Burnout and health behaviors in health professionals from seven European countries

  • Anna Alexandrova-KaramanovaEmail author
  • Irina Todorova
  • Anthony Montgomery
  • Efharis Panagopoulou
  • Patricia Costa
  • Adriana Baban
  • Asli Davas
  • Milan Milosevic
  • Dragan Mijakoski
Original Article



Within an underlying health-impairing process, work stressors exhaust employees’ mental and physical resources and lead to exhaustion/burnout and to health problems, with health-impairing behaviors being one of the potential mechanisms, linking burnout to ill health. The study aims to explore the associations between burnout and fast food consumption, exercise, alcohol consumption and painkiller use in a multinational sample of 2623 doctors, nurses and residents from Greece, Portugal, Bulgaria, Romania, Turkey, Croatia and Macedonia, adopting a cross-national approach.


Data are part of the international cross-sectional quantitative ORCAB survey. The measures included the Maslach Burnout Inventory and the Health Behaviors Questionnaire.


Burnout was significantly positively associated with higher fast food consumption, infrequent exercise, higher alcohol consumption and more frequent painkiller use in the full sample, and these associations remained significant after the inclusion of individual differences factors and country of residence. Cross-national comparisons showed significant differences in burnout and health behaviors, and some differences in the statistical significance and magnitude (but not the direction) of the associations between them. Health professionals from Turkey, Greece and Bulgaria reported the most unfavorable experiences.


Burnout and risk health behaviors among health professionals are important both in the context of health professionals’ health and well-being and as factors contributing to medical errors and inadequate patient safety. Organizational interventions should incorporate early identification of such behaviors together with programs promoting health and aimed at the reduction of burnout and work-related stress.


Burnout Health behaviors Health professionals Cross-national 



The research leading to these results has received funding from the European Union’s Seventh Framework Programme [FP7-HEALTH-2009-single-stage] under Grant Agreement No. [242084].

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Anna Alexandrova-Karamanova
    • 1
    • 2
    Email author
  • Irina Todorova
    • 1
  • Anthony Montgomery
    • 3
  • Efharis Panagopoulou
    • 4
  • Patricia Costa
    • 5
  • Adriana Baban
    • 6
  • Asli Davas
    • 7
  • Milan Milosevic
    • 8
  • Dragan Mijakoski
    • 9
  1. 1.Health Psychology Research CenterSofiaBulgaria
  2. 2.Department of Psychology, Institute for Population and Human StudiesBulgarian Academy of SciencesSofiaBulgaria
  3. 3.Department of Education and Social PolicyUniversity of MacedoniaThessalonikiGreece
  4. 4.Medical SchoolAristotle University of ThessalonikiThessalonikiGreece
  5. 5.Business Research Unit - Instituto Universitário de LisboaLisbonPortugal
  6. 6.Department of PsychologyBabes Bolyai UniversityCluj-NapocaRomania
  7. 7.Department of Public HealthEge UniversityBornovaTurkey
  8. 8.School of Medicine, Andrija Stampar School of Public HealthUniversity of ZagrebZagrebCroatia
  9. 9.Institute of Occupational Health of RMWHO Collaborating CenterSkopjeRepublic of Macedonia

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