title: Factors associated with burnout among Chinese hospital doctors: a cross-sectional study.
abstract: BACKGROUND
  Burnout has been a major concern in the field of occupational health. However, there is a paucity of research exploring the factors related to burnout among Chinese doctors. Investigation of these factors is important to improve the health of doctors and the quality of healthcare services in China.
  
  
  METHODS
  The study population consisted of 1,618 registered hospital doctors from Liaoning province of China. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey. Occupational stress was measured using the Chinese versions of the Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire. Data were collected on the respondents' demographic characteristics and work situations. Of the doctors solicited for enrollment, 1,202 returned the completed questionnaire (555 men, 647 women), giving a response rate of 74.3%. A general linear regression model was applied to analyze the factors associated with burnout.
  
  
  RESULTS
  The burnout mean scores were 11.46 (7.51) for emotional exhaustion, 6.93 (5.15) for cynicism, and 24.07 (9.50) for professional efficacy. In descending order of standardized estimates, variables that predicted a high level of emotional exhaustion included: high extrinsic effort, dissatisfaction with doctor-patient relationship, high overcommitment, working >40 h per week, low reward, and high psychological job demands. Variables that predicted a high level of cynicism included: high extrinsic effort, low reward, dissatisfaction with doctor-patient relationship, high overcommitment, low decision authority, low supervisor support, and low skill discretion. Variables that predicted a low perceived professional efficacy included: high psychological job demands, low coworker support, high extrinsic effort, low decision authority, low reward, and dissatisfaction with doctor-patient relationship.
  
  
  CONCLUSIONS
  These findings suggest that occupational stress is strongly related to burnout among hospital doctors in China. Strategies that aim to improve work situations and decrease occupational stress are necessary to reduce burnout, including health education, health promotion, and occupational training programs.
authors.affiliation: Department of Social Medicine, School of Public Health, China Medical University, No, 92 Beier Road, Heping District, Shenyang, Liaoning 110001, People's Republic of China. liewang@mail.cmu.edu.cn.
authors.forename: Hui
authors.initials: H
authors.lastname: Wu
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.forename: Xue
authors.initials: X
authors.lastname: Zhao
authors.forename: Lie
authors.initials: L
authors.lastname: Wang
mesh_terms: D000328:Adult; D044466:Asian People; D002055:Burnout, Professional / Q000453:epidemiology* / Q000523:psychology; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D020445:Hospitalists / Q000523:psychology*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology; D009786:Occupational Health Services; D011795:Surveys and Questionnaires