A Qualitative Analysis of Stress and Relaxation Themes Contributing to Burnout in First-Year Psychiatry and Medicine Residents

• Published in: Academic psychiatry 2018-10, Vol.42 (5), p.630-635
• Main Authors: Benson, Nicole M., Chaukos, Deanna, Vestal, Heather, Chad-Friedman, Emma F., Denninger, John W., Borba, Christina P. C.
• Format: Article
• Language: English
• Subjects: Academic Achievement; Adult; Burnout; Burnout, Professional - psychology; Coding; Curricula; Data Analysis; Depression; Diaries; Educational Environment; Emotional Response; Female; Hospitals, Teaching; Humans; In Brief Report; Internal medicine; Internal Medicine - education; Internship and Residency; Intervention; Male; Medical Education; Medicine; Medicine & Public Health; Meta Analysis; Physicians; Physicians - psychology; Pilot projects; Psychiatry; Psychiatry - education; Psychological Patterns; Qualitative Research; Relaxation - psychology; Responsibilities; Statistical Analysis; Stress; Stress Management; Teaching Methods; Trainees; Urban Teaching; Well being
• ISSN: 1042-9670; 1545-7230
• DOI: 10.1007/s40596-018-0934-2

Objective Qualitative research on trainee well-being can add nuance to the understanding of propagators of burnout, and the role for interventions aimed at supporting well-being. This qualitative study was conducted to identify (i) situations and environments that cause stress for trainees, (ii) stress-reducing activities that trainees utilize, and (iii) whether trainees who report distress (high burnout and depression scores) describe different stressors and relaxation factors than those who do not. Methods The study was conducted with a convenience sample of first-year medicine and psychiatry residents at a large urban teaching hospital. Participants were asked to complete electronic stress and relaxation diaries daily for 1 week. Diary entries were coded for recurrent themes. Participants were screened for burnout and depression. Codes were compared by subgroup based on baseline burnout and depression status to elucidate if specific themes emerged in these subgroups. Results Study sample included 51 interns. Sixteen (16/50, 32%) screened positive for burnout and three (3/50, 14%) had a positive depression screen. The most common stressors related to aspects of the learning environment, compounded by feeling under-equipped, overwhelmed, or out of time. The majority of relaxation activities involved social connection, food, other comforts, and occurred outside of the hospital environment. Conclusions This study reveals that interns (regardless of burnout or depression screen) identify stressors that derive primarily from organizational, interpersonal, and cultural experiences of the learning environment; whereas relaxation themes are diversely represented across realms (home, leisure, social, health), though emphasize activities that occur outside of the work place.