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Recovery experiences mediate the effect of burnout on life satisfaction among Chinese physicians: a structural equation modeling analysis

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Abstract

Purpose

Recovery experiences not only make it possible for individuals to restore their energy resources and return to pre-stressor levels but also contribute to the formation of their subjective well-being. This paper investigates the effect of burnout on life satisfaction among Chinese physicians who are frequently confronted with a considerable number of work-related stressors and examines the mediating role of recovery experiences in the relationship between burnout and life satisfaction.

Methods

A total of 642 physicians working in five public tertiary hospitals in China responded to a self-administered questionnaire including demographic information, the Satisfaction with Life Scale, the Maslach Burnout Inventory-General Scale, and the Recovery Experience Questionnaire. Hierarchical multiple regression analysis was conducted to test the incremental variance of any given set of independent variables. Structural equation modeling was employed to test the presumed relationships between variables involved. Asymptotic and resampling strategies were used to examine the mediating effects of recovery experiences in the relationship between burnout and life satisfaction.

Results

Burnout and recovery experiences were important predictors of life satisfaction and the direct effect of burnout on life satisfaction was statistically significant and negative and the path coefficients of burnout with life satisfaction were significantly decreased when recovery experiences were modeled as mediators.

Conclusion

Findings of the study highlight the importance of promoting recovery experiences to reduce burnout and improve life satisfaction among physicians rather than focusing on the less easily modifiable work-related stressors.

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References

  • Ahola K, Hakanen J (2007) Job strain, burnout, and depressive symptoms: a prospective study among dentists. J Affect Disord 104(1–3):103–110

    Article  Google Scholar 

  • An J (2013) Which future for doctors in China? Lancet 382(9896):936–937

    Google Scholar 

  • Baron RM, Kenny DA (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51:1173–1182

    Article  CAS  Google Scholar 

  • Boekhorst JA, Singh P, Burke R (2017) Work intensity, emotional exhaustion and life satisfaction—the moderating role of psychological detachment. Pers Rev 46(5):891–907

    Article  Google Scholar 

  • Chen ZM, Godfrey R (1991) Becoming a doctor in China. Lancet 338:169–172

    Article  CAS  Google Scholar 

  • Chida Y, Steptoe A (2008) Positive psychological well-being and mortality: a quantitative review of prospective observational studies. Psychosom Med 70:741–756

    Article  Google Scholar 

  • Chirico F, Taino G, Magnavita N, Giorgi I, Ferrari G, Mongiovi MC, Imbriani M (2019) Proposal of a method for the evaluation of burnout risk in teachers: the VA. RI. BO (Evaluation RIschio Burn-Out). G Ital Med Lav Ergon 41(3):221–235

    Google Scholar 

  • Daig I, Herschbach P, Lehmann A, Knoll N, Decker O (2009) Gender and age differences in domain-specific life satisfaction and the impact of depressive and anxiety symptoms: a general population survey from Germany. Qual Life Res 18:669–678

    Article  Google Scholar 

  • DeJonge T, Veenhoven R, Kalmijn W, Arends L (2016) Pooling time series based on slightly different questions about the same topic forty years of survey research on happiness and life satisfaction in The Netherlands. Soc Indic Res 126(2):863–891

    Article  Google Scholar 

  • Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB (2000) A model of burnout and life satisfaction amongst nurses. J Adv Nurs 32(2):454–464

    Article  CAS  Google Scholar 

  • Diener E, Biswas-Diener R (2002) Will money increase subjective well-being? Soc Indic Res 57:119–169

    Article  Google Scholar 

  • Diener E, Emmons RA, Larsen RJ, Griffin S (1985) The satisfaction with life scale. J Pers Assess 49:71–75

    Article  CAS  Google Scholar 

  • Diener E, Sandvik E, Seidlitz L, Diener M (1993) The relationship between income and well-being: subjective or absolute? Soc Indic Res 28:195–223

    Article  Google Scholar 

  • Diener E, Ng W, Harter J, Arora R (2010) Wealth and happiness across the world: Material prosperity predicts life evaluation, whereas psychosocial prosperity predicts positive feeling. J Pers Soc Psychol 99:52–61

    Article  Google Scholar 

  • Dolan P, Peasgood T, White M (2008) Do we really know what makes us happy? A review of the economic literature on the factors associated with subjective well-being. J Econ Psychol 29:94–122

    Article  Google Scholar 

  • Dyrbye LN, Shanafelt TD (2011) Physician burnout: a potential threat to successful health care reform. JAMA 305:2009–2010

    CAS  Google Scholar 

  • Dyrbye LN, Massie FS Jr, Eacker A, Harper W, Power D, Durning SJ, Thomas MR, Moutier C, Satele D, Sloan J, Shanafelt TD (2010) Relationship between burnout and professional conduct and attitudes among US medical students. JAMA 304:1173–1180

