Background: Physician burnout is a growing problem worldwide. Several interventions aimed at lowering burnout rates among physicians have been implemented. To date, there is no established structured program to combat burnout in the Philippine General Hospital. This study evaluated the effectiveness of the I-CARE program, a physician resilience and wellness program which adapted the different components of the international programs for the Philippine setting.

Objective: To evaluate the effectiveness of the I-CARE program in reducing medical residents' burnout level.

Methods: After key components of the I-CARE program were identified, the program was implemented in 2 phases. The first phase involved training of consultants to hone their facilitation skills. The second phase was a before-and-after study of the I-CARE program. The participants' burnout level was measured before and after the program using the Maslach Burnout Inventory.

Results: The I-CARE program was implemented in the Department of Pediatrics from March to August 2020. There was no significant change in the overall burnout levels of 59 pediatric residents after the I-CARE implementation (p=0.32). This may be due to several challenges encountered during the implementation, such as time constraints, the increased workload caused by the COVID-19 pandemic, and the lack of physical meetings due to the restrictions of the pandemic. However, the feedback of the administrators, facilitators and residents was generally positive. All the interviewed participants recommended the continuation of the I-CARE program in the Department of Pediatrics.

Conclusion: The I-CARE program shows potential in promoting mental health and emotional wellness among physicians in training.

Background: The highly demanding nature of medical education may lead to development of burnout in medical students which may persist beyond medical school. Burnout can be a predictor of psychological impairments and incorrect patient care Objective: This study aimed to determine the prevalence of burnout and its relationship to socio-demographic variables and associated stressors among 1st to 4th year medical students of Cebu Institute of Medicine for school year 2018-2019 Methods: This is cross-sectional study using a self-administered three-part questionnaire composed of socio-demographic data, stressors, and the Copenhagen Burnout Inventory (CBI). Descriptive statistics were taken for all variables. T-test analysis was used for dichotomous independent variables while Analysis of Variance was utilized for independent samples with multiple variables. Multiple regression analysis was done to determine significant relationship between identified stressors and the determinant score on the CBI Results: Participants had high degree of burnout with average CBI score of 71.53. Majority of the respondents (94.88%) showed at least moderate burnout. Only Year Level (p=0.027) was significantly associated with burnout. Stressors associated with burnout were: lack of belief in what you do (p=0.000), insufficient rewards (p=0.007), poor communication (p=0.002), poor leadership (p=0.009), sense of never ending competition (p=0.009) and scoring lower than hoped (p=0.003). Conclusion Students are at risk for burnout as they temporally progress through medical school peaking at 3rd year level. Stressors encompass personal, study, colleague, and teacher related factors. It is important to address these stressors due to their progressive negative effect both on self and others.
Burnout, Psychological

Introduction: With the growing number of females employed as factory workers, it is important to look into the phenomenon of burnout and related organizational climate affecting these workers. Objectives: The study's objectives were: 1) to come up with the indices of burnout among Filipino female factory workers and; 2) to come up with indices of organizational climate components of job autonomy, the content of the job, and nature of management through exploratory factor analysis. Methods: The secondary data used for this study were from a cross-sectional study involving 344 female factory workers. The indicators of the organizational climate were derived through exploratory factor analysis of items in the dataset. Exploratory Factor Analysis was used to reduce the variables into a fewer set of “Component Variables.” The technique explored the relationship of each indicator and then grouped them according to which component they were highly correlated. Using the factor loadings as weights, the index score was generated. The organizational climate indices were derived from the factor loading scores. Burnout Score was derived from respondents’ answers on nine items relating to burnout. The organizational climate indexes were also generated using factor analysis with these components- job autonomy, content of the job, and nature of management. Cronbach alpha was generated for all the items under each index to show the internal consistency and scale reliability. Results: There were 344 female respondents with a mean age of 26 (SD=5.02), and the majority were single (69.21%). Nine items were measured with the lowest average response “work is boring” (0.259 ± .560) for burnout indices. The highest mean answer for the item “work requires new skills or upskilling regularly” at 1.619 ± .762, suggesting that most respondents were required to upskill regularly. “Salary is not enough to meet worker’s needs” also has a high average response, suggesting that most respondents felt that their salary was insufficient to sustain their daily needs. The total burnout score indicates that workers experienced moderate burnout. The indices for burnout have good internal consistency and scale reliability (Cronbach alpha= 0.712). The organizational climate was grouped into Indexes through factor analysis, namely, Autonomy on Quality Index, Autonomy on Rest Index, Skilled work content Index, Physical work content Index, Hazardous work content Index, Health, Safety, and Compensation Index, and Training Index. Autonomy on Quality Index has a mean of 66.877 ± 31.934, suggesting that the autonomy on quality for respondents was moderately high, while Autonomy on Rest Index was 24.159 ± 30.788, suggesting that respondents have low autonomy on rest. The skilled work content index was high at an average of 70.801 ± 22.87, while physical work content and hazardous work content index were low at 29.398 and 25.377, respectively. Health, Safety, and Compensation index average was very low at 8.891 ± 8.524. Conclusion This study came up with indices of burnout unique to female factory workers. The indexes were boredom/boring work, repetitious tasks, fast-paced work, work pressure, not sufficient compensation, work-home conflicts, upskilling, physically tiring, mentally tiring, and salary is not sufficient to meet basic needs. This study also came up with the indexes of organizational climate relating to job autonomy, content of job, and nature of management. The several items under each of these components were subjected to Factor Analysis to come up with indexes of organizational climate. Thus, the contribution of this study is coming up with a burnout index unique to the Filipino factory worker, not just based on subjective expert opinion, but data-driven and statistically derived.
Burnout, Psychological

Introduction: Physician burnout (BO) is an increasing global concern due to its rising prevalence and effect on patient care Objective: This study determined the prevalence of BO, compassion fatigue (CF), and compassion satisfaction (CS), among residents of obstetrics and gynecology in the Philippines, and identified the factors associated with these Methods: This was a cross‑sectional study, which used stratified random sampling. The strata comprised public and private hospitals that were subdivided into Luzon, Visayas, Mindanao, and National Capital Region. From these, 33 training hospitals were randomly selected, which served as clusters wherein all resident physicians of obstetrics and gynecology were invited to answer either an online or printed version of the Professional Quality of Life Scale Version 5 questionnaire Results: Majority of the 311 participants included had average level of BO (n = 281, 90.4%), CF (n = 237, 76.2%), and CS (n = 213, 68.5%). CS was negatively correlated with burnout (r = −0.31, P < 0.001) and CF (r = −0.34, P < 0.001), whereas BO and CS were positively correlated (r = +0.48, P < 0.001). Type of institution, sleeping hours, and interrupted leaves were the common factors that yield significant differences in BO (P = 0.037, P < 0.001, and P < 0.001) and CF (P = 0.002, P = 0.043, and P = 0.005). Significant differences were observed in CS scores in terms of age (P = 0.016), marital status (P = 0.038), child dependents (P = 0.006), level of training (P = 0.005), and location and type of institution (P ≤ 0.001 and P = 0.003). Conclusion There is a need to develop active awareness of BO and CF among resident physicians to effect interventions at the individual and institutional level.
Burnout, Psychological ; Compassion Fatigue

Introduction: Teaching is considered to be a high-risk occupation for developing burnout, a phenomenon where chronic workplace stress is unsuccessfully managed. Despite studies on burnout in high- and upper-middle income countries, there is limited evidence for lower-middle-income (LMIC) countries and in the context of the COVID-19 pandemic. Objective: This study aimed to determine the prevalence and factors associated with burnout under worker’s health, working environment, and working culture among junior high school teachers. Methods: Data were collected through a six-part, self-administered questionnaire that measured sociodemographics and teacher characteristics, musculoskeletal pain, comorbidities, job insecurity, workplace social support, and burnout from 16 public high schools in Quezon City. Bivariate and multivariate analyses were used to assess significant factors associated with burnout. Results: Of the 171 JHS teachers in the study, the prevalence of burnout was 5.3%. Teachers who were more likely to have burnout were males, younger age, lower teaching positions, fewer working hours and teaching experience, blended work setup, with musculoskeletal pain and mental comorbidities, job insecurity, and low workplace social support. Bivariate analysis found that mental comorbidities and job insecurity were significant, however, these were not significant in the multivariate analysis. Conclusion This study presents alternative findings for the factors associated with burnout when contextualized in an LMIC setting. Despite not finding significance when adjusted for other variables, descriptive statistics have shown the characteristics of teachers who are more likely to have burnout. Efforts to detect, manage, and prevent burnout should take these into consideration to identify teacher with burnout.
Burnout, Psychological ; Occupational Health

