Relation between immune variables and burnout in a sample of physicians
Annalisa Bargellinia, Alberto Barbierib, Sergio Rovestia, Roberto Vivolia, Roberto Roncagliac, Paola Borellaa
a Dipartimento di
Scienze Igienistiche, Microbiologiche e Biostatistiche, Via Campi 287, I-41100 Modena, Italy, b Department of Emergency
Care, c Department of
Immune-haematology and Transfusion, Azienda Policlinico, Modena, Italy
Correspondence to: Professor Paola Borella borella{at}unimo.it
Accepted 25 February
2000
OBJECTIVES
To evaluate
in a group of physicians the relation between burnout, demographic or
job characteristics, anxiety, and immune variables.
METHODS
Seventy one
physicians of all grades were recruited among different departments to
a cross sectional survey. The Maslach burnout inventory, scales of
emotional exhaustion, depersonalisation, and personal accomplishment,
the trait scale of anxiety inventory (STAI-Y2), and a questionnaire on
personal and professional characteristics were administered. The immune
profile included quantitative (number (%) of lymphocytes and subsets)
and functional (natural killer cytotoxicity) measures.
RESULTS
With
a model of stepwise multiple regression analysis, emotional exhaustion
was significantly affected by both personal (marital, sex) and job
characteristics (qualification, working activity), whereas only patient
contact explained a portion of variation in depersonalisation.
Furthermore, trait anxiety was found to predict the Maslach burnout
inventory scores. After correction for potential confounders,
physicians who scored high levels of personal accomplishment showed
significantly higher numbers of total lymphocytes, T cells (CD3), T
helper cells (CD4), and T suppressor cells (CD8) than those who scored
low levels. No other correlation was found between burnout and immune variables.
CONCLUSIONS
In
our group of relatively young physicians a high degree of personal
accomplishment was associated with an increase in the number of
peripheral lymphocytes, particularly T subsets. The meaning of this is
not clear, although it could be speculated that to evaluate oneself
positively, particularly with regard to work with patients in the
health services, might help to stimulate the immune system. By
contrast, there is no evidence that to work hard, to feel tired from
work, and to have a cynical reaction towards patient care is related to immunosuppression.
Keywords: burnout; physicians; immune variables
© 2000 by Occupational and Environmental Medicine
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