Burnout and areas of work-life among anaesthetists in South Africa Part 2: Areas of work-life

Abstract

Introduction: The purpose of this two-part study was to determine the prevalence and severity of the burnout syndrome among South African anaesthetists working in the public and private sectors, and to identify areas of work-life (AWLs) that predispose to burnout. We reported our burnout findings in Part 1.1 In this paper (Part 2) we report on the AWLs.
Methods: Invitations were e-mailed to 1 852 SASA members, requesting responses to a validated questionnaire, the Areas of Worklife Survey (Mindgarden Inc. Menlo Park, USA). The questionnaire results in scores for six AWLs that impact on the development of the burnout syndrome, namely workload, control, reward, community, fairness and values.
Results: 189 public sector and 309 private sector anaesthetists responded. 85% of public sector respondents worked in academic hospitals. The values AWL could not be properly assessed due to respondents’ misinterpretations regarding that particular item. Compared to private sector, public sector anaesthetists had lower (i.e. more adverse) median scores for five AWLs. Greater proportions of public sector anaesthetists had low scores for the five AWLs. Correspondingly, smaller proportions of public sector anaesthetists had high (i.e. favourable) scores for workload, control, reward, and fairness. Multivariable least squares regression analysis identified the following significant explanatory variables for the following burnout dimensions: For emotional exhaustion these were workload, reward, community and control. For cynicism they were workload, reward, control, gender and years of experience. Predictors for efficacy were reward, community, control and years of experience. Logistic regression analysis included workload, reward and control AWL as explanatory variables for a clinical diagnosis of burnout with workload the dominant variable.
Conclusions: Public sector anaesthetists experience more adverse AWLs than those in private practice. The most important factor appears to be excessive workload. Additionally, the reward, community and control AWLs are important determinants of anaesthetists’ psychological relationships with their work.