Introduction: Due to COVID-19 pandemic, it became imperative for the education sector to shift to online curriculum and eventually hybrid education. However, this policy posed challenges to educators and students, such as increased workload, prolonged screen time, and burnout. This study determined the association of online screen media exposure and burnout among adolescent senior high school students enrolled in different online curricula in Metro Manila. Methods: This analytic cross-sectional study identified adolescent senior high school students in Metro Manila who were recruited via non-probability convenience sampling. Online screen media exposure was assessed based on the cut off value of four (4) or more hours of device usage related to online schooling, and participants answered the Copenhagen Burnout Inventory (CBI) to ascertain presence or absence of said condition. Data analysis included cross-tabulation for prevalence rate ratio (PRR), and Chi-square test for statistical significance. Results: Of the 117 respondents, most had significant online screen media exposure (75.21%). For the CBI, 51 study subjects garnered a score of 50 and above, suggesting that 43.59% of the adolescents might be suffering from burnout. In addition, PRR was calculated to be 3.9 (p-value of .002). Conclusion Among adolescent senior high school students with significant online screen media exposure of four hours or more, there was 3.9 higher risk of exhibiting burnout symptoms, and this was statistically significant.
Adolescent ; Burnout, Psychological

RESEARCH QUESTION: What are the profiles and the degree of burnout among resident physicians in private tertiary hospitals in Bacolod City? BACKGROUND: Exhaustion from work may result into negative effects not only to the medical staff and patients. Systematic reviews revealed an association in physician burnout and suboptimal quality of care, patient safety and patient satisfaction. However, the prevalence of burnout among resident physicians in Bacolod City has not been established. OBJECTIVES: The study aimed to determine the profiles and the degree of burnout among resident physicians in private tertiary hospitals in Bacolod City. STUDY DESIGN: Cross-sectional survey PARTICIPANTS: We invited all resident physicians in private hospitals in Bacolod City. OUTCOME MEASURE: This study used the 22-item Maslach Burnout Inventory-Human Services Survey. ANALYSIS: IBM SPSS version 22 was used in the data analysis. Mean and frequency distribution were utilized. Analysis of percentage of distribution was used to determine their difference. RESULTS: From December 2019 to January 2020, ninety-three resident physicians consented to participate in the study. The majority of the participants were young adults, females and single. Only a minority of the residents exercised regularly. The majority were practicing their religion. Most of the residents are in their early years of training. Residents in Internal Medicine comprised the majority of the respondents. Among the respondents, in the Emotional Exhaustion (EE) domain: 24.7% were low, 37.6% were moderate, and 37.6% were high. While in the Depersonalization (DP) domain: 43% were low, 34.4% were moderate, and 22.6% were high. Lastly, in the Personal Achievement (PA) domain: 33.3% were low, 35.5% were moderate, and 31.2% were high. High burnout was present in 22.6% among the respondents. CONCLUSIONS: High burn out was seen among young adults, male, single, and more senior resident physicians. Furthermore, residents who exercise regularly and practice their religion have lower burnout. And Internal Medicine residents were seen to have high burnout compared to other training specialization. Organizational- and physician-directed interventions have an essential role in preventing and reducing burnout in training institutions.
Burnout, Professional ; Burnout, Psychological ; Hospitals, Private ; Physicians

Introduction: Burnout and job satisfaction among healthcare providers have been subjects of interest for the past decades due to its impact on a person’s well-being and the possible consequence of compromising patient care. Awareness of this phenomenon will aid in developing strategies to prevent burnout and increase job satisfaction in the workplace. Objective: This study aimed to determine the prevalence of burnout and job satisfaction among healthcare providers employed at the Zamboanga City Medical Center. Methods: The study utilized a descriptive, cross-sectional design. Multi-stage random sampling was used. A total of three hundred sixty-two (362) employees of various occupational groups participated in the study. A self-administered questionnaire was employed to gather data which comprised of sociodemographic data, questions from the Copenhagen Burnout Inventory (CBI) and Job Satisfaction Scale (JSS). Analysis and presentation of results were done using descriptive statistics such as frequency and percentages. Results The prevalence of burnout was 23.49%. It was common among nurses (38.83%) followed by doctors (24%) administrative assistants (10.59%) and nursing attendants (9.42%). Majority (33.15%) had personal burnout followed by work-related (24.04%) and client related burnout 22.93%. Around 48.35% reported satisfaction with their current jobs, while 50% were ambivalent and only 1.66% were dissatisfied. Majority (80.39%) were satisfied with nature of work followed by supervision (74.04%), coworker (66.3%), communication (65.75%) and pay (58.57%). In contrast, less than half were satisfied with fringe benefits (44.76%). Moreover, around 44.2% were dissatisfied with their working conditions. Ambivalence was seen in a range of 42.27% (promotion) to 47.52% (contingent rewards).
Burnout, Psychological ; Job Satisfaction ; Burnout, Professional

