Prevalence of burnout among intensive care physicians: a systematic review

Abstract Objective: We performed a systematic review to summarize the knowledge regarding the prevalence of burnout among intensive care unit physicians. Methods: We conducted a systematic review of the MEDLINE and PubMed® databases (last update 04.02.2019) with the goal of summarizing the evidence on burnout among intensive care unit physicians. We included all studies reporting burnout in intensive care unit personnel according to the Maslach Burnout Inventory questionnaire and then screened studies for data on burnout among intensive care unit physician specifically. Results: We found 31 studies describing burnout in intensive care unit staff and including different healthcare profiles. Among these, 5 studies focused on physicians only, and 12 others investigated burnout in mixed intensive care unit personnel but provided separate data on physicians. The prevalence of burnout varied greatly across studies (range 18% - 49%), but several methodological discrepancies, among them cut-off criteria for defining burnout and variability in the Likert scale, precluded a meaningful pooled analysis. Conclusion: The prevalence of burnout syndrome among intensive care unit physicians is relatively high, but significant methodological heterogeneities warrant caution being used in interpreting our results. The lower reported levels of burnout seem higher than those found in studies investigating mixed intensive care unit personnel. There is an urgent need for consensus recommending a consistent use of the Maslach Burnout Inventory test to screen burnout, in order to provide precise figures on burnout in intensive care unit physicians.

摘要 研究目的：本研究开展系统综述，旨在总结重症监护室（intensive care unit, ICU）医师职业倦怠（Burnout）患病率的相关研究进展。
研究方法：我们对MEDLINE及PubMed®数据库（最后更新时间为2019年2月4日）进行系统综述，以汇总重症监护室医师职业倦怠的相关研究证据。本研究纳入所有依据马氏职业倦怠量表（Maslach Burnout Inventory, MBI）报告重症监护室人员职业倦怠情况的研究，并进一步筛选出专门针对重症监护室医师职业倦怠数据的相关文献。
研究结果：共检索到31项描述重症监护室工作人员职业倦怠情况的研究，涵盖不同医疗照护人员群体。其中5项研究仅聚焦于医师群体，另有12项研究针对混合重症监护室人员开展职业倦怠调查，但提供了医师群体的单独统计数据。不同研究报告的职业倦怠患病率差异显著（范围为18%~49%），但多项方法学差异——包括职业倦怠判定的截断标准及李克特量表（Likert scale）的使用差异——导致无法开展具有实质意义的合并分析。
研究结论：重症监护室医师群体的职业倦怠综合征患病率相对较高，但存在显著的方法学异质性，因此解读本研究结果时需保持谨慎。现有研究显示该群体的职业倦怠报告水平高于针对混合重症监护室人员的相关研究。当前亟需达成行业共识，推荐统一使用马氏职业倦怠量表开展职业倦怠筛查，以便精准获取重症监护室医师职业倦怠的具体统计数据。