Abstract
Background
Burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, can negatively impact patient care. While burnout is well-studied in developed nations, research in resource-constrained settings like Sierra Leone remains limited. This study aimed to quantify burnout prevalence among Sierra Leone's public sector physicians and its impact on self-reported patient care practices.
Methods
The study involved a random sample of physicians from major government hospitals across Sierra Leone's administrative regions. Burnout was assessed using the Maslach Burnout Inventory (MBI), and self-reported patient care practices were evaluated using an adapted version of Shanafelt et al.'s 2002 questionnaire. Statistical analyses included chi-square tests, Fisher exact tests, and logistic regression to explore associations between burnout, demographic variables, and patient care practices.
Results
A total of 140 physicians (31% female, 69% male, p = 0.8), 51.4% met burnout criteria. Burnout was similar across genders (p = 0.8) and age groups (p = 0.5). Most respondents were aged 26–35. Marital status did not differ significantly (p = 0.8), with 54% single overall. Regional distribution showed no significant difference (p = 0.5), with 78% from Western Urban. Duration of practice was also similar (p = 0.5), with 35% house officers, 39% medical officers, and 26% senior medical officers. Physicians experiencing burnout were more likely to report high emotional exhaustion (62%), high depersonalization (44%), and low personal accomplishment (46%). Burnout was also associated with suboptimal patient care practices, including avoiding diagnostic tests due to cost concerns, expediting patient discharge, and prescribing medication without proper evaluation.
Conclusion
This study revealed a high prevalence of physician burnout in Sierra Leone, which significantly impacts patient care and physician well-being. A multipronged, collaborative approach is necessary to address burnout, involving individual, organizational, and systemic interventions. Further longitudinal research is needed to develop contextually relevant strategies to support healthcare workers in resource-constrained settings.