Background and Objective: The burden of caring for others comes naturally for healthcare providers particularly nurses as this is part of their altruistic nature. The right balance of caring for others and self-care is key to a healthy professional quality of life (ProQOL) which encompasses Compassion Satisfaction and prevents Burnout (BO) and Secondary Traumatic Stress (STS). With the challenge of the COVID-19 pandemic that has resulted in higher morbidity and mortality, the demands of the healthcare system on nurses are overwhelming. The objective of this study was to determine the prevalence, and the related factors of compassion satisfaction, burnout, and secondary traumatic stress among nurses in a government facility during a pandemic Method: This was a cross-sectional descriptive study which utilized a validated Professional Quality of Life (ProQOL) selfadministered questionnaire measuring Compassion Satisfaction, Burnout, and Secondary Traumatic Stress (Stamm, 2010). The survey was conducted from June 1-30, 2020 among a sample size of 204 qualified and willing nurses who signed an informed consent. All data were analyzed using descriptive statistics and parametric statistical tests (T-test and ANOVA). Statistical significance was at 99% CI and p-value of 0.05. Results: A total of 204 qualified and willing nurses were included in the study. Majority of the respondents belonged to the 2035 years of age bracket. Sixty-seven percent were female, married (54%); with no children (50%); finished BSN (91%); currently holding a Nurse II position (34%) with less than 5 years government service (56%) and with less than 5 years of field experience (58%). Seventy-seven percent (77%) did not have pre-existing diseases while 33% had either Hypertension, Diabetes Mellitus, Bronchial Asthma and other non-communicable diseases. Overall ProQOL mean scores ranged from average to high compassion satisfaction; low to average Burnout; and low to average Secondary Traumatic Stress. Related factors found significant at p vale 0.05 or less were areas of rotation and years in the field of practice Conclusion The study showed that the mean scores of the nurse respondents’ ProQOL encompassing Compassion Satisfaction, Burnout, and Secondary Traumatic Stress indicate a healthy ProQOL from June 1-30, 2020. Areas of rotation and years in the field of practice are statistically significant in relation to ProQOL mean scores. All other factors are not statistically significant correlates
Burnout, Psychological ; Compassion Fatigue ; Nurses ; COVID-19 ; Burnout, Professional

Objectives: Internal Medicine physician trainees faced unique challenges as the primary frontline physicians at a tertiary COVID-19 government referral center during the COVID-19 pandemic. This study examined the prevalence of burnout and resilience of these physician trainees during the early period of the pandemic, the determinants of burnout, and their sources of anxiety and coping mechanisms.

Methods: Using a mixed-methods approach, we conducted an online cross-sectional survey to measure burnout and resilience among 196 Internal Medicine physician trainees using the Maslach Burnout Index Human Services Survey for Medical Personnel and the Connor-Davidson Resiliency questionnaires, respectively. We then conducted virtual focus group discussions and in-depth key informant interviews to explore the trainees' sources of anxiety and coping mechanisms until thematic saturation was satisfied.

Results: Out of 146 respondents (from 196 eligible participants, 74% response rate), four percent of physician trainees fit the frank burnout profile, 40% were engaged, while the majority had intermediate profiles (23% ineffective, 28% overextended, and 4% disengaged). The mean resilience score was 72.9 (SD 12.4). Resilience was a significant negative predictor for burnout (Beta Coefficient = -0.73, p<0.001). Its protective effect decreases in those with more exposure to patient deaths (Beta Coefficient = 6.767, p<0.05). Significant sources of anxiety included changes in the practice of medicine (changes in workflow, working in full personal protective equipment, telemedicine and zoom fatigue, constant threat of acquiring the infection) and having competing demands between service and training. Coping mechanisms included preserving a haven, maintaining social relationships, and self-care.

Conclusion: In the largest government hospital in the Philippines, four percent of Internal Medicine physician trainees had burnout, 40% were engaged, and the majority were at-risk for burnout a few months into the COVID-19 pandemic in 2020. Resilience reduces the risk for burnout. However, its protective effect decreased with exposure to a higher number of patient deaths per week.