Physical and mental health of medical professionals: a systematic review

Gracino, Mariana Evangelista; Zitta, Ana Laura Lima; Mangili, Otavio Celeste; Massuda, Ely Mitie

doi:10.1590/0103-1104201611019

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REVIEW • Saúde debate 40 (110) • Jul-Sep 2016 • https://doi.org/10.1590/0103-1104201611019 linkcopy

Physical and mental health of medical professionals: a systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The objective of this systematic literature review was to identify the main diseases that affect physicians worldwide, through an electronic survey in the Virtual Health Library (BVS) database based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma) methodology. We analyzed 57 of the 374 scientific papers published on this subject between 2005 and 2015 in English, Portuguese, and Spanish. The findings showed that mental affections prevailed, highlighting the occupational exhaustion (burnout syndrome). Among the physical ailments, musculoskeletal affections prevailed.

KEYWORDS
Occupational diseases; Burnout, professional; Occupational health

Study (authors)	Year	Journal	Country	Language	Method	Short definition
Aldrees et al.	2013	Annals of Saudi Medicine	India	English	Cross -sectional study	Prevalence of burnout syndrome in physicians of various specializations at a hospital in Saudi Arabia.
Arigoni et al.	2009	Supportive Care in Cancer	Germany	English	Cross-sectional study	Prevalence of burnout and psychiatric diseases among Swiss oncologists, pediatricians and generalist physicians.
Assunção et al.	2013	Occupational Medicine	United Kingdom	English	Cross-sectional study	Detects that in Brazil common mental disorders affect more female than male physicians.
Balch et al.	2011	Annals of Surgical Oncology	United States	English	Cross-sectional study	Comparative of the incidence of burnout, depression, suicidal ideation, professional satisfaction and quality of life between oncologist surgeons and 14 other surgical specializations.
Bellieni et al.	2012	Journal of Maternal-Fetal and Neonatal Medicine	United Kingdom	English	Cross-sectional study	Level of professional burnout of neonatologists and its association with suicidal ideation, time in the profession, children, and religion.
Beltrán; Moreno	2007	Revista Medica del Uruguay	Uruguay	Spanish	Cross-sectional study	Most frequent diseases: musculoskeletal, respiratory, gastrointestinal, and psychological.
Brown; Goske; Johnson	2009	Journal of the American College of Radiology	Holland	English	Bibliographic review	Interference of conditions such as depression, burnout and stress on the disruptive behavior of physicians, jeopardizing the professional practice.
Chen et al.	2013	International Journal of Medical Sciences	Australia	English	Cross-sectional study	Incidence of burnout and its correlation with the dissatisfaction and bad professional practice and alcohol abuse in Taiwan physicians.
Dewa et al.	2014	BMC Health Services Research	United Kingdom	English	Systematic review	Incidence of burnout syndrome in five studies and its impact on physicians’ productivity.
Dyrbye et al.	2013	Mayo Clinic Proceedings	United Kingdom	English	Cross-sectional study	Incidence of burnout syndrome throughout the career in the various medical specializations in the United States.
Dyrbye et al.	2014	Academic Medicine	United States	English	Cross-sectional study	Comparison between the prevalence of occupational exhaustion, depression, suicidal ideation, and fatigue in the different stages of the medical career with the general population in the US.
Escribà-Agüir; Artazcoz; Pérez-Hoyos	2008	Gaceta Sanitária	Spain	Spanish	Cross-sectional study	Interference of psychosocial risk factors and sources of satisfaction at work on the burnout syndrome in physicians of several specializations and stages of the career in Spain
Fogaça; Carvalho; Nogueira-Martins	2010	Revista da Escola de Enfermagem da USP	Brazil	Portuguese	Descriptive study	Detection of low quality of life of intensivist pediatricians and neonatologist physicians.
Galán-Rodas et al.	2011	Revista Peruana de Medicina Experimental y Salud Pública	Peru	Spanish	Baseline study	Relates depression to lack of logistic and human resources for medical practice.
Gander et al.	2010	Academic Medicine	United States	English	Cross-sectional study	Physicians in New Zealand described social isolation due to long working hours.
Garcia et al.	2014	Pediatric Critical Care Medicine	United States	English	Cohort study	Relates the great responsibility over patients’ life to the higher incidence of burnout among Brazilian pediatric intensivists.
Gurman; Klein; Weksler	2012	Journal of Clinical Monitoring and Computing	Holland	English	Bibliographic review	High incidence of burnout among anesthesiologists due to the great responsibility regarding a patient’s safety during surgery.
Harms et al.	2005	Annals of Surgery	United States	English	Cross-sectional study	Highlights the rate of alcohol dependence among interviewed surgeons.
Lee et al.	2013	Human Resources for Health	United Kingdom	English	Meta-Analysis	Main factors associated to occupational burnout in several regions and specializations.
Leiter; Frank; Matheson	2009	Canadian Family Physician	Canada	English	Cross-sectional study	Influence of high workload and incongruence between personal values and health system on the burnout syndrome in Canadian physicians.
