Lussier, ''Nursing Management'' Chicago: Apr 2006. Vol. 37, Iss. 4; p. 14
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| * “A Scientific Solution To Librarian Burnout”, Craig S. Shaw ''New Library World Year'' 1992 Volume: 93 Number: 5
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| * ''Stress and Burnout in Library Service'', Caputo, Janette S. Phoenix, AZ: Oryx Press, 1991.
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| * ''An assessment of burnout in academic librarians in America using the Maslach Burnout Inventor'' (the MBI) Ray, Bernice, Ph.D., Rutgers University - New Brunswick, 2002, 90 pages; AAT 3066762
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| [[Category:Psychological conditions]]
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| [[Category:sociology]]
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| [[Category:Psychological stress]]
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