Abstract

Purpose: About 35-54% of nurses and physicians in the U.S. suffer from burnout. Currently, there is a lack of an objective biologic measure of burnout. This study will assess the feasibility of using DNA methylation (DNAm) as a biomarker of healthcare provider burnout and identify work conditions, particularly during a pandemic, that would inform future implementation of targeted strategies to reduce healthcare provider burnout.

Method: Cross-sectional, feasibility study. Participants included clinicians (nurses and physicians, n=31) and non-clinicians (n=25). Burnout and the work environment were measured using the Maslach Burnout Inventory, Areas of Worklife Survey, Pandemic Experience & Perceptions Survey. OGD-600 saliva collection kits were used to collect for the DNAm analysis. Bivariate analysis was conducted to assess the relationship between the work environment factors and the three subcategories of burnout. For the multivariable models, all statistically significant bivariate results (p< 0.05) were included in the multivariable analysis. DNAm was analyzed via whole genome bisulfite sequencing.

Results: Clinicians reported higher emotional exhaustion (p=0.047) and depersonalization (p<0.001) as compared to non-clinicians, while no significant differences were reported in personal accomplishment between the two groups. Higher workload and lower community were identified as predictors that contribute most to higher emotional exhaustion for clinicians as compared to non-clinicians. Lower control and lower resources were identified as predictors that contribute most to higher depersonalization. Analysis results on the relationship between DNAm and self-reported levels of burnout are pending.

Conclusions/Implications: Our study underscores the importance of a comprehensive and tailored program aimed at improving various aspects of the work environment that can meet the needs of both clinicians and non-clinicians alike. Targeted strategies including clinician peer support groups to improve a sense of community and shared decision-making opportunities to enhance feelings of control may be also helpful in decreasing emotional exhaustion and depersonalization among clinicians.

Description

Dr. Kim was a recipient of the Sigma/American Nurses Foundation Grant, 2019-2020 cohort.

Author Details

Linda Y. Kim, PhD, MSN, RN, PHN, CPHQ, Research Scientist; Wenrui Xu, MPH, Clinical Research Specialist; Harriet Aronow, PhD, FAAN, Research Scientist IV; Mana Manoukian, MSN, RN, AGCNS-BC, Clinical Nurse Specialist; Bernice Coleman, PhD, ACNP-BC, FAHA, FAAN, Research Scientist III

Sigma Membership

Gamma Tau at-Large

Lead Author Affiliation

Cedars-Sinai Medical Center, Los Angeles, California, USA

Type

Report

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Quantitative Research

Keywords:

Burnout, Healthy Workplace Environments, DNA Methylation

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Sigma Grant Recipient Report

Acquisition

Self-submission

Date of Issue

2022-01-04

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