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. 2023 Mar 1;6(3):e233652.
doi: 10.1001/jamanetworkopen.2023.3652.

Job Strain, Burnout, and Suicidal Ideation in Tenured University Hospital Faculty Staff in France in 2021

Martin Dres  1   2 , Marie-Christine Copin  3 , Alain Cariou  4   5 , Muriel Mathonnet  6 , Raphael Gaillard  7   8   9 , Tait Shanafelt  10 , Bruno Riou  11   12 , Michael Darmon  4   13 , Elie Azoulay  11   12
Affiliations

Job Strain, Burnout, and Suicidal Ideation in Tenured University Hospital Faculty Staff in France in 2021

Martin Dres et al. JAMA Netw Open. .

Abstract

Importance: The ability to attract and retain university hospital faculty staff is in jeopardy because of the high levels of mental symptoms in this professional group.

Objective: To examine the prevalence and determinants of symptoms of severe burnout, job strain, and suicidal ideation in tenured associate and full professors in university hospitals.

Design, setting, and participants: This nationwide cross-sectional study offered online surveys to 5332 tenured university hospital faculty members in France from October 25, 2021, to December 20, 2021.

Exposures: Burnout and job strain.

Main outcomes and measures: Participants completed the 22-item Maslach Burnout Inventory and a 12-item job strain assessment tool, reported suicidal ideation, and used visual analog scales to evaluate unidimensional parameters. The primary outcome was presence of severe burnout symptoms. Factors associated with mental health symptoms were identified by multivariable logistic regression.

Results: Completed questionnaires were returned by 2390 of 5332 faculty members (response rate, 45%; range, 43%-46%). Tenured associate professors were a median of 40 (IQR, 37-45) years old with a sex ratio of 1:1, whereas tenured full professors were a median of 53 (IQR, 46-60) years old with a sex ratio of 1:5. Of 2390 respondents, 952 (40%) reported symptoms of severe burnout. Symptoms of job strain (296 professors [12%]) and suicidal ideation (343 professors [14%]) were also reported. Compared with full professors, significantly more associate professors reported feeling overwhelmed at work (496 [73%] vs 972 [57%]; P < .001), considering resignation (365 [54%] vs 834 [49%]; P = .004), or considering a career change (277 [41%] vs 496 [29%]; P < .001). Factors independently associated with less burnout were a longer time being a professor (adjusted odds ratio [aOR], 0.97; 95% CI, 0.96-0.98 per year of age), sleeping well (aOR, 0.88; 95% CI, 0.83-0.92), feeling valued by colleagues (aOR, 0.91; 95% CI, 0.86-0.95 per visual analog scale point) or the public (aOR, 0.92; 95% CI, 0.88-0.96 per visual analog scale point), and accepting more tasks (aOR, 0.82; 95% CI, 0.72-0.93). Factors independently associated with more burnout were having a nonclinical position (OR, 2.48; 95% CI, 1.96-3.16), reporting work encroachment on private life (OR, 1.17; 95% CI, 1.10-1.25), feeling the need to constantly put on a brave face (OR, 1.82; 95% CI, 1.32-2.52), considering a career change (OR, 1.53; 95% CI, 1.22-1.92), and having experienced harassment (OR, 1.52; 95% CI, 1.22-1.88).

Conclusions and relevance: These findings suggest that the psychological burden on tenured university hospital faculty staff in France is considerable. Hospital administrators and health care authorities should urgently develop strategies for burden prevention and alleviation and for attraction of the next generation.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Dres reported receiving personal fees from lungpacer outside the submitted work. Dr Shanafelt reported having a patent for the Well-being Index with royalties paid by the Mayo Clinic and a patent for the Leadership Impact Index with royalties paid by the Mayo Clinic and receiving an honorarium for work as an expert in clinician well-being. Dr Darmon reported receiving grants from MSD and personal fees from Astellas and Gilead outside the submitted work. Dr Azoulay reported receiving grants from MSD and personal fees from Pfizer, Alexion, and Sanofi outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Distribution of the Visual Analog Scale Scores Used to Assess the Intensity of Unidimensional Parameters in Tenured University Hospital Professors With and Without Symptoms of Severe Burnout
The scales ranged from 0 (no symptoms [best possible rating]) to 10 (most intense symptoms [worst rating]). Participants with symptoms of severe burnout are shown in dark blue and participants without symptoms in light blue. P < .001 for all comparisons.
Figure 2.
Figure 2.. Association of the Presence of Symptoms of Severe Burnout With Professional Plans of Tenured University Hospital Professors
Participants with symptoms of severe burnout are shown in dark blue and participants without symptoms in light blue. aSignificant difference between respondents with and without burnout (P < .01 for every test).
See this image and copyright information in PMC

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