The European Journal of Public Health Advance Access published online on April 29, 2009
The European Journal of Public Health, doi:10.1093/eurpub/ckp056
Relationships between work satisfaction, emotional exhaustion and mental health among Swiss primary care physicians
Patrick A. Bovier1, Flavia Arigoni2, Martin Schneider1 and Martine Bouvier Gallacchi3
1 Division of Primary Care Medicine, Department of Community and Primary Care medicine, University Hospitals of Geneva, Switzerland
2 Division of oncology, Department of General Internal medicine University Hospitals of Geneva, Switzerland
3 Community-based General Internist, Melide, Ticino, Switzerland
Correspondence:Patrick A. Bovier, 2 Grand-Rue, CH-1095 Lutry, Switzerland, tel: +41 78 793 5507, fax: +41 21 791 1369, e-mail: patrick.bovier{at}post.harvard.edu
Received August 6, 2008 , accepted March 30, 2009
Background: Work-related satisfaction is an important determinant of quality of care. However, its relationship with doctors’ mental health is poorly understood. It could have an independent beneficial effect on mental health (direct association) or simply reduce the impact of work stress on mental health (moderating or ‘buffering’ role). Methods: One thousand seven hundred and thirty-two Swiss primary care physicians (824 board-certified generalists, 436 general internists, 162 paediatricians, 147 internal medicine specialists and 163 physicians without specialty qualification) completed a mailed questionnaire. Previously, validated instruments were used to measure mental health (SF-12), emotional exhaustion [Maslach Burnout Inventory (MBI)] and work-related satisfaction. Linear regression models with mental health as dependant variable were used to study the relationships between these variables. Differences in mental health scores were standardized to represent a one standard deviation (SD) difference in the other scales [standardized beta coefficients (SBC)]. Results: In multivariate analyses, higher levels of mental health were found in respondents with higher work-related satisfaction with current income and social prestige (SBC 1.04) and professional relations (SBC 0.57), and in respondents with lower emotional exhaustion (SBC –4.98) and higher personal accomplishment scores (SBC 1.72). Interaction terms between these dimensions of work-related satisfaction and emotional exhaustion were significant, supporting a ‘buffering’ role of these dimensions. Conclusion: Work-satisfaction with current income, social prestige and professional relations are important correlates of mental health among primary care physicians, as well as emotional exhaustion. Higher levels of these dimensions of work-related satisfaction seems to mitigate the relationship between emotional exhaustion and physicians’ mental health.
Keywords: burnout, mental health, physicians' health, primary care, work-related satisfaction