    Article  CAS  Google Scholar 

  • Eckleberry-Hunt J, Kirkpatrick H, Taku K, Hunt R, Vasappa R (2016) Relation between physicians’ work lives and happiness. South Med J 109(4):207–212

    Article  Google Scholar 

  • Fredrickson BL, Levenson RW (1998) Positive emotions speed recovery from the cardiovascular sequelae of negative emotions. Cog Emo 12:191–220

    Article  Google Scholar 

  • Freudenberger HJ (1974) Staff burnout. J Soc Issues 30:159–165

    Article  Google Scholar 

  • Fritz C, Sonnentag S (2006) Recovery, well-being, and performance-related outcomes: The role of workload and vacation experiences. J Appl Psychol 91:936–945

    Article  Google Scholar 

  • Gamaiunova L, Brandt PY, Bondolfi G, Kliegel M (2019) Exploration of psychological mechanisms of the reduced stress response in long-term meditation practitioners. Psychoneuroendocrino 104:143–151

    Article  Google Scholar 

  • Georgellis Y, Lange T (2012) Traditional versus secular values and the job-life satisfaction relationship across Europe. Brit J Manage 23(4):437–454

    Article  Google Scholar 

  • Georgellis Y, Tsitsianis N, Yin Y (2009) Personal values as mitigating factors in the link between income and life satisfaction: evidence from the European social survey. Soc Indic Res 91:329–344

    Article  Google Scholar 

  • Geurts SA, Sonnentag S (2006) Recovery as an explanatory mechanism in the relation between acute stress reactions and chronic health impairment. Scand J Work Env Hea 32(6):482–492

    Article  Google Scholar 

  • Gove WR, Hughes M, Style CB (1983) Does marriage have positive effects on the psychological well-being of an individual? J Health Soc Behav 24:122

    Article  CAS  Google Scholar 

  • Grant N, Wardle J, Steptoe A (2009) The relationship between life satisfaction and health behavior: a cross-cultural analysis of young adults. Int J Behav Med 16(3):259–268

    Article  Google Scholar 

  • Hahn VC, Binnewies C, Sonnentag S, Mojza EJ (2011) Learning how to recover from job stress: effects of a recovery training program on recovery, recovery-related self-efficacy, and well-being. J Occup Health Psychol 16(2):202–216

    Article  Google Scholar 

  • Hakanen JJ, Schaufeli WB (2012) Do burnout and work engagement predict depressive symptoms and life satisfaction? A three-wave seven-year prospective study. J Affect Disord 141(2–3):415–424

    Article  Google Scholar 

  • Hobfoll SE (1989) Conservation of resources. A new attempt at conceptualizing stress. Am Psychol 44(3):513–524

    Article  CAS  Google Scholar 

  • Hobfoll SE (2002) Social and psychological resources and adaptation. Rev Gen Psychol 6:307–324

    Article  Google Scholar 

  • Kahneman D, Deaton A (2010) High income improves evaluation of life but not emotional well-being. Proc Natl Acad Sci USA 107:16489–16493

    Article  CAS  Google Scholar 

  • Kinnunen U, Feldt T (2013) Job characteristics, recovery experiences and occupational well-being: testing cross-lagged relationships across 1 year. Stress Health 29(5):369–382

    Article  Google Scholar 

  • Klaghofer R, Stamm M, Buddeberg C, Bauer G, Hämmig O, Knecht M, Buddeberg-Fischer B (2011) Development of life satisfaction in young physicians: results of the prospective SwissMedCareer Study. Int Arch Occup Environ Health 84(2):159–166

    Article  Google Scholar 

  • Lacy BE, Chan JL (2018) Physician burnout: the hidden health care crisis. Clin Gastroenterol H 16(3):311–317

    Article  Google Scholar 

  • Lancet (2014) Violence against doctors: Why China? Why now? What next? Lancet 383(9922):1013

    Article  Google Scholar 

  • Lancet (2019) Physician burnout: a global crisis. Lancet 394(10193):93

    Article  Google Scholar 

  • Lapa T, Carvalho S, Viana J, Ferreira PL, Pinto-Gouveia J, Cabete AB (2018) Development and evaluation of a global burnout index derived from the use of the Copenhagen burnout inventory in Portuguese physicians. Acta Med Port 31(10):534–541

    Article  Google Scholar 

  • Lee KH, Choo SW, Hyun SS (2016) Effects of recovery experiences on hotel employees' subjective well-being. Int J Hosp Manag 52:1–12

    Article  Google Scholar 

  • Li L (2007) Social medicine. People’s Medical Publishing House, Beijing

    Google Scholar 

  • Liu Y (2014) Violence against doctors in China. Lancet 384(9945):745

    Article  Google Scholar 

  • Liu H, Li S, Feldman MW (2013) Gender in marriage and life satisfaction under gender imbalance in China: the role of intergenerational support and SES. Soc Indic Res 114(3):915–933

    Article  Google Scholar 

  • Magnavita N, Fileni A, Bergamaschi A (2009) Satisfaction at work