Lim; Pinto	2009	Journal of Medical Imaging and Radiation Oncology	United Kingdom	English	Cross-sectional study	Rates of occupational burnout and stress among radiologist physicians practicing in public and private hospitals in New Zealand
Liu et al.	2012	BMC Public Health	United Kingdom	English	Cross-sectional study	Characterizes the exposure to strong physical and emotional demands as generator of internal and external stressors.
Lovseth et al.	2013	Stress and Health	United States	English	Cross-sectional study	Medical confidentiality as a barrier to seeking emotional support among hospital physicians in Sweden, Norway, Iceland, and Italy, influencing in occupational burnout
Magnavita; Fileni	2013	Radiologia Medica	Italy	English	Cross-sectional study	Prevalence of depression and anxiety symptoms among radiologist physicians participating in the National Congress of the Italian Society of Medical Radiology.
Magnavita et al.	2008	Radiologia Médica	Italy	English	Pilot study	Occupational stress and its psychosocial effects on Italian radiologists and radiotherapists
McAbee et al	2015	Journal of Neurosurgery	United States	English	Cross-sectional study	Rate of burnout syndrome in North American neurosurgeons and its impact on bad medical practices and satisfaction with the career
Misiołek et al.	2014	Anaesthesiology Intensive Therapy	Poland	English	Cross-sectional study	Risk for occupational burnout among physicians practicing in intensive care and pain clinic care departments.
Mendonça; Coelho; Júca	2012	Psicologia em Pesquisa	Brazil	Portuguese	Cross-sectional study	Correlation between stress at work with occupational burnout and fatigue among medical teachers at a Brazilian faculty.
Nishimura et al.	2014	Circulation: Cardiovascular Quality and Outcomes	United States	English	Cross-sectional study	Incidence and risk factors for burnout syndrome among Japanese neurologists and neurosurgeons.
Oliveira Júnior et al.	2013	2013 Anesthesia and analgesia	United States	English	Cross-sectional study	Rate of depression and occupational burnout among medical residents in anesthesiology, correlated with suicidal ideation, drug abuse and medical errors rates.
Opoku; Apenteng	2014	International Health	United Kingdom	English	Cross-sectional study	Factors associated with burnout syndrome and professional satisfaction among physicians in Ghana.
Picard et al.	2015	Psychology, Health and Medicine	United Kingdom	English	Cross-sectional study	Relation between empathy and occupational burnout among residents.
Pistelli et al.	2011	Archivos Argentinos de Pediatria	Argentina	Spanish	Cross-sectional study	Incidence of the professional waste syndrome among residents in pediatrics and pediatricians at a children’s hospital in Argentina
Popa et al.	2010	Journal of Medicine and Life	Romania	English	Cross-sectional study	Causal factors, coping mechanisms and repercussions of occupational burnout and depression among emergency physicians.
Roth et al.	2011	Pediatric Blood and Cancer	United States	English	Cross-sectional study	Prevalence of occupational burnout among oncology pediatricians in 13 countries.
Rubin	2014	JAMA - Journal of the American Medical Association	United States	English	Theoretical reflection	Reflection on suicide rates among medical population.
Serralheiro et al.	2011	Arquivos Brasileiros de Ciências da Saúde	Brazil	Portuguese	Cross-sectional study	Prevalence of burnout syndrome among Brazilian anesthesiologists and its relation with physical activity.
Shanafelt et al.	2011	JAMA Surgery	United States	English	Cross-sectional study	Rate of suicidal ideation among North American surgeons and its link with depression, occupational burnout, medical errors, and antidepressant use.
Nascimento Sobrinho et al.	2006	Revista da Associação Médica Brasileira	Brazil	Portuguese	Cross-sectional study	Identifies mental tiredness as the most prevalent symptom among Brazilian physicians interviewed.
Stafford; Judd	2010	Gynecologic Oncology	United States	English	Cross-sectional stud	Prevalence of psychiatric diseases and occupational burnout among oncologist gynecologists in Australia and its influence on professional satisfaction
Taft; Keefer; Keswani	2011	Journal of Clinical Gastroenterology	United States	English	Cross-sectional study	Coping strategies among North American gastroenterologists in stressing situations and its relation to burnout
Tomioka et al.	2011	Occupational Medicine	United Kingdom	English	Cross sectional study	Demonstrates a positive relation between working hours and the prevalence of depression.
Torres et al.	2011	Revista Brasileira de Epidemiologia	Brazil	Portuguese	Cross-sectional study	Self-evaluation of quality of life, professional satisfaction, and physical and mental health by physicians in Brazil.
Wada et al.	2010	BMC Public Health	United Kingdom	English	Cross-sectional study	Relates depressive condition to the number of off duty days among Japanese physicians.
Wang et al.	2010	International Archives of Occupational and Environmental Health	Germany	English	Cross-sectional study	Associates the suffering inherent to the medical profession with the higher rate of depressive symptoms among Chinese physicians than among the general Chinese population.

