Elsevier

The Surgeon

Volume 16, Issue 1, February 2018, Pages 12-19
The Surgeon

Are ENT surgeons in the UK at risk of stress, psychological morbidities and burnout? A national questionnaire survey

https://doi.org/10.1016/j.surge.2016.01.002Get rights and content

Abstract

Introduction

Work-related stress, psychological disorders and burnout are common occupational disorders affecting UK doctors. To date, there are no studies looking at these psychosocial morbidities amongst ENT surgeons worldwide.

Methods

The General Health Questionnaire-12 (GHQ-12) and abbreviated Maslach Burnout Inventory (aMBI) were incorporated into a questionnaire on occupational diseases amongst ENT surgeons and distributed to the entire membership of ENT-UK. The survey study also acquired demographic data on grade of respondent, years of experience in ENT and subspecialty interest.

Results

We received 108 (8.1% response rate) appropriately filled GHQ-12 and 121 (9.0% response rate) aMBI questionnaires. 61 respondents (56.5%) on the GHQ-12 were at high risk of developing stress and psychological morbidity and 35 (28.9%) had high enough aMBI scores to suggested burnout. When comparing scores of both GHQ-12 and aMBI with grade of respondent, years of experience in ENT and subspecialty, statistical difference was only found on the risk of stress and psychiatric disorders amongst paediatric ENT surgeons (7 high risk vs 0 low risk, p = 0.02), however the number of these respondents was small (7 in total). Both questionnaires had been validated for use within our population.

Conclusion

We found high incidence rates of stress and psychological morbidity (56.5%) and a burnout prevalence rate of 28.9% amongst our responding cohort of UK Oto-rhino-laryngologists. No meaningful differences were found between stress, psychological morbidity and burnout with grade of ENT surgeon, years of experience in ENT and subspecialty within ENT.

Introduction

Work-related stress is amongst the commonest reported occupational illnesses affecting UK doctors.1, 2 It is postulated to stem from a combination of clinical and managerial work overload, raised patients' expectations, perceived poor handling of clinical and professional issues by management and feeling under resourced.3, 4 A delay in recognition and subsequent treatment of such precursor conditions can give rise to other psychiatric conditions, such as anxiety and depression, as well as burnout.5, 6 This ‘burnout’ term, coined by Freudenberger, is defined as a physical, emotional and mental exhaustion in respect of a person's job or career as a consequence of inadequate job satisfaction.5, 7

Such conditions can affect a clinician's job performance and decision-making ability, which in turn could result in a deleterious impact on patient safety.5 Additionally, personal life may also suffer with substance abuse, broken relationships and disrupted family life cited as possible consequences.3, 5 Affected doctors are more likely to take early retirement. If seen on a large scale, the consequent reduction in the workforce would not only place a significant strain on the efficient running of National Health Service (NHS) services, but could impact on the training of future generations of clinicians.3, 4

Worryingly, Taylor et al. reported that psychiatric morbidity and burnout are on the rise and had shown an increase of 5% and 9% respectively amongst hospital consultants between 1994 and 2002.7 The authors concluded that this was a result of increasing job stress without a comparable rise in job satisfaction.7 A review on occupational diseases amongst UK surgeons3 found that these conditions were widely reported in the literature amongst various surgical subspecialties, however, no studies had been conducted amongst ENT surgeons either in the UK or worldwide.3 In view of the risks of developing the aforementioned consequences from under diagnoses, we conducted a cross-sectional study to assess the incidence of stress and psychological diseases as well as the prevalence of burnout amongst UK Oto-rhino-laryngologists.

Section snippets

Ethical consideration

NREC ethical approval was not required as this was a cross-sectional study on volunteering healthcare professionals who were members of ENT-UK, a registered UK charity.

Setting and participants

A national survey study of occupational-related diseases was undertaken by sending out a questionnaire to all members of ENT-UK, the British Association of Otolaryngologists Head and Neck Surgeons. The survey was edited and approved by the ENT UK Survey Guardian prior to its distribution via email invitation between October and

Stress and psychological morbidity (GHQ-12)

We received 115 (8.6%) filled GHQ-12 questionnaires. 7 were excluded as they were under filled with pertinent demographic information missing. Of the remaining 108 respondents, 61 were at high risk of developing stress and psychiatric conditions giving an incidence rate of 56.5%.

  • i)

    Grade of respondents

There were responses from 81 consultants, 20 specialist registrars (SpR)/specialty trainees (StR) and 7 from associate specialist/staff grades. There were no differences seen in the risk of

Discussion

To the best of our knowledge, this is the first reported epidemiological study on occupational psychosocial morbidities amongst ENT surgeons. We found that the incidence of stress and psychological morbidity and the prevalence of burnout within our responding cohort of UK Oto-rhino-laryngologists was 56.5% and 28.9% respectively. We also compared the presence of these illnesses between the varying grades, subspecialties and years of experience in ENT and found that only Paediatric ENT surgeons

Conclusion

In the first study looking at psychosocial disorders amongst ENT surgeons, we found high incidence rates of stress and psychological morbidity (56.5%) and a burnout prevalence rate of 28.9% amongst our cohort of responding UK Oto-rhino-laryngologists. No meaningful differences were found on stress, psychological morbidity or burnout according to grade of ENT surgeon, years of experience in ENT and subspecialty within ENT, but power for this issue was low. This study serves as a guide for

Conflict of interest

None declared.

Financial support and declaration

None.

Acknowledgement

We would like to thank Mr. David Lowe (ENT-UK Survey Guardian), the survey team at ENT-UK and ENT-UK members who helped edit, distribute and develop knowledge within our speciality by sharing their reflections on practice. We would also like to express our utmost gratitude to Professor Mark Haggard from the University of Cambridge for his advice and assistance on the statistical analyses and writing of this paper.

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