Trends in Anaesthesia and Critical Care 14 (2017) 19e20
Contents lists available at ScienceDirect
Trends in Anaesthesia and Critical Care
journal homepage: www.elsevier.com/locate/tacc
Beyond clinician burnout predisposing factors, what is the appropriate
intervention?
Dear Editor,
The rise of burnout signals is alarming worldwide. Bienvenu [1],
summarized the predisposing risk factors for clinician burnout to
include younger clinicians without families, overloaded work
schedule, practitioners dealing with withdrawing life support deci-
sions, quality of working relationships, practitioners who care for
dying patients, and visiting hours policy.
Fassier and Azoulay emphasized the critical value of individual
control at workplace where dispute and conflicts enhance the
burnout development [2] moreover, unclear roles and assignments
is another burnout potentiation. Slight in the decision-making
could be associated with reduced performance and lower workload
coordination and hence the reducing the control, lowering the
chances of achieving individuals commitment, with lower energy
and health [3]. Unfair intrinsic or extrinsic rewarding system
indeed could increase the chances for burnout experience [3].
Understanding the traumatizing factors is needed to prevent
burnout. Social interaction, conflicts, reciprocal support, vicinity,
and teamwork are the core value of organizational community.
Pross (2006) empahsized that community related social and polit-
ical pressure put the employers under stress. Population character-
istics, and financial backup, public support and financial backup
undergo continuous changes which could be reflected on the
workers stress [4]. Hobfoll (2001) added that trends to resources
conservation could decipher the resource loss in stressful situa-
tions. Resources conservation and appraisal-based procedures
could be influential for the stress process [5].
Recently nationality emerges in evolvement of burnout. Omar
et al. (2015) reported higher burnout in Syrian practitioners work-
ing in a multinational community, where civil war in their native
country added to the manifest stressors [6]. Similarly Al-Turki [6]
et al., (2010) found that non-Saudi nurses were more susceptible
to emotional exhaustion than Saudi nurses [7]. Satisfaction and
well-being of the physician appear to be linked to the leadership
quality. This in turn gives evidence about the importance of leader-
ship selection in attempt to reduce burnout [8]. There is a growing
awareness that physician burnout is influenced by institutional fac-
tors including the practice environment efficacy, the practitioners
provided autonomy, and workload [8e11].
http://dx.doi.org/10.1016/j.tacc.2017.03.005
2210-8440/© 2017 Elsevier Ltd. All rights reserved.
Downloaded for Anonymous User (n/a) at Hamad Medical Corporation from ClinicalKey.com by Elsevier on October 24,
2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved.
A recent systemic review and meta-analysis summarized the in-
terventions required for burnout reduction into organizational and
individual focused approaches [12]. The diversity of predisposing
factors of burnout mandate working plan aim at early recognition
and organization based management, hence reducing chances for
its evolvement.
1. Conclusions
Burnout is getting more attention, appropriate intervention
should aim at better orientation, early identification, and manage-
ment of predisposing factors could prevent its hazardous on
practitioners.
Compliance with ethical standards
Conflicts of interest
Dr. Omar is a consultant in Hamad Medical Corporation (HMC),
Qatar, declares no potential financial or personal conflict of interest
with a third party that could influence the content of this article.
References
[1] O.J. Bienvenu, Is this critical care clinician burned out? Intensive Care Med.
(2016) 1e3. Aug 16.
[2] T. Fassier, E. Azoulay, Conflicts and communication gaps in the intensive care
unit, Curr. Opin. Crit. care 16 (6) (2010) 654e665. Dec 1.
[3] C. Maslach, M.P. Leiter, Early predictors of job burnout and engagement. Jour-
nal of applied psychology 93 (3) (2008) 498. May.
[4] C. Pross, Burnout, vicarious traumatization and its prevention, Torture. 16 (1)
(2006) 1e9.
[5] S.E. Hobfoll, The influence of culture, community, and the nested-self in the
stress process: advancing conservation of resources theory, Appl. Psychol.
50 (3) (2001) 337e421. Jul 1.
[6] A.S. Omar, S. Elmaraghi, M.S. Mahmoud, et al., Impact of leadership on ICU cli-
nicians' burnout, Intensive Care Med. 18 (3) (2015) 139. Nov 1.
[7] H.A. Al-Turki, R.A. Al-Turki, H.A. Al-Dardas, et al., Burnout syndrome among
multinational nurses working in Saudi Arabia, Ann. Afr. Med. 9 (4) (2010).
Oct 1.
[8] T.D. Shanafelt, G. Gorringe, R. Menaker, et al., Impact of organizational leader-
ship on physician burnout and satisfaction, in: Mayo Clinic Proceedings, vol.
90, Elsevier, 2015, pp. 432e440. Apr 30, No. 4.
[9] J.E. Wallace, J.B. Lemaire, W.A. Ghali, Physician wellness: a missing quality in-
dicator, Lancet. 374 (9702) (2009) 1714e1721.
20 A.S. Omar, A. Taha / Trends in Anaesthesia and Critical Care 14 (2017) 19e20

[10] P. Van Bogaert, L. Peremans, D. Van Heusden, et al., Predictors of burnout, Department of Critical Care Medicine, Beni Suef University, Egypt
work engagement and nurse reported job outcomes and quality of care: a
mixed method study, BMC Nurs. 16 (1) (2017) 5. Jan 18. Adel Taha, MD, PhD
[11] B. Egener, W. McDonald, B. Rosof, et al., Perspective: organizational profes-
Department of Critical Care Medicine, Kink Khaled Specialized
sionalism: relevant competencies and behaviors, Acad. Med. 87 (5) (2012)
668e674. Hospital, Damam, Saudi Arabia
[12] C.P. West, L.N. Dyrbye, P.J. Erwin, et al., Interventions to prevent and reduce
physician burnout: a systematic review and meta-analysis, Lancet 388 *
(10057) (2016) 2272e2281. Nov 11.
Corresponding author. Department of Cardiothoracic Surgery/ICU
Section, Heart Hospital, Hamad Medical Corporation, Doha, (PO:
3050), Qatar.
Amr S. Omar, MD, PhD, MBA* E-mail address: a_s_omar@yahoo.com (A.S. Omar).
Department of Cardiothoracic Surgery/ ICU Section, Heart Hospital,
Hamad Medical Corporation, Doha, (PO: 3050), Qatar 29 January 2017
Department of Clinical Medicine, Weill Cornell Medical College, Qatar

Downloaded for Anonymous User (n/a) at Hamad Medical Corporation from ClinicalKey.com by Elsevier on October 24,
2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved.