To examine the relationship between self-compassion, compassion for others and Burnout in medical students and physicians.
Methods
A cross-sectional study was conducted. Medicine students and general physicians from two Colombian cities participated (n = 359). The Compassion Scales and the Maslach Inventory were administered. An Exploratory Structural Equation approach was used for validating new measures and testing for relationships between latent variables.
Results
Most participants were students (85.9%), mean age was 22 years (SD = 7), 55.2% were female, 62,6% dedicated more than 48 weekly hours to study or practice, while physicians had worked a mean of 10.34 years (SD = 8.67). Self-compassion and Compassion for others action subscales were validated, but engagement subscales of were not. Participant´s compassion actions for others and self-compassion actions are negatively related to depersonalization and emotional exhaustion, respectively. Additionally, compassion dimensions were positively associated with professional accomplishment.
Conclusion
Our findings indicate that compassion and self-compassion actions inversely relate to different components of Burnout and could constitute protective factors against the stress of healthcare. Compassion and self-compassion training programs for medical students and physicians might be an alternative to avoid Burnout, diminishing physicians’ depersonalization and emotional exhaustion while enhancing their professional accomplishment.
AzamK.KhanA.AlamM. T. (2017). Causes and adverse impact of physician burnout: A systematic review. Journal of the College of Physicians and Surgeons--Pakistan: JCPSP, 27(8), 495–501.
CarmelS.GlickS. M. (1996). Compassionate-empathic physicians: Personality traits and social-organizational factors that enhance or inhibit this behavior pattern. Social Science & Medicine, 43(8), 1253–1261. https://doi.org/10.1016/0277-9536(95)00445-9
4.
CavanaghN.CockettG.HeinrichC.DoigL.FiestK.GuichonJ. R.PageS.MitchellI.DoigC. J. (2019). Compassion fatigue in healthcare providers: A systematic review and meta-analysis. Nursing Ethics, 27(3), 639–665. https://doi.org/10.1177/0969733019889400
5.
CórdobaL.TamayoJ. A.GonzálezM. A.MartínezM. I.RosalesA.BarbatoS. H. (2011). Adaptation and validation of the maslach burnout inventory-human services survey in Cali, Colombia. Colombia Medica. https://doi.org/10.25100/cm.v42i3.874.
6.
CostelloA.OsborneJ. (2019). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research, and Evaluation, 10(1). https://doi.org/10.7275/jyj1-4868
7.
CrawfordP.BrownB.KvangarsnesM.GilbertP. (2014). The design of compassionate care. Journal of Clinical Nursing, 23(23–24), 3589–3599. https://doi.org/10.1111/jocn.12632
8.
Davalos-BatallasV.Vargas-MartínezA.-M.Bonilla-SierraP.Leon-LariosF.Lomas-CamposM.-M.Vaca-GallegosS.-L.de Diego-CorderoR. (2020). Compassionate engagement and action in the education for health care professions: A cross-sectional study at an Ecuadorian university. International Journal of Environmental Research and Public Health, 17(15). https://doi.org/10.3390/ijerph17155425
9.
DomínguezL. C.SanabriaÁ.RamírezA.VargasF.PachecoM.JiménezGermán. (2019). Desgaste profesional en residentes colombianos de cirugía: Resultados de un estudio nacional. Revista Colombiana de Cirugía, 32(2), 121–127. https://doi.org/10.30944/20117582.16
10.
DunnT. J.BaguleyT.BrunsdenV. (2014). From alpha to omega: A practical solution to the pervasive problem of internal consistency estimation. British Journal of Psychology (London, England : 1953), 105(3), 399–412. https://doi.org/10.1111/bjop.12046
FernandoA. T.ConsedineN. S. (2014). Beyond compassion fatigue: The transactional model of physician compassion. Journal of Pain and Symptom Management, 48(2), 289–298. https://doi.org/10.1016/j.jpainsymman.2013.09.014
13.
FurrR. M. (2011). Scale construction and psychometrics for social and personality. Sage.
14.
GilbertP. (2009). The compassionate mind:A new approach to life’s challenges. New Harbinger Publications.
GilbertP.CatarinoF.DuarteC.MatosM.KoltsR.StubbsJ.CeresattoL.DuarteJ.Pinto-GouveiaJ.BasranJ. (2017). The development of compassionate engagement and action scales for self and others. Journal of Compassionate Health Care, 4(1), 4. https://doi.org/10.1186/s40639-017-0033-3
Gil-MonteP. R. (2005). Factorial validity of the maslach burnout inventory (MBI-HSS) among Spanish professionals. Revista De Saude Publica, 39(1), 1–8. https://doi.org/10.1590/s0034-89102005000100001
21.
GribbenJ. L.KaseS. M.WaldmanE. D.WeintraubA. S. (2019a). A cross-sectional analysis of compassion fatigue, burnout, and compassion satisfaction in pediatric critical care physicians in the United States. Pediatric Critical Care Medicine: A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 20(3), 213–222. https://doi.org/10.1097/PCC.0000000000001803
22.
GribbenJ. L.MacLeanS. A.PourT.WaldmanE. D.WeintraubA. S. (2019b). A cross-sectional analysis of compassion fatigue, burnout, and compassion satisfaction in pediatric emergency medicine physicians in the United States. Academic Emergency Medicine, 26(7), 732–743. https://doi.org/10.1111/acem.13670
23.
HairJ.HultG. T. M.RingleC. M.SarstedtM. (2016). A primer on partial least squares structural equation modeling (2nd ed.). SAGE Publications, Inc.
24.
HairJ. F.RingleC. M.SarstedtM. (2011). PLS-SEM: Indeed a silver bullet. Journal of Marketing Theory and Practice, 19(2), 139–152. https://doi.org/10.2753/MTP1069-6679190202
HeffernanE.WeinsteinB. E.FergusonM. A. (2020). Application of rasch analysis to the evaluation of the measurement properties of the hearing handicap inventory for the elderly. Ear and Hearing, 41(5), 1125–1134. https://doi.org/10.1097/AUD.0000000000000832
27.
HuL. T.BentlerP. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
28.
HwangS.KimG.YangJ.-W.YangE. (2016). The moderating effects of age on the relationships of self-compassion, self-esteem, and mental health. Japanese Psychological Research, 58(2), 194–205. https://doi.org/10.1111/jpr.12109
29.
JazaieriH.JinpaG. T.McGonigalK.RosenbergE. L.FinkelsteinJ.Simon-ThomasE.CullenM.DotyJ. R.GrossJ. J.GoldinP. R. (2013). Enhancing compassion: A randomized controlled trial of a compassion cultivation training program. Journal of Happiness Studies, 14(4), 1113–1126. https://doi.org/10.1007/s10902-012-9373-z
30.
KalraS.PriyaG.GrewalE.AyeT. T.WaraichB. K.SweLattT.KhunT.PhanvarineM.SuttaS.KaushU.ManilkaR. S.KalraB. (2018). Lessons for the health-care practitioner from buddhism. Indian Journal of Endocrinology and Metabolism, 22(6), 812–817. https://doi.org/10.4103/ijem.IJEM_286_17
31.
KemperK. J.McClaffertyH.WilsonP. M.SerwintJ. R.BatraM.MahanJ. D.SchubertC. J.StaplesB. B.SchwartzA.Pediatric Resident Burnout-Resilience Study Consortium. (2019). Do mindfulness and self-compassion predict burnout in pediatric residents?Academic Medicine: Journal of the Association of American Medical Colleges, 94(6), 876–884. https://doi.org/10.1097/ACM.0000000000002546
32.
KemperK. J.SchwartzA.WilsonP. M.MahanJ. D.SchubertC. J.StaplesB. B.McClaffertyH.SerwintJ. R.BatraM.Pediatric Resident Burnout-Resilience Study Consortium. (2020). Burnout in pediatric residents: Three years of national survey data. Pediatrics, 145(1), Article e20191030. https://doi.org/10.1542/peds.2019-1030
33.
