How are spiritual health and burnout associated?

Problem

Burnout is defined by the World Health Organisation as an occupational phenomenon, resulting in exhaustion, mental distance, feelings of negativity or cynicism towards the job, and reduced professional efficacy. Burnout is thought to be contributing to the current workforce crisis in the UK, as well as higher rates of hazardous drinking and suicide among doctors. While burn out is not seen as an illness, it does appear to be associated with mental illness. General Practitioners (GPs) are particularly vulnerable to burnout, possibly because of high workloads. Previous authors have described a loss of meaning in work, and objectification of patients and their families, rather than engaging with their humanity. Christina Maslach (Maslach Burnout Inventory author) argued that burnout is “erosion of the soul.” Soul, meaning and humanity are terms associated with spirituality, and were used in answers GPs gave in a recent survey on spiritual health. Spiritual health has been linked with reduced risk of burn out in other groups. This study aims to understand the association between burn out and spiritual health.

Approach

A systematic review of the global literature identified ten studies that had measured burnout in doctors, and made an assessment of spirituality. The quality of the studies does not allow conclusions to be drawn. Key weaknesses were sampling bias, response bias, and the lack of a ‘gold standard’ to assess spirituality. Given the flaws in the current literature on the topic, a robust survey of the primary healthcare team is planned to explore any connection between spiritual health and burnout. The available spiritual wellbeing scales are being evaluated, to identify a scale that has validity for measuring spiritual aspects of health and wellbeing, is cross-cultural, and will be accepted by GPs of all faiths and none, for example the Spiritual Health Scale 20111. Qualitative interviews are planned to explore the spiritual needs of the primary care team who have ‘burnt out’, or are at risk of burning out.

Findings

While some studies in the systematic review found an association between spirituality and burnout, this was inconsistent across the different domains of the burnout score, and not statistically significant on meta-analysis. At the time of the SAPC meeting, hopefully interim findings from the survey will be available.

Consequences

As GPs seek to provide holistic care for patients, they also need to consider their own holistic health, and whether implementing policies to support the spiritual health of staff could reduce burnout rates. This also may contribute to addressing current recruitment and retention problems in primary care.