title: An exploration of the role of religion/spirituality in the promotion of physicians' wellbeing in Emergency Medicine.
abstract: BACKGROUND
  Burnout is highly prevalent among Emergency Medicine (EM) physicians and has significant impact on quality of care and workforce retention. The objective of this study was to determine whether higher religion/spirituality (R/S) is associated with a lower prevalence of burnout among EM physicians (primary outcome). A history of malpractice lawsuits and maladaptive behaviors were the secondary outcomes.
  
  
  METHODS
  This was a cross-sectional, survey-based study conducted among a random sample of physicians from the Massachusetts College of Emergency Physicians mailing list. Burnout was measured using a validated 2-item version of the Maslach Burnout Inventory. Maladaptive behaviors (smoking, drinking, and substance use) and medical malpractice were self-reported. R/S measures included organized religiosity, religious affiliation, private R/S practice, self-rated spirituality, religious rest, and religious commitment. Logistic regression was used to model study outcomes as a function of R/S predictors.
  
  
  RESULTS
  Of 422 EM physicians who received the invitation to participate, 138 completed the survey (32.7%). The prevalence of burnout was 27%. No significant associations were observed between burnout and R/S indicators. Maladaptive behaviors (adjusted OR = 0.42, CI: 0.19 to 0.96; p = 0.039) and history of medical malpractice (adjusted OR = 0.32; CI: 0.11 to 0.93; p = 0.037) were less likely among physicians reporting to be more involved in organized religious activity and to observe a day of rest for religious reasons, respectively.
  
  
  CONCLUSIONS
  This study provides preliminary evidence for a possible protective association of certain dimensions of R/S on maladaptive behaviors and medical malpractice among EM physicians.
authors.affiliation: Department of Medicine, Warren Alpert School of Medicine, Brown University & Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States.
authors.forename: Elena
authors.initials: E
authors.lastname: Salmoirago-Blotcher
authors.affiliation: Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, United States.
authors.forename: George
authors.initials: G
authors.lastname: Fitchett
authors.affiliation: Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Katherine
authors.initials: K
authors.lastname: Leung
authors.affiliation: Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Gregory
authors.initials: G
authors.lastname: Volturo
authors.affiliation: Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Edwin
authors.initials: E
authors.lastname: Boudreaux
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Sybil
authors.initials: S
authors.lastname: Crawford
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Ira
authors.initials: I
authors.lastname: Ockene
authors.affiliation: Trent Center for Bioethics, Humanities, and History of Medicine, and Duke Divinity School, Duke University, Durham, NC, United States.
authors.forename: Farr
authors.initials: F
authors.lastname: Curlin
keywords: Burnout; Emergency medicine; Prevention; Religion; Spirituality