Burnout syndrome in paediatricians working in paediatric emergency care settings. Prevalence and associated factors: a multilevel analysis

Introduction: The aim of our study was to describe the prevalence of burnout syndrome (BOS) in paediatricians working in paediatric emergency care settings and to analyse its association with potential risk factors. Material and Methods: Multicentre cross-sectional study through a survey of paediatricians working in paediatric emergency care settings in hospitals affiliated to the Research Network of the Spanish Society of Paediatric Emergency Medicine (SEUP) between September 2019 and January 2020. We analysed the association between social/family-related, demographic, occupational and satisfaction factors and the presence of BOS by means of multivariate and multilevel mixed-effects logistic regression models. Results: The estimated prevalence of BOS was 36.5% (95% confidence interval [CI], 31.7 %–41.2%). In the multivariate analysis, lacking a stable group of friends (OR, 2.57; 95% CI, 1.10−5.97), problems in and out of the work setting (OR, 3.06; 95% CI, 1.60−5.88) and a work experience of 9 years or less (OR, 2.31; 95% CI, 1.37−3.90) were identified as individual factors that increased the risk of SBO, while feeling acknowledged by coworkers (OR, 0.48; 95% CI, 0.30−0.79) and acknowledged by one’s supervisor (OR, 0.62; 95% CI, 0.41−0.93) were protective factors. In relation to the hospital, the paediatric emergency unit being a subdepartment of the Department of Paediatrics (OR, 3.81; 95% CI, 1.85−7.85), the presence of an on-call emergency medicine specialist around the clock (OR, 3.53; 95% CI,1.62−7.73) and a volume of 28 or more paediatric emergency encounters a day to be managed per on-call physician (OR, 2.05; 95% CI, 1.01−4.16) were identified as independent risk factors for SBO. There was no variability in the prevalence of BOS attributable to differences between hospitals and autonomous communities, save for the described situations. Conclusions: The prevalence of SBO among these providers is high. There are modifiable factors that we can intervene on to address BOS, independently of the hospital or region. Resumen: Introducción: El objetivo del estudio es describir la prevalencia de Síndrome de Burnout (SBO) entre pediatras con actividad en Urgencias Pediátricas (UP) y analizar su asociación con potenciales factores de riesgo. Material y métodos: Estudio de encuestas transversales multicéntrico, entre pediatras con actividad asistencial en UP, en Hospitales miembros de la Red de Investigación de la Sociedad Española de UP (RiSEUP-SPERG), entre septiembre 2019 y enero 2020. Se analizó la relación de factores sociofamiliares, demográficos, laborales y de satisfacción con la presencia de SBO mediante modelos mixtos de regresión logística multivariable y multinivel. Resultados: La prevalencia estimada fue 36,5% (IC95%:31,7–41,2%). Tras el análisis multivariable, no disponer de un círculo de amigos estable (OR:2,57; IC95%:1,10−5,97), tener problemas en el ámbito laboral y extralaboral (OR:3,06; IC95%:1,60−5,88) y llevar trabajando 9 años o menos (OR:2,31; IC95%:1,37−3,90) se presentaron como factores individuales que aumentaron el riesgo de SBO; sentirse reconocido por compañeros (OR:0,48; IC95%:0,30−0,79) y supervisor (OR:0,62;IC95%:0,41−0,93) parecieron actuar como protectores. En el ámbito hospitalario, que la Urgencia dependiera del Servicio de Pediatría (OR:3,81; IC95%:1,85−7,85), siempre hubiera un especialista en Urgencias de guardia (OR:3,53; IC95%:1,62−7,73) y que cada médico de guardia atendiera 28 episodios de urgencias/día o más (OR:2,05; IC95%:1,01–4,16), constituyeron factores de riesgo independiente para el SBO. No existió variabilidad en la presencia de SBO atribuible a la diferencia entre Hospitales y Comunidades Autónomas (CC.AA), al margen de las situaciones descritas. Conclusiones: La prevalencia de SBO en estos profesionales es elevada. Existen factores sobre los que podemos incidir para modificar el SBO, independientemente del Hospital o CC.AA.