title: Correlation of burnout syndrome with specific coping strategies, behaviors, and spiritual attitudes among interns at Yale University, New Haven, USA.
abstract: OBJECTIVE
  This study aimed to determine the correlation of burnout syndrome with specific coping strategies, behaviors, and spiritual attitudes among interns in internal medicine, primary care, and internal medicine/pediatrics residency programs at two institutions.
  
  
  METHODS
  Intern physicians completed anonymous voluntary surveys prior to starting the internship in June 2009 and in the middle of the internship in February 2010. Three validated survey instruments were used to explore burnout, coping, and spiritual attitudes: the Maslach Burnout Inventory, the COPE Inventory, and the Hatch Spiritual Involvement and Beliefs Scale. The interns were in programs at the Yale University School of Medicine and a Yale-affiliated community hospital, New Haven, Connecticut, USA.
  
  
  RESULTS
  The prevalence of self-identified burnout prior to starting the internship was 1/66 (1.5%) in June 2009, increasing to 10/53 (18.9%) in February 2010 (P<0.0001). From June 2009 to February 2010, the prevalence of high emotional exhaustion increased from 30/66 (45.5%) to 45/53 (84.9%) (P<0.0001), and that of high depersonalization increased from 42/66 (63.6%) to 45/53 (84.9%) (P=0.01). Interns who employed the strategies of acceptance and active coping were less likely to experience emotional exhaustion and depersonalization (P<0.05). Perceptions of high personal accomplishment was 75.5% and was positively correlated with total scores on the Hatch Spiritual Involvement and Beliefs Scale, as well as the internal/fluid and existential/meditative domains of that instrument. Specific behaviors did not impact burnout.
  
  
  CONCLUSIONS
  Burnout increased during the intern year. Acceptance, active coping, and spirituality were correlated with less burnout. Specific behaviors were not correlated with burnout domains.
authors.affiliation: Department of Internal Medicine, Yale University School of Medicine, New Haven, USA ; Department of Pediatrics, Yale University School of Medicine, New Haven, USA.
authors.forename: Benjamin R
authors.identifier: 0000-0002-6922-6556
authors.initials: BR
authors.lastname: Doolittle
authors.affiliation: Department of Internal Medicine, Yale University School of Medicine, New Haven, USA.
authors.forename: Donna M
authors.identifier: 0000-0001-5304-4224
authors.initials: DM
authors.lastname: Windish
keywords: Attitude; Depersonalization; Internship and residency; Psychological adaptation; United States