Study	Year	Journal	Country	Language	Method	Short definition
Auerbach et al.	2011	Spine	United States	English	Cross-sectional study	Prevalence of musculoskeletal disorders in spine surgeons due to bad ergonomics.
Brennan et al.	2011	British Journal of Oral and Maxillofacial Surgery	United States	English	Hypothetical study	Elevation of serum testosterone in head and neck surgeons directly proportional to the complexity of the procedure.
Beloyartseva et al.	2012	Archives of Osteoporosis	United Kingdom	English	Cross-sectional study	Proves that 79% of the Indians subjects in the study presented Vitamin D deficiency due to long working hours in environments with no access to sunlight.
Krupinski; Berbaum	2009	Academic Radiology	United States	English	Cross-sectional study	Work with digital displays causing oculomotor nerve fatigue
Liang et al.	2013	PLoS One	United States	English	Cross-sectional study	Frequent musculoskeletal disorders in surgeons due to the emergence of less invasive surgical techniques but ergonomically unfavorable.
Magnavita; Fileni	2014	Radiologia Médica	Italy	English	Cross-sectional study	Increase on HDL and triglyceride levels and abdominal obesity in radiologists due to occupational stress
Mehrdad; Dennerlein; Morshedizadeh	2012	Archives of Iranian Medicin	Iran	English	Cross-sectional study	Relation between working conditions and ergonomic risks with the main musculoskeletal disorders in clinicians.
Mohseni-Bandpei et al.	2011	Journal of Manipulative and Physiological Therapeutics	United States	English	Cross-sectional study	Influence of low satisfaction with work on the increase of risk from low back pain.
Mrena et al.	2011	Scandinavian Journal of Work, Environment & Health	Scandinavia	English	Cross-sectional study	Prevalence of opacity in the crystalline and cataract among Finnish physicians
Peters et al.	2011	BMC Infectious Diseases	United Kingdom	English	Systematic review	Higher level of infection by H. pylori in gastroenterologists
Rauchenzauner et al.	2009	European Heart Journal	United Kingdom	English	Cross-sectional study	Influence of working hours and conditions on cardiovascular health of Austrian physicians.
Ruitenburg; Frings-Dresen; Sluiter	2013	International Archives of Occupational and Environmental Health	Germany	English	Cross-sectional study	Relates fine movements and relatively static posture of surgeons to physical work-related complaints.

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[TFN3] Source: The authors.