The experience of burnout across different surgical specialties in the United Kingdom: a cross-sectional survey.

BACKGROUND: We used a cross-sectional e-mail survey to assess the prevalence of psychological morbidity across different surgical specialties and identify predictor variables of burnout in surgeons. METHOD: The survey was sent to 1971 surgeons from 127 National Health Service (NHS) hospital trusts across the United Kingdom. Burnout prevalence and mood were assessed using the Maslach Burnout Inventory-General Survey and Profile of Mood States (POMS), respectively. Demographic and POMS factors were investigated as predictors of burnout using linear and stepwise regression analyses. RESULTS: Responses to the survey were received from 342 surgeons (17% response rate). One-third of 313 respondents showed high mean levels of burnout on exhaustion (2.32; standard deviation [SD], 1.62) and cynicism (2.34; SD, 1.44) subscales. Some specialties worked significantly more hours per week (F[8, 252] = 2.89; P = .004), but burnout prevalence did not differ significantly between specialty, grade, age, gender, hours worked per week, or years spent in post. The number of years in specialty (ß = -0.17; P = .003) independently predicted surgeons' scores on exhaustion. POMS factors significantly predicted burnout, where fatigue (ß = 0.58; P < .001) was the best predictor of exhaustion scores, depression (ß = 0.28; P < .001) the best predictor of cynicism, and vigor (ß = 0.29; P < .001) the best predictor of professional efficacy. Management issues were cited as contributing to psychological morbidity. CONCLUSION: UK surgeons show high levels of cynicism and exhaustion burnout irrespective of their specialty, grade, or hours worked per week. Surgeons' mood profiles significantly predicted burnout, indicating the POMS could be used as part of an assessment for preventive interventions. NHS management and infrastructure are highlighted as influences on surgeons' psychological health.

Prevalence of abdominal aortic aneurysms in over 65-year-old men with inguinal hernias.

INTRODUCTION: The aim of this study was to determine the prevalence of abdominal aortic aneurysms (AAAs) in over 65-year-old men who have inguinal hernias and discuss if pre-operative selective screening of this population is appropriate. PATIENTS AND METHODS: A prospective study on 70 consecutive male patients with an age range of 65-88 years (mean, 74 years) who were referred to a single vascular consultant's out-patient clinic with an inguinal hernia were screened for the presence of an AAA with an ultrasound scan before hernia repair over a period of 3 years. RESULTS: Two patients were found to have an AAA measuring 3.8 cm and 6.0 cm giving an AAA prevalence of 3% (exact 95% confidence interval = 0-10%). CONCLUSIONS: This study does not demonstrate an increased AAA prevalence in over 65-year-old male patients with inguinal hernias, scanned pre-operatively when compared to screening programmes. Selective screening of this cohort cannot be justified on this evidence.