A model of resilience, burnout and intention to quit among general practitioners

  • Huntley J. Evans

Western Sydney University thesis: Doctoral thesis

Abstract

Within Australia, General Practitioners (GPs) are the cornerstone of the healthcare system. As the first port of contact, GPs consult a large number of patients presenting with a range of both physical and psychological ailments, potentially resulting in excessive demands on the GP. The workload of a GP is exacerbated by the responsibilities of referral writing and other administrative duties. The increased demands of general practice can be the basis of work-family conflict (WFC), resulting in further stress for the GP. Due to the increasing prevalence of chronic health conditions, the ageing population, and recent government reforms, the role of a GP is becoming increasingly demanding, potentially leading to burnout, increased medical errors, decreases in GP-wellbeing, and reduced retention rates. Resilience is hypothesised to reduce the influence that the demands of general practice can have on the GP, ultimately reducing burnout and intention to quit the profession. Yet there is currently no model to adequately measure this proposition. Extending the integrated job stress model, this study proposes a model to measure the influence of resilience on perceived job demands, burnout, and an intention to quit the profession, as reported by GPs. This study used an exploratory mixed-methods research design to develop a holistic understanding of the situation. The sample includes GPs practicing in the metropolitan areas of New South Wales, Queensland, Victoria, and South Australia (n=221). Participants were invited to complete a survey comprised of established scales to measure the lessening influence that resilience has on GP burnout. Following this, a small number of participants were invited to participate in a semi-structured interview (n=10), to gain further insight into the lived experiences of GPs, thus complementing the survey results. Following the structural equation modelling of the survey data, it was apparent that despite being associated with lower levels of WFC, resilience did not have the anticipated benefits in reducing GP burnout. A thematic analysis of the qualitative interview data suggests this might be due external factors that are not within the immediate control of GPs, such as the attitudes of difficult patients and the changing roles of a GP. This study suggests that the primary way to influence job demands and decrease burnout is via the provision of job resources. Job resources have been shown to reduce job demands. Job demands are suggested to exacerbate burnout directly (by intensifying the demands of work) and indirectly (by generating work-family conflict). Therefore, through the increased provision of job resources, GPs are likely to: experience lower levels of burnout, experience improved wellbeing, deliver better patient care, and remain in their profession. Given the current challenges facing Australian GPs, it is important to improve the capacity of the primary care workforce. Through its theoretical contribution, this thesis demonstrates ways to bolster this capacity.
Date of Award2015
Original languageEnglish

Keywords

  • burn out (psychology)
  • physicians (general practice)
  • job stress
  • mental health
  • Australia

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