Burnout, coping, and spirituality among internal medicine resident physicians

Abstract

Background: Burnout in physicians is common, and studies show a prevalence of 30% to 78%. Identifying constructive coping strategies and personal characteristics that protect residents against burnout may be helpful for reducing errors and improving physician satisfaction.

Objective: We explored the complex relationships between burnout, behaviors, emotional coping, and spirituality among internal medicine and internal medicine-pediatrics residents.

Methods: We anonymously surveyed 173 internal medicine and medicine-pediatrics residents to explore burnout, coping, and spiritual attitudes. We used 3 validated survey instruments: the Maslach Burnout Inventory, the Carver Coping Orientation to Problems Experienced (COPE) Inventory, and the Hatch Spiritual Involvement and Beliefs Scale (SIBS).

Results: A total of 108 (63%) residents participated, with 31 (28%) reporting burnout. Residents who employed strategies of acceptance, active coping, and positive reframing had lower emotional exhaustion and depersonalization (all, P < .03). Residents who reported denial or disengagement had higher emotional exhaustion and depersonalization scores. Personal accomplishment was positively correlated with the SIBS total score (r = +.28, P = .003), as well as the internal/fluid domain (r = +.32, P = .001), existential axes (r = +.32, P = .001), and humility/personal application domain (r = +.23, P = .02). The humility/personal application domain also was negatively correlated with emotional exhaustion (r = -.20, P = .04) and depersonalization (r = -.25, P = .009). No activity or demographic factor affected any burnout domain.

Conclusions: Burnout is a heterogeneous syndrome that affects many residents. We identified a range of emotional and spiritual coping strategies that may have protective benefit.