Modifiable risk factors related to burnout levels in the medical workplace in Taiwan: cross-sectional study

Abstract

Objectives: To detect the combined effects of lifestyle factors on work-related burnout (WB) and to analyse the impact of the number of weekend catch-up sleep hours on burnout risk in a medical workplace.

Design: Cross-sectional study.

Setting: Hospital-based survey in Taiwan.

Participants: In total, 2746 participants completed the hospital's Overload Health Control System questionnaire for the period from the first day of January 2016 to the end of December 2016, with a response rate of 70.5%. The voluntary participants included 358 physicians, 1406 nurses, 367 medical technicians and 615 administrative staff.

Primary and secondary outcome measures: All factors that correlated significantly with WB were entered into a multinomial logistic regression after adjustment for other factors. The dose-response relationship of combined lifestyle factors and catch-up sleep hours associated with WB was explored by logistic regression.

Results: Abnormal meal time (adjusted OR 2.41, 95% CI 1.85 to 3.15), frequently eating out (adjusted OR 1.49, 95% CI 1.12 to 1.97), lack of sleep (adjusted OR 5.13, 95% CI 3.94 to 6.69), no exercise (adjusted OR 1.41, 95% CI 1.10 to 1.81) and >40 work hours (adjusted OR 2.72, 95% CI 2.08-3.57) were independently associated with WB (for high level compared with low level). As the number of risk factors increased (1-5), so did the proportion of high severity of WB (adjusted OR 1.39, 95% CI 0.45 to 4.27, to adjusted OR 32.98, 95% CI 10.78 to 100.87). For those with more than 7 hours' sleep on workdays, weekend catch-up sleep (≤0/>0 and ≤2/>2 hours) was found to be related to an increase of burnout risk (adjusted OR 4.91, 95% CI 2.24 to 10.75/adjusted OR 4.94, 95% CI 2.54 to 9.63/adjusted OR 6.74, 95% CI 2.94 to 15.46).

Conclusion: WB in the medical workplace was affected by five unhealthy lifestyle factors, and combinations of these factors were associated with greater severity of WB. Weekend catch-up sleep was correlated with lower burnout risk in those with a short workday sleep duration (less than 7 hours). Clinicians should pay particular attention to medical staff with short sleep duration without weekend catch-up sleep.

Keywords: combined lifestyle factors; weekend catch-up sleep; work-related burnout.