title: Burnout and patient care in junior doctors in Mexico City.
abstract: BACKGROUND
  Burnout is known to occur in public service workers leading to a reduction in effectiveness at work.
  
  
  OBJECTIVE
  To estimate the prevalence of burnout in junior doctors and its impact on patient care.
  
  
  METHODS
  A cross-sectional study of junior doctors at three hospitals in Mexico City was conducted. Measures used included the Maslach Burnout Inventory (MBI), measuring depersonalization (DP), emotional exhaustion (EE) and personal achievement (PA), a questionnaire about patient care practices and attitudes and one on sociodemographic characteristics. Logistic regression analysis was used to assess the association between burnout and suspected risk factors.
  
  
  RESULTS
  A total of 312 junior doctors participated (response rate 65%). In total, 57% were male and the average age was 28. Average scores in MBI subscales were EE: 18.2, DP: 6.9 and PA: 37.6. Burnout prevalence was 40% (126). Junior doctors with burnout were more likely to report suboptimal patient care practices occurring monthly (OR 5.5; 95% CI 2.7-11.2) and weekly (OR 5.2; 95% CI 1.6-16.3). The logistic regression model for burnout included shifts lasting >12 h, current depression, former major depression, first- or second-year junior doctors, male gender and single status.
  
  
  CONCLUSIONS
  Burnout was most strongly associated with shifts >12 h and with both current and previous depression. Reported suboptimal patient care was also associated with working shifts of >or=12 h. Burnout may be adversely affecting junior doctors' health and their patients' care.
authors.affiliation: Coordinación de Salud en el Trabajo, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, DF, México. rodrigo.toral@imss.gob.mx
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Toral-Villanueva
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Aguilar-Madrid
authors.forename: Cuauhtémoc Arturo
authors.initials: CA
authors.lastname: Juárez-Pérez
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000453:epidemiology*; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008800:Mexico / Q000453:epidemiology; D005791:Patient Care / Q000592:standards*; D010815:Physician Impairment / Q000706:statistics & numerical data*; D055815:Young Adult