Author ORCID Identifier

https://orcid.org/0000-0002-7413-172X

Year of Publication

2021

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Communication and Information Studies

Department

Communication

First Advisor

Dr. Allison Scott Gordon

Abstract

Burnout is a common experience among physicians and has been identified as a precursor to substance abuse and suicide ideation. When not addressed, burnout can have many negative personal, relational and professional consequences. Research about the burnout experience is limited due to the taboo nature of the topic. The present study used a multiple goals theoretical perspective to examine how physicians disclose burnout in order to access social support. Attending physicians from various specialties (N = 30) participated in one-on-one interviews and were asked to discuss their burnout experience, conversational goals during burnout disclosure, catalysts and barriers for disclosure, and provide details about how they evaluated supportive messages from others. Participants also completed a questionnaire in which they were asked to provide demographic information and details about their work experience. Interviews were transcribed and coded using qualitative descriptive analysis. Overall, the findings highlight conversational goals and dilemmas that were salient for participants when disclosing burnout and how they evaluated supportive responses from others. Specifically, results indicated participants’ burnout experiences involved emotional exhaustion, depersonalization, loss of work fulfillment, feeling stuck or wanting to leave the field of medicine, and recognition of changes about themselves. Participants reported having multiple task and identity goals during disclosure and identified how these goals often led to conversational dilemmas. Participants described using several strategies for disclosing burnout, including not calling it burnout, sharing knowledge with other physicians, choosing appropriate confidants, sharing selective information, and not disclosing. Factors that made it easier for them to disclose included normalization of burnout, others disclosing burnout, shared professional experiences, perceived confidentiality, and their role as an attending. Participants also identified factors that made disclosure difficult, including stigma and fear of judgment, the perception that no one cares or that support is unavailable. Additionally, participants found responses more supportive when they included listening, support for professional changes, sympathy and compassion or reassurance. Less supportive responses included dismissal of feelings, canned responses, or inadequate professional support. Theoretically, the results provide evidence for the three categories commonly used to conceptualized burnout (i.e., emotional exhaustion, depersonalization, loss of work fulfillment), while also highlighting two sub-categories related to loss of work fulfillment (i.e., wanting to leave medicine but feeling stuck; recognizing changes about themselves). The results also provide evidence of how stigma influences conversational goals, highlighting an opportunity to further investigate potential connections between types of goals and evaluation of supportive responses. Practically, the findings provide insight for how physicians can effectively disclose burnout and how healthcare administrators and friends and family members of physicians can be more supportive when responding to burnout disclosure.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2021.056

Funding Information

This study was supported by the UK Graduate School Dissertation Year Fellowship in 2020.

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