Burnout and Associated Risk Factors in Pediatric Residents

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Figure 1.
Respondents’ satisfaction with work-life balance, career choice of pediatrics, and salary.

Table 1.

Demographic Characteristics of the Pediatric Resident Respondents (n=264)

Variable	Value
Age, years, n (%)
<25	7 (2.7)
25-27	173 (65.5)
28-30	79 (29.9)
31-33	3 (1.1)
34-36	2 (0.8)
Sex, n (%)
Female	141 (53.4)
Male	123 (46.6)
Marital status, n (%)
Unmarried	173 (65.5)
Married	91 (34.5)
Residency year, n (%)
1	108 (40.9)
2	75 (28.4)
3	45 (17.0)
4	36 (13.6)
Smoking status, n (%)
No	198 (75.0)
Yes	66 (25.0)
Exercise, n (%)
Never	139 (52.7)
≥1 day/week	125 (47.3)
Hours of sleep/day, mean ± SD	6.15 ± 1.33
Number of on-calls/month, mean ± SD	5.16 ± 0.91
Number of hours working in the hospital/day, mean ± SD	8.81 ± 2.31
Number of clinics/week, mean ± SD	2.29 ± 2.95
Number of patients under daily care, mean ± SD	5.63 ± 3.71

Table 2.

Mean Scores for Burnout Domains, Prevalence of Negative Scores, and Prevalence of Overall High Burnout Among Pediatric Residents (n=264)

Variable	Value
Continuous presentation, mean ± SD (range)
Emotional exhaustion	30.8 ± 11.6 (2-54)
Depersonalization	9.51 ± 5.91 (1-26)
Sense of personal accomplishment	30.9 ± 8.45 (8-47)
Categorical presentation, n (%)
High emotional exhaustion
No	96 (36.4)
Yes	168 (63.6)
High depersonalization
No	191 (72.3)
Yes	73 (27.7)
Low personal accomplishment
No	136 (51.5)
Yes	128 (48.5)
High burnout
No	222 (84.1)
Yes	42 (15.9)

Notes: High emotional exhaustion was defined as a score >26, high depersonalization was defined as a score >12, and low sense of personal accomplishment was defined as a score <32. High burnout was defined as coexisting high emotional exhaustion, high depersonalization, and low personal accomplishment.

Table 3.

Association of Demographic and Work-Related Factors With High Burnout

Variable	High Burnout n=42	Odds Ratio (95% CI)	P Value (LR)^a	P Value^b
Age, years, n (%)				0.501
<28	31 (73.8)	Reference	Reference
≥28	11 (26.2)	0.73 (0.33-1.50)	0.403
Sex, n (%)				0.982
Female	23 (54.8)	Reference	Reference
Male	19 (45.2)	0.94 (0.48-1.83)	0.852
Marital status, n (%)				0.994
Unmarried	27 (64.3)	Reference	Reference
Married	15 (35.7)	1.07 (0.52-2.12)	0.846
Residency year, n (%)
1 and 2	33 (78.6)	Reference	Reference	0.217
3 and 4	9 (21.4)	0.58 (0.25-1.23)	0.158
Smoking status, n (%)				1.000
No	31 (73.8)	Reference	Reference
Yes	11 (26.2)	1.09 (0.49-2.26)	0.833
Exercise, n (%)				0.640
Never	24 (57.1)	Reference	Reference
≥1 days/week	18 (42.9)	0.81 (0.41-1.57)	0.532
Hours of sleep/day, mean ± SD	6.24 ± 1.51	1.06 (0.83-1.35)	0.646	0.681
Number of on-calls/month, mean ± SD	5.57 ± 0.99	1.88 (1.27-2.77)	0.001	0.004
Number of hours working in the hospital/day, mean ± SD	8.79 ± 0.84	1.00 (0.86-1.15)	0.948	0.906
Number of clinics/week, mean ± SD	2.05 ± 2.88	0.97 (0.86-1.09)	0.565	0.560
Number of patients under daily care, mean ± SD	6.17 (3.63)	1.04 (0.96-1.13)	0.314	0.305

Note: High burnout was defined as coexisting high emotional exhaustion, high depersonalization, and low personal accomplishment.
↵^aUnivariate logistic regression (LR).
↵^bChi-square test (categorical variables) or t test (continuous variables).

Table 4.

Univariate Logistic Regression Analysis of Career Variable Satisfaction and Burnout Domains and High Burnout

	High Emotional		High		Low Personal		High
	Exhaustion		Depersonalization		Accomplishment		Burnout
Career Variable	OR (95% CI)	P Value	OR (95% CI)	P Value	OR (95% CI)	P Value	OR (95% CI)	P Value
Salary	0.50 (0.38-0.67)	<0.001	0.52 (0.39-0.68)	<0.001	0.68 (0.53-0.87)	0.002	0.44 (0.32-0.62)	<0.001
Pediatrics career	0.47 (0.35-0.64)	<0.001	0.71 (0.55-0.92)	0.008	0.55 (0.43-0.71)	<0.001	0.59 (0.44-0.79)	0.001
Work-life balance	0.28 (0.20-0.41)	<0.001	0.48 (0.35-0.65)	<0.001	0.70 (0.55-0.90)	0.006	0.42 (0.29-0.63)	<0.001

Notes: Odds ratios (ORs) and 95% CIs represent each 1-unit increase in satisfaction for the career variables. High burnout was defined as coexisting high emotional exhaustion, high depersonalization, and low personal accomplishment.

Table 5.

Multivariate Logistic Regression Analysis Results

	High Emotional		High		Low Personal		High
	Exhaustion		Depersonalization		Accomplishment		Burnout
Variable	OR (95% CI)	P Value	OR (95% CI)	P Value	OR (95% CI)	P Value	OR (95% CI)	P Value
Sex
Male	0.51 (0.29-0.99)	0.025
Smoking status
Yes	2.49 (1.12-5.53)	0.046
Residency year
3 and 4			0.49 (0.25-0.97)	0.04
Number of on-calls/month	1.59 (1.09-2.31)	0.015					1.66 (1.12-2.46)	0.012
Salary satisfaction	0.62 (0.44-0.88)	0.007	0.61 (0.45-0.82)	0.001			0.47 (0.33-0.66)	<0.001
Pediatrics career satisfaction					0.55 (0.43-0.71)	<0.001
Work-life balance satisfaction	0.34 (0.23-0.49)	<0.001	0.57 (0.41-0.8)	0.001
R²	37.7%		13.9%		12%		19.1%

Notes: Only variables included in the final model using stepwise backward elimination are displayed. High burnout was defined as coexisting high emotional exhaustion, high depersonalization, and low personal accomplishment.
OR, odds ratio; R², coefficient of determination or the proportion of variance in the dependent variable that is explained by the model.