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      A Systematic Review of the Impact of Physicians’ Occupational Well-Being on the Quality of Patient Care

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          Abstract

          Background

          It is widely held that the occupational well-being of physicians may affect the quality of their patient care. Yet, there is still no comprehensive synthesis of the evidence on this connection.

          Purpose

          This systematic review studied the effect of physicians’ occupational well-being on the quality of patient care.

          Methods

          We systematically searched PubMed, Embase, and PsychINFO from inception until August 2014. Two authors independently reviewed the studies. Empirical studies that explored the association between physicians’ occupational well-being and patient care quality were considered eligible. Data were systematically extracted on study design, participants, measurements, and findings. The Medical Education Research Study Quality Instrument (MERSQI) was used to assess study quality.

          Results

          Ultimately, 18 studies were included. Most studies employed an observational design and were of average quality. Most studies reported positive associations of occupational well-being with patient satisfaction, patient adherence to treatment, and interpersonal aspects of patient care. Studies reported conflicting findings for occupational well-being in relation to technical aspects of patient care. One study found no association between occupational well-being and patient health outcomes.

          Conclusions

          The association between physicians’ occupational well-being and health care’s ultimate goal—improved patient health—remains understudied. Nonetheless, research up till date indicated that physicians’ occupational well-being can contribute to better patient satisfaction and interpersonal aspects of care. These insights may help in shaping the policies on physicians’ well-being and quality of care.

          Electronic supplementary material

          The online version of this article (doi:10.1007/s12529-015-9473-3) contains supplementary material, which is available to authorized users.

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          Most cited references44

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          WORK ENGAGEMENT: A QUANTITATIVE REVIEW AND TEST OF ITS RELATIONS WITH TASK AND CONTEXTUAL PERFORMANCE

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            Burnout and self-reported patient care in an internal medicine residency program.

            Burnout is a syndrome of depersonalization, emotional exhaustion, and a sense of low personal accomplishment. Little is known about burnout in residents or its relationship to patient care. To determine the prevalence of burnout in medical residents and explore its relationship to self-reported patient care practices. Cross-sectional study using an anonymous, mailed survey. University-based residency program in Seattle, Washington. 115 internal medicine residents. Burnout was measured by using the Maslach Burnout Inventory and was defined as scores in the high range for medical professionals on the depersonalization or emotional exhaustion subscales. Five questions developed for this study assessed self-reported patient care practices that suggested suboptimal care (for example, "I did not fully discuss treatment options or answer a patient's questions" or "I made...errors that were not due to a lack of knowledge or inexperience"). Depression and at-risk alcohol use were assessed by using validated screening questionnaires. Of 115 (76%) responding residents, 87 (76%) met the criteria for burnout. Compared with non-burned-out residents, burned-out residents were significantly more likely to self-report providing at least one type of suboptimal patient care at least monthly (53% vs. 21%; P = 0.004). In multivariate analyses, burnout--but not sex, depression, or at-risk alcohol use--was strongly associated with self-report of one or more suboptimal patient care practices at least monthly (odds ratio, 8.3 [95% CI, 2.6 to 26.5]). When each domain of burnout was evaluated separately, only a high score for depersonalization was associated with self-reported suboptimal patient care practices (in a dose-response relationship). Burnout was common among resident physicians and was associated with self-reported suboptimal patient care practices.
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              Workaholism, Burnout, and Work Engagement: Three of a Kind or Three Different Kinds of Employee Well-being?

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                Author and article information

                Contributors
                +31 (0)6 30090916 , r.a.scheepers@amc.nl
                Journal
                Int J Behav Med
                Int J Behav Med
                International Journal of Behavioral Medicine
                Springer US (New York )
                1070-5503
                1532-7558
                3 March 2015
                3 March 2015
                2015
                : 22
                : 6
                : 683-698
                Affiliations
                [ ]Professional Performance Research Group, Center for Evidence-Based Education, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22700, 1100 DE Amsterdam, The Netherlands
                [ ]Department of Epidemiology, The Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA USA
                [ ]UCLA Center for Health Policy Research, Los Angeles, CA USA
                [ ]Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
                Article
                9473
                10.1007/s12529-015-9473-3
                4642595
                25733349
                79f9552f-3269-4553-933e-12aa02250d20
                © The Author(s) 2015

                Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

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                © International Society of Behavioral Medicine 2015

                Clinical Psychology & Psychiatry
                occupational well-being,job satisfaction,physicians,quality of patient care,patient satisfaction

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