title: Higher burnout scores in paediatric residents are associated with increased brain activity during attentional functional magnetic resonance imaging task.
abstract: OBJECTIVE
  Burnout syndrome is common in healthcare workers. We evaluated its prevalence in paediatric residents and investigated its influence on cerebral function correlations, using functional magnetic resonance imaging (MRI), when they carried out an attentional paradigm.
  
  
  METHODS
  This cross-sectional descriptive study involved 28 residents from the Department of Paediatrics at the University of São Paulo. The functional MRI was carried out while the residents completed the Stroop colour word task paradigm to investigate their attentional task performance. The Maslach Burnout Inventory (MBI) was applied, and stress was assessed using the Lipp Inventory of Stress Symptoms for Adults and by a visual analogue mood scale.
  
  
  RESULTS
  The MBI subscales of depersonalisation and emotional exhaustion indicated that 53.1% of the residents had moderate or high burnout syndrome. The whole-brain multivariate analysis showed positive correlations between the blood oxygenation level dependent effect and the MBI depersonalisation and emotional exhaustion indices in the dorsolateral prefrontal cortex, which controls for anxiety.
  
  
  CONCLUSIONS
  Increased brain activation during an attention task, measured using functional MRI, was associated with higher burnout scores in paediatric residents. This study provides a biological basis for the implementation of measures to reduce burnout syndrome at the start of residency training programmes.
authors.affiliation: Faculty of Medicine, Department of Paediatric, University of Sao Paulo, Sao Paulo, Brazil.|Brain Institute, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: Anarella Penha Meirelles
authors.initials: AP
authors.lastname: de Andrade
authors.affiliation: Brain Institute, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.|Faculty of Medicine, Department of Radiology, University of Sao Paulo, Sao Paulo, Brazil.|Institute of Education and Research, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: Edson
authors.initials: E
authors.lastname: Amaro
authors.affiliation: Faculty of Medicine, Department of Paediatric, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Sylvia Costa Lima
authors.initials: SC
authors.lastname: Farhat
authors.affiliation: Faculty of Medicine, Department of Paediatric, University of Sao Paulo, Sao Paulo, Brazil.|Institute of Education and Research, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: Claudio
authors.initials: C
authors.lastname: Schvartsman
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002055:Burnout, Professional / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008279:Magnetic Resonance Imaging; D008297:Male; D010372:Pediatrics; D055815:Young Adult
keywords: Attention; Burnout syndrome; Functional magnetic resonance imaging; Paediatric residents