Swiss Health Professionals’ activities for Managing Occupational Burnout in their Patients: Results from a nationwide cross-sectional study, STOBS-VD survey - Switzerland

Abstract
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Objective: We aimed to describe the sociodemographic and professional characteristics and current practices of Swiss health professionals who treat patients with occupational burnout (POB), namely the general practitioners (GP), psychiatrist-psychotherapists (PP), occupational physicians (OP) and psychologists...

Methods: A 48-item e-questionnaire in RedCAP was distributed via the national professional associations between April and July 2021. Data were analyzed using logistic and multinomial regression models.

Results: Among 3216 respondents, 2951 reported to consult POB, and 1130 (713 physicians and 410 psychologists) to treat them. Most respondents (n=894, 79%) work in private practice and have an average of 16.9-years of professional experience. The study showed that POB management constitutes 5 to 25% of health care professionals’ activity, with an inequal distribution of POBs across professionals’ specialties and specializations, but also across geographic regions. We found no association between age, sex, number of consultations, experience length and the treatment options prescribed to POB, which were determined by profession, specialty, and practice place. Psychologists treat POB more often than physicians [OR=1.97], and especially psychological psychotherapists compared to work psychologists [OR=6.35]. Psychiatrists treat burnout more frequently than GPs [OR=12.6] while OPs treat them less frequently than GPs [OR=0.19]. The profile of POB consulted also differs across professionals. Work psychologists see more often POB at early burnout stage, GPs have most patients with moderate burnout, while PPs report the largest proportion of patients with severe burnout.
The treatment practices depend on burnout severity. Psychiatrists [OR=3.8] and physicians with double specialty (GP-OPs and GP-PPs) [OR=5.86] treat patients with more severe burnout than GPs. Psychologists treating patients with severe burnout the most also collaborate with other health professionals and contact the POB’s employer and/or health insurance [OR=2.15]. Treatment practices and burnout severity are not associated with the proportion of relapsed patients and patients who return to work. Yet, the former is associated with professionals’ age, sex, and specialty. Physicians with waiting time >3 months have a higher proportion of relapsed patients [OR=2.5]. GPs prescribe most often sick leaves, while PPs are the most frequent prescribers of pharmacological treatment. PPs collaborate significantly more often than GPs with pharmacologists and contact POB’s employer and health insurance. Among psychologists, work psychologists differ from other psychologists by a more frequent POB (psycho)education and coaching, namely on how to negotiate with employer and family, as well as on physical exercise. They also more often contact POB’s employer. Besides profession and specialization, we observed important regional variation in treatment modalities chosen by both physicians and psychologists.

Conclusions: The current practices of Swiss professionals in POB management present important regional variations, especially in terms of interdisciplinary collaborations. Future actions should focus on the comparison of the current practices with specific professional practice guidelines and education, especially GPs’ pre-gradual and continuous education.

Geographic coverage
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All Swiss regions

Analysis unit
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Individuals. 1130 participants

Universe
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Healthcare professionals who treat patients with occupational burnout

Kind of data
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Self-reported data collected from online questionnaire.

Mode of data collection
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E-Questionnaire

Research instrument
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REDCap

摘要
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研究目标：本研究旨在阐述瑞士治疗职业倦怠（POB）患者（即全科医生（GP）、精神科医生-心理治疗师（PP）、职业医生（OP）和心理学家）的健康专业人员的社情民意和专业特征，以及他们目前的实践情况。

研究方法：2021年4月至7月间，通过全国专业协会发放了一份包含48个问题的e-问卷（RedCAP）。数据采用逻辑回归和多因素回归模型进行分析。

研究结果：在3216名受访者中，2951人报告了咨询POB，其中1130人（713名医生和410名心理学家）进行治疗。大多数受访者（n=894，79%）在私人诊所工作，平均拥有16.9年的专业经验。研究显示，POB的管理构成了医疗保健专业人员活动量的5%至25%，POB在专业和专长以及地理区域之间的分布不均。研究发现，年龄、性别、咨询次数、经验长度与POB的治疗方案之间没有关联，治疗方案由职业、专长和实践地点决定。与医生相比，心理学家更常治疗POB[OR=1.97]，尤其是心理治疗师与工作心理学家相比[OR=6.35]。精神科医生比全科医生更频繁地治疗倦怠[OR=12.6]，而职业医生比全科医生更少治疗倦怠[OR=0.19]。不同专业人员的POB咨询情况也存在差异。工作心理学家更常看到早期倦怠阶段的POB，全科医生的大部分患者为中度倦怠，而PP报告的严重倦怠患者比例最高。

治疗方法取决于倦怠的严重程度。与全科医生相比，精神科医生[OR=3.8]和双专长医生（GP-OPs和GP-PPs）[OR=5.86]治疗更严重倦怠的患者。治疗严重倦怠的患者最多的心理学家也与其他医疗保健专业人员合作，并联系POB的雇主和/或健康保险公司[OR=2.15]。治疗实践和倦怠的严重程度与复发的患者比例和重返工作患者的比例无关。然而，前者与专业人员的年龄、性别和专长有关。等待时间超过3个月的医生有更高比例的复发患者[OR=2.5]。全科医生最常开具病假单，而PP是最常开具药物治疗处方的人。PP与药物学家合作得比GP更频繁，并更常联系POB的雇主和健康保险公司。在工作心理学家中，与雇主和其他心理学家相比，工作心理学家更频繁地进行POB（心理）教育和指导，即如何与雇主和家庭协商，以及进行体育锻炼。他们也更常联系POB的雇主。除了职业和专长外，我们还观察到医生和心理学家在选择治疗方法时存在重要的区域差异。

结论：瑞士专业人员目前对POB的管理实践存在重要的区域差异，特别是在跨学科合作方面。未来的行动应集中在将当前实践与具体的职业实践指南和教育进行比较，特别是全科医生的预毕业和继续教育。

地理覆盖范围：瑞士所有地区

分析单位：个体。1130名参与者

总体：治疗职业倦怠患者的医疗保健专业人员

数据类型：通过在线问卷收集的自我报告数据。

数据收集方式：E-问卷

研究工具：REDCap