The
findings raise concerns that, "In addition to effects on the health of
anesthesiology trainees, burnout and depression may also affect patient
care and safety," write Dr Gildasio S. de Oliveira, Jr, and colleagues
of Northwestern University, Chicago.
The
researchers performed an Internet survey of U.S. anesthesiology
residents nationwide. Confidential responses from 1,508 residents were
analyzed to assess the frequency of burnout and depression, and whether
trainees at high risk of these conditions would report more medical
errors.
Forty-one percent of residents were considered at risk of burnout, based on high scores for emotional exhaustion and depersonalization and/or low scores for personal accomplishment. In addition, 22 percent of residents had possible depression, based on a standard screening test. Seventeen percent of trainees were at risk of both burnout and depression.
Compared to people of similar age,
anesthesiology residents were nearly twice as likely to have screen
positive for depression. They were also twice as likely to report
suicidal thoughts.
Both burnout and depression were more likely
for residents who worked more than 70 hours per week, those with higher
alcohol use (more than five drinks per week), and female residents.
Smoking was an additional risk factor for depression.
There
was some evidence that burnout and depression affected the quality of
patient care and the risk of medical errors. Rated on a 30-point "best
practice" score, performance was about two points lower for residents at
high risk for burnout and four points lower for those at high risk of
both burnout and depression, compared to those at low risk.
Residents
with burnout and depression also reported being less attentive to
patients and making more mistakes with negative consequences for
patients. One-third of residents with high burnout and depression risk
said they had made multiple medication errors in the last year, compared
to less than one percent of lower-risk responders.
Previous studies have identified medical residents as a group at high risk of burnout, which may lead to an increased risk of medical errors. The new study is the first to focus on the risk of burnout and depression among anesthesiology residents.
Burnout, depression, and suicidal
thoughts are "very frequent" among anesthesiology residents, the results
suggest. Dr de Oliveira and coauthors note that these problems may not
only contribute to the risk of medical errors, but are also linked to
high-risk behaviors such as smoking and alcohol use. The researchers
discuss some possible approaches to reducing burnout in anesthesia
trainees—such as balancing workload with quality of life or providing
some type of psychological screening.
Source: International Anesthesia Research Society (IARS) via Newswise