title: Association between low empathy and high burnout among primary care physicians and nurses in Lleida, Spain.
abstract: BACKGROUND
  Burnout is a growing problem among healthcare professionals and may be mitigated and even prevented by measures designed to promote empathy and resilience.
  
  
  OBJECTIVE
  We studied the association between burnout and empathy in primary care practitioners in Lleida, Spain and investigated possible differences according to age, sex, profession, and place of practice (urban versus rural).
  
  
  METHODS
  All general practitioners (GPs) and family nurses in the health district of Lleida (population 366 000) were asked by email to anonymously complete the Maslach Burnout Inventory (MBI) and the Jefferson Scale of Physician Empathy (JSPE) between May and July 2014. Tool consistency was evaluated by Cronbach's α, the association between empathy and burnout by Spearman's correlation coefficient, and the association between burnout and empathy and sociodemographic variables by the χ2test.
  
  
  RESULTS
  One hundred and thirty-six GPs and 131 nurses (52.7% response rate) from six urban and 16 rural practices participated (78.3% women); 33.3% of respondents had low empathy, while 3.7% had high burnout. The MBI and JSPE were correlated (P < .001) and low burnout was associated with high empathy (P < .05). Age and sex had no influence on burnout or empathy.
  
  
  CONCLUSIONS
  Although burnout was relatively uncommon in our sample, it was associated with low levels of empathy. This finding and our observation of lower empathy levels in rural settings require further investigation. [Box: see text].
authors.affiliation: a Primary Care, Lleida Health Region , Spain.
authors.forename: Oriol
authors.initials: O
authors.lastname: Yuguero
authors.affiliation: b Support Unit , Primary Care Research Institute (IDIAP) Jordi Gol. Autonomous University of Barcelona , Lleida , Catalonia , Spain.|c Epidemiology unit, University Hospital Vall d'Hebron , Barcelona , Catalonia , Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Ramon Marsal
authors.affiliation: d Borja institute of Bioethics , Barcelona , Spain.|e School of Medicine , University of Lleida , Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Esquerda
authors.affiliation: f Platform for Bioethics and Medical Education , La Rioja Biomedical Research Center , Logroño (CIBIR) , Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Vivanco
authors.affiliation: a Primary Care, Lleida Health Region , Spain.|e School of Medicine , University of Lleida , Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Soler-González
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004645:Empathy; D005260:Female; D058005:General Practitioners / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care / Q000523:psychology*; D019035:Rural Health Services; D013030:Spain; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D019037:Urban Health Services
keywords: Communication; empathy; family medicine; primary care; professionalism