KlimeckiO. M.LeibergS.RicardM.SingerT. (2014). Differential pattern of functional brain plasticity after compassion and empathy training. Social Cognitive and Affective Neuroscience, 9(6), 873–879. https://doi.org/10.1093/scan/nst060
34.
MarshH. W.MorinA. J. S.ParkerP. D.KaurG. (2014). Exploratory structural equation modeling: An integration of the best features of exploratory and confirmatory factor analysis. Annual Review of Clinical Psychology, 10(1), 85–110. https://doi.org/10.1146/annurev-clinpsy-032813-153700
35.
MillsJ.WandT.FraserJ. A. (2018). Examining self-care, self-compassion and compassion for others: A cross-sectional survey of palliative care nurses and doctors. International Journal of Palliative Nursing, 24(1), 4–11. https://doi.org/10.12968/ijpn.2018.24.1.4
NeffK. D.VonkR. (2009). Self-compassion versus global self-esteem: Two different ways of relating to oneself. Journal of Personality, 77(1), 23–50. https://doi.org/10.1111/j.1467-6494.2008.00537.x
39.
OlsonK.KemperK. J.MahanJ. D. (2015). What factors promote resilience and protect against burnout in first-year pediatric and medicine-pediatric residents?Journal of Evidence-Based Complementary & Alternative Medicine, 20(3), 192–198. https://doi.org/10.1177/2156587214568894
40.
PodsakoffP. M.MacKenzieS. B.LeeJ.-Y.PodsakoffN. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879–903. https://doi.org/10.1037/0021-9010.88.5.879
41.
PotterR. F.YarK.FrancisA. J.SchusteS. (2014). Self-compassion mediates the relationship between parentalcriticism and social anxiety | IJPSY. International Journal of Psychology and Psychological Therapy, 14(1), 33–43.
42.
RotensteinL. S.TorreM.RamosM. A.RosalesR. C.GuilleC.SenS.MataD. A. (2018). Prevalence of burnout among physicians: A systematic review. JAMA, 320(11), 1131–1150. https://doi.org/10.1001/jama.2018.12777
43.
SinclairS.KondejewskiJ.JaggiP.Roze des OrdonsA. L.KassamA.HaydenK. A.HarrisD.HackT. F. (2021). What works for whom in compassion training programs offered to practicing healthcare providers: A realist review. BMC Medical Education, 21(1), 455. https://doi.org/10.1186/s12909-021-02863-w
44.
SiroisF. M.KitnerR.HirschJ. K. (2015). Self-compassion, affect, and health-promoting behaviors. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 34(6), 661–669. https://doi.org/10.1037/hea0000158
45.
SpectorP. E. (2019). Do not cross me: Optimizing the use of cross-sectional designs. Journal of Business and Psychology, 34(2), 125–137. https://doi.org/10.1007/s10869-018-09613-8
46.
StammB. H. (2002). Measuring compassion satisfaction as well as fatigue: Developmental history of the compassion satisfaction and fatigue test. In FigleyC.R. (Ed.), Treating compassion Fatigue (pp. 107–119). Routledge.
47.
WeintraubA. S.GeithnerE. M.StroustrupA.WaldmanE. D. (2016). Compassion fatigue, burnout and compassion satisfaction in neonatologists in the US. Journal of Perinatology, 36(11), 1021–1026. https://doi.org/10.1038/jp.2016.121
48.
WestC. P.DyrbyeL. N.ShanafeltT. D. (2018). Physician burnout: Contributors, consequences and solutions. Journal of Internal Medicine, 283(6), 516–529. https://doi.org/10.1111/joim.12752
49.
WheelerD. L.VassarM.WorleyJ. A.BarnesL. L. B. (2011). A reliability generalization meta-analysis of coefficient alpha for the maslach burnout inventory. Educational and Psychological Measurement, 71(1), 231–244. https://doi.org/10.1177/0013164410391579
50.
WHO. (2019). Burn-out an “occupational phenomenon”: International classification of diseases: WHO.
