Haifa F.Al-Mobeeriek1, Azizah F.Al-Mobeeriek2
How to CITE:
J PakDentAssoc. 2011 (4) 199-205
OBJECTIVE
The aimof this studywas to compare burnout levels between dental academics and nonacademics in Riyadh andEastern Province, SaudiArabia and investigate the factors affecting their burnout levels.
METHODOLOGY
The Maslach Burnout Inventory Survey (Arabic version), including the emotional exhaustion, depersonalization, and personal accomplishment scales, and questions on demographic information were used to evaluate burnout among 370 Saudi dentists in academic and nonacademic hospitals. The data were statistically analyzed byANOVAand t-test.
RESULTS
The compliance ratewas 62.97%(223/370).Among the analyzed subjects, age, gender, patients/week, working hours/week, years of experience, and rank were factors affecting the burnout levels.Academics had lower burnout levels than non academics.
CONCLUSIONM
Among Saudi dentists, non academics tend to have higher burnout levels than academics. Burnout levels are affected by age, gender, years of experience, rank, and workload
KEYWORDS
MaslachBurnout Inventory,Dentist,Burnout,Occupational stress,Workload
Introduction
Burnout is a possible consequence of chronic occupational stress. It is defined as a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment. Both dentists and dental students are prone to professional burnout, anxiety disorders, and clinical depression.
Factors that may contribute to professional burnout among dentists include expectations, teaching tasks, type of work, and depression. Dentists who experience a reality worse than that expected show higher burnout levels. Further, teaching tasks in addition to the clinical role may increase the levels of stress; on the other hand, the dual role may reduce job-related stress in some dentists. In terms of the type of work, general dentists and oral surgeons reportedly have the highest levels of burnout, whereas orthodontists have the lowest levels of burnout. Moreover, burnout has a relationship with depressive symptoms In the medical professions, burnout levels are affected by specialty, primary language, race, cultural background, and self-reported sub optimal patient-care practices. Differences in burnout levels have also been attributed to coping style, gender, load, and self expectations.
Specifically, male dentists tend to have higher depersonalization levels than female dentists. Further, dentists with an active coping mechanism show relatively low levels of burnout,compared with those with a passive coping style.
Professional burnout among dentists has negative effects; it impacts personal relationships, well-being,and health. Nevertheless, dentists who experience burnout relatively early in their career are more likely to stay in their chosen career and adopt a more flexible approach to theirwork routines.
The aim of this study was to compare burnout levels between dental academics and nonacademics in Riyadh and Eastern Province, Saudi Arabia and investigate the factors affecting the burnout levels.
Methodology
Subjects and Questionnaire
The study included 370 practicing dentists from both academic and nonacademic hospitals in Riyadh and Eastern Province, SaudiArabia.
The questionnaire used for the survey consisted of two parts: the first part contained questions on demographic information such as age, gender, years of experience, rank, specialty, working hours/week, patients/week, and workplace. The second part comprised the Maslach Burnout Inventory (MBI) Survey, which is used to measure the amount of burnout in different occupations. The MBI-Human Services Surveyconsists of 22 statements related to feelings produced by contact between the care provider and the care recipient (i.e., the dentist and patient). Each statement relates to one of three independent aspects (scales) of burnout: emotional exhaus tion, depersonalization, and personal accomplishment. The statements are scored on a 7-point scale from ‘0’ for never to ‘6’ for every day. The Arabic version of the questionnaires was translated, peerreviewed, and tested among Saudi in a pilot study by Al- Wabli
DataAnalysis
The collected data were analyzed by using SPSS version 16 (IBM SPSS, Chicago, IL, USA). Simple descriptive statistics, analysis of variance (ANOVA), correlation analysis, and t-test were performed to determine the relationship and statistical significance among the variables in the two parts of the questionnaire. P<0.05 indicates statistical significance.
RESULTS
ResponseRate andDemographicData The response rate of the survey was 62.97% (223/370). Twenty-one dentists were excluded, because they submitted incomplete questionnaires. The demographic data of the subjects are listed in Table 1. Most of the respondents were female (58.9%, 119/223) and in the 2530 age range (35.1%; 71/223). Further, 29.7% (60/223) of the subjects had more than 16 years of experience, and the majority worked for more than 45 hours/week (40.1%, 81/223) and saw more than 50 patients/week (45.0%, 91/223). Finally, non academics constituted almost half of the analyzed population (46.0%, 133/223).
BurnoutData
The burnout scores are summarized inTables 2 and 3. In general, the youngest age group (2530 years) and female subjects had higher scores in all the three MBI scales. Further, interns, general Data representnumber of subjects (%).
practitioners, and those with 15 years of experience tended to have high burnout scores.Respondents above 40 years, nonacademics, and those who saw more than 50 patients/week had higher scores in all the scales than the other groups. Female subjects had higher emotional exhaustion scores since 62 (30.7%) had a high emotional exhaustion compared to 24 (11.9%)males (Table 2), and gender was positively related to emotional exhaustion (P = 0.0000; Table 4). Age was another factor affecting the burnout
scores and was significantly related to emotional exhaustion (P= 0.005). Specifically, younger respondents (2535 years) tended to have higher emotional exhaustion
scores. Significant differences in emotional exhaustion scores were noted between the 2535 and the 4650 age groups (P=0.017;Table 5).Number ofworking hours/day was also significantly related to emotional exhaustion (P= 0.004;Table 5).
With regard to depersonalization, age was again a significant factor affecting the scores (P = 0.009). Further, rank and years of experience were significant influencing factors (P = 0.001 and P = 0.000, respectively; Table 6). Rankwas also positively related to depersonalization (P =0.001;Table 6).
Personal accomplishment was affected by rank (P = 0.009), working hours/week (P = 0.001), and years of experience (P=0.000;Table 7). Itwas positively related to patients seen/week (P = 0.01) and negatively related to years of experience (P= 0.000) andworkplace (P=0.006). Finally, academics had significantly higher scores of both depersonalization and personal accomplishment (P = 0.000 and P=0.012, respectively;Table 8).
Discussion
Dentists are prone to professional burnout. Its consequences include low energy, lowered motivation, and negative attitude toward self, work, and others. The present study shows that academics have lower burnout levels than nonacademic dentists in Riyadh and Eastern Province, Saudi Arabia.Studies have indicated that age, years as a consultant, number of salaried sessions, intrinsic job satisfaction, and time spent on the perceived most meaningful activity are inversely related to burnout.28-30 Personal professional life imbalance and selfperceived medical errors have also been identified as important risk factors for burnout. In this study, female subjects had significantly higher scores of depersonalization and personal
accomplishment. This finding is similar to that of a recent Turkish study, in which female faculty experienced significantly greater depersonalization than male faculty. Further, in a US study, female faculty had significantly higher scores of emotional exhaustion than male faculty. On the contrary, studies have shown that Dutchmale dentists, Turkish male academics, andUSmale university faculty have higher depersonalization levels. However, a recent meta-analysis of gender differences has revealed that these variations are almost zero and sma l l f o r emotional exhaustion and depersonalization effect sizes, respectively. The authors stated that women are likelier to report emotional exhaustion than men, whereas men are likelier to report depersonalization than women.
A possible explanation for the high burnout scores in the present study is the lack of sufficient support and coping assistance with stressors among female dentists, which cause burnout. In fact, lack of social support and high workload are important environmental factors causing burnout.
The household and childcare responsibilities of womenmay account for their increasedworkload. Van Emmerik found that socioemotional aid from the supervisor and colleagues as well as support and practical assistance at the workplace could reduce burnout especially amongwomen. The present results indicate possible influences of age and rank on burnout levels among dentists, given that the younger age group and general practitioners scored higher on emotional exhaustion and lower on personal accomplishment. These findings are similar to the results of Humphris et al. and Croom. Low personal accomplishment and high emotional exhaustion have been linked to less job satisfaction Teaching assistants and general practitioners along with those with 15 years of experience tended to have high levels of burnout. In agreement, a study has shown that burnout is a common finding among medical residents and is related to self-reported suboptimal patient care. However, heath care professionals with early burnout are more likely to stay in their career.
In this study, dentists with a high number of patients/week and those working in the public sector had higher levels of burnout, similar to the results reported previously. Work characteristics have been credited as stressors in the dental team. Although this study seems to be the first application of the MBI Arabic version to address burnout among dentists, it is a cross-sectional survey using a convenient sample. Therefore, the results cannot be generalized. Further studies using a larger sample and longitudinal design are needed to ascertain these preliminary results.
The present findings highlight the importance of creating a stress-free work environment to enhance work quality and reduce burnout. This may include employing measures such as reducing workload and number of patients, and designing programs that focus on behavioral, cognitive, and physical strategies to alleviate work stressors. Preventive and interventional programs including both the person and the organization have been shown to be beneficial and have positive effects on burnout.
Such programs should therefore be implemented, evaluated, and optimized.
Conclusion
1. Burnout is a negative long-term consequence of work stress that needs anticipation, interference, and prevention.
2. Dentists should be able to recognize burnout and identify the risk factors to prevent it.
3. Among Saudi dentists, nonacademics tend to have higher burnout levels than academics.
4. Burnout levels are affected by age, gender, years of experience, rank, andworkload.
ACKNOWLEDGEMENTS
The authorwould like to acknowledgeAbeerAl- Shween for her help during the distribution of the questionnaire.
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