Correlates of physician burnout across regions and specialties: a meta-analysis.

BACKGROUND: Health care organizations globally realize the need to address physician burnout due to its close linkages with quality of care, retention and migration. The many functions of health human resources include identifying and managing burnout risk factors for health professionals, while also promoting effective coping. Our study of physician burnout aims to show: (1) which correlates are most strongly associated with emotional exhaustion (EE) and depersonalization (DP), and (2) whether the associations vary across regions and specialties. METHODS: Meta-analysis allowed us to examine a diverse range of correlates. Our search yielded 65 samples of physicians from various regions and specialties. RESULTS: EE was negatively associated with autonomy, positive work attitudes, and quality and safety culture. It was positively associated with workload, constraining organizational structure, incivility/conflicts/violence, low quality and safety standards, negative work attitudes, work-life conflict, and contributors to poor mental health. We found a similar but weaker pattern of associations for DP.Physicians in the Americas experienced lower EE levels than physicians in Europe when quality and safety culture and career development opportunities were both strong, and when they used problem-focused coping. The former experienced higher EE levels when work-life conflict was strong and they used ineffective coping. Physicians in Europe experienced lower EE levels than physicians in the Americas with positive work attitudes. We found a similar but weaker pattern of associations for DP.Outpatient specialties experienced higher EE levels than inpatient specialties when organization structures were constraining and contributors to poor mental health were present. The former experienced lower EE levels when autonomy was present. Inpatient specialties experienced lower EE levels than outpatient specialties with positive work attitudes. As above, we found a similar but weaker pattern of associations for DP. CONCLUSIONS: Although we could not infer causality, our findings suggest: (1) that EE represents the core burnout dimension; (2) that certain individual and organizational-level correlates are associated with reduced physician burnout; (3) the benefits of directing resources where they are most needed to physicians of different regions and specialties; and (4) a call for research to link physician burnout with performance.

Regret in later life: exploring relationships between regret frequency, secondary interpretive control beliefs, and health in older individuals.

The present study examined what older people regret, and the relationships between regret, health and life satisfaction. The study also explored the role of secondary interpretive control beliefs in relation to regret. Participants (N= 228; 79-98 years old) were asked to report on the content and frequency of their regret, secondary interpretive control beliefs (e.g., beliefs in finding the "silver lining" in a dark cloud), health, and life satisfaction. A content analysis revealed that participants most commonly reported feeling regret due to things they had not done, the death of a loved one, and their own or others' health problems. Regression analyses indicated that experiencing regret more frequently was associated with poorer health and life satisfaction. Moreover, evidence for an emotion-modifying role of secondary interpretive control beliefs was shown through its negative association with regret. Results suggest that older adults may be experiencing age-related regrets that differ in content from those experienced at younger ages and that certain control beliefs may serve to lessen regret.

Validation of the Narrative Emplotment Scale and its correlations with well-being and psychological adjustment.

Two studies examined correlates of the Narrative Emplotment Scale (NES), which measures the extent to which individuals perceive chance events and unchosen experiences as meaningfully connected. In Study 1 (N=99), the NES demonstrated adequate test-retest stability and good internal reliability. The scale was positively related to paranormal beliefs, mystical experiences, and absorption. In Study 2 (N=342), personality measures indicative of external locus of control, intrinsic religiosity, well-being, satisfaction with life, and a measure of frequency of coincidence experience were all positively correlated with narrative emplotment, providing further support for the construct validity of the scale. In terms of the question of whether meaning making is predictive of better or worse psychological adjustment, analyses indicated that the relationship between narrative emplotment and psychological adjustment was moderated by individual differences in coping strategies. Path analysis indicated that emplotment was a mediator of the pathway between religiosity and well-being. Emplotment had a negative effect on well-being through chance locus of control. These analyses suggest that this type of meaning-making is an important variable for understanding religious/spiritual beliefs and their influence on psychological adjustment.

The role of attributional retraining and elaborative learning in college students' academic development.

In the present longitudinal study, the authors examined the impact of attributional retraining (AR) techniques on academic motivation and achievement for college students who are either frequently or infrequently using elaborative learning strategies. During the 1st semester, 203 students completed an initial questionnaire assessing elaborative learning followed by 1 of 3 treatment conditions (No AR, Writing AR, Aptitude Test AR). Results indicated improvements in students' end-of-year perceptions of control, success, and emotions, as well as course-specific and overall academic performance for those receiving either AR format, with "high elaborators" showing higher levels on these measures than "low elaborators." The authors discussed the importance of elaborative and attributional processes underlying the effectiveness of the AR treatment and the potential utility of individualized AR techniques in the college classroom.