jeudi 6 avril 2023

ETUDE RECHERCHE Stress professionnel, épuisement professionnel et idées suicidaires chez les enseignants hospitalo-universitaires titulaires en France en 2021

Job Strain, Burnout, and Suicidal Ideation in Tenured University Hospital Faculty Staff in France in 2021
Martin Dres, PhD1,2; Marie-Christine Copin, MD, PhD3; Alain Cariou, MD, PhD4,5; et al Muriel Mathonnet, MD, PhD6; Raphael Gaillard, MD, PhD7,8,9; Tait Shanafelt, MD10; Bruno Riou, MD, PhD11,12; Michael Darmon, MD, PhD4,13; Elie Azoulay, MD, PhD11,12
Author Affiliations
  • 1Sorbonne Université, INSERM, UMRS 1158, Paris, France
  • 2Department of Critical Care Medicine, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
  • 3Université Angers, CHU Angers, INSERM, CNRS, CRCI2NA, Angers, France
  • 4Paris Cité University, Paris, France
  • 5Department of Critical Care Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
  • 6Department of Digestive, General, and Endocrinology Surgery, University of Limoges, INSERM, UMR 1308, Limoges, France
  • 7Paris Cité University and Sorbonne Université, INSERM, UMR S894, Paris, France
  • 8Centre Hospitalier Sainte-Anne, Paris, France
  • 9Centre de Psychiatrie et Neurosciences, Paris, France
  • 10Stanford School of Medicine, Stanford, California
  • 11Sorbonne Université, INSERM, UMR 1166, Fondation pour l’Innovation en Cardiométabolisme et Nutrition, Paris, France
  • 12Emergency Department, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
  • 13Department of Critical Care Medicine, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France

JAMA Netw Open. 2023;6(3):e233652. doi:10.1001/jamanetworkopen.2023.3652
Key Points

Question  How much burnout, job strain, and suicidal ideation are experienced by tenured university hospital faculty staff in France?

Findings  In a nationwide cross-sectional survey of 2390 tenured university hospital faculty members, 40% of participants reported severe burnout, 12% reported job strain, and 15% reported suicidal ideation. Risk factors amenable to improvement included work encroachment on private life and perceived lack of support from the institution.

Meaning  These findings underscore the urgent need for measures to improve working conditions for university hospital faculty and increase job attractiveness for the next generation.

Abstract

Importance  The ability to attract and retain university hospital faculty staff is in jeopardy because of the high levels of mental symptoms in this professional group.

Objective  To examine the prevalence and determinants of symptoms of severe burnout, job strain, and suicidal ideation in tenured associate and full professors in university hospitals.

Design, Setting, and Participants  This nationwide cross-sectional study offered online surveys to 5332 tenured university hospital faculty members in France from October 25, 2021, to December 20, 2021.

Exposures  Burnout and job strain.

Main Outcomes and Measures  Participants completed the 22-item Maslach Burnout Inventory and a 12-item job strain assessment tool, reported suicidal ideation, and used visual analog scales to evaluate unidimensional parameters. The primary outcome was presence of severe burnout symptoms. Factors associated with mental health symptoms were identified by multivariable logistic regression.

Results  Completed questionnaires were returned by 2390 of 5332 faculty members (response rate, 45%; range, 43%-46%). Tenured associate professors were a median of 40 (IQR, 37-45) years old with a sex ratio of 1:1, whereas tenured full professors were a median of 53 (IQR, 46-60) years old with a sex ratio of 1:5. Of 2390 respondents, 952 (40%) reported symptoms of severe burnout. Symptoms of job strain (296 professors [12%]) and suicidal ideation (343 professors [14%]) were also reported. Compared with full professors, significantly more associate professors reported feeling overwhelmed at work (496 [73%] vs 972 [57%]; P < .001), considering resignation (365 [54%] vs 834 [49%]; P = .004), or considering a career change (277 [41%] vs 496 [29%]; P < .001). Factors independently associated with less burnout were a longer time being a professor (adjusted odds ratio [aOR], 0.97; 95% CI, 0.96-0.98 per year of age), sleeping well (aOR, 0.88; 95% CI, 0.83-0.92), feeling valued by colleagues (aOR, 0.91; 95% CI, 0.86-0.95 per visual analog scale point) or the public (aOR, 0.92; 95% CI, 0.88-0.96 per visual analog scale point), and accepting more tasks (aOR, 0.82; 95% CI, 0.72-0.93). Factors independently associated with more burnout were having a nonclinical position (OR, 2.48; 95% CI, 1.96-3.16), reporting work encroachment on private life (OR, 1.17; 95% CI, 1.10-1.25), feeling the need to constantly put on a brave face (OR, 1.82; 95% CI, 1.32-2.52), considering a career change (OR, 1.53; 95% CI, 1.22-1.92), and having experienced harassment (OR, 1.52; 95% CI, 1.22-1.88).

Conclusions and Relevance  These findings suggest that the psychological burden on tenured university hospital faculty staff in France is considerable. Hospital administrators and health care authorities should urgently develop strategies for burden prevention and alleviation and for attraction of the next generation.

 Etude accessible : https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802817