Burnout Subtypes and Absence of Self-Compassion in Primary Healthcare Professionals: A Cross-Sectional Study.
BACKGROUND
Primary healthcare professionals report high levels of distress and burnout. A new model of burnout has been developed to differentiate three clinical subtypes: 'frenetic', 'underchallenged' and 'worn-out'. The aim of this study was to confirm the validity and reliability of the burnout subtype model in Spanish primary healthcare professionals, and to assess the explanatory power of the self-compassion construct as a possible protective factor.


METHODS
The study employed a cross-sectional design. A sample of n = 440 Spanish primary healthcare professionals (214 general practitioners, 184 nurses, 42 medical residents) completed the Burnout Clinical Subtype Questionnaire (BCSQ-36), the Maslach Burnout Inventory General Survey (MBI-GS), the Self-Compassion Scale (SCS), the Utrecht Work Engagement Scale (UWES) and the Positive and Negative Affect Schedule (PANAS). The factor structure of the BCSQ-36 was estimated using confirmatory factor analysis (CFA) by the unweighted least squares method from polychoric correlations. Internal consistency (R) was assessed by squaring the correlation between the latent true variable and the observed variables. The relationships between the BCSQ-36 and the other constructs were analysed using Spearman's r and multiple linear regression models.


RESULTS
The structure of the BCSQ-36 fit the data well, with adequate CFA indices for all the burnout subtypes. Reliability was adequate for all the scales and sub-scales (R≥0.75). Self-judgement was the self-compassion factor that explained the frenetic subtype (Beta = 0.36; p<0.001); isolation explained the underchallenged (Beta = 0.16; p = 0.010); and over-identification the worn-out (Beta = 0.25; p = 0.001). Other significant associations were observed between the different burnout subtypes and the dimensions of the MBI-GS, UWES and PANAS.


CONCLUSIONS
The typological definition of burnout through the BCSQ-36 showed good structure and appropriate internal consistence in Spanish primary healthcare professionals. The negative self-compassion dimensions seem to play a relevant role in explaining the burnout profiles in this population, and they should be considered when designing specific treatments and interventions tailored to the specific vulnerability of each subtype.
Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain.|Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain, and Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.
Jesus
J
Montero-Marin
Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain, and Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.
Fernando
F
Zubiaga
Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain, and Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.
Maria
M
Cereceda
Mente Aberta - Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Universidade Federal de Sao Paulo, UNIFESP, Sao Paulo, Brazil.
Marcelo Marcos
MM
Piva Demarzo
Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain, and Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.
Patricia
P
Trenc
Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain, and Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.|Miguel Servet Hospital and University of Zaragoza, Zaragoza, Spain.
Javier
J
Garcia-Campayo
D000223:Adaptation, Psychological; D000328:Adult; D000533:Altruism; D002055:Burnout, Professional / Q000145:classification* / Q000503:physiopathology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D004645:Empathy; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015999:Multivariate Analysis; D058007:Physicians, Primary Care / Q000523:psychology*; D011320:Primary Health Care; D013030:Spain; D013315:Stress, Psychological / Q000503:physiopathology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D000078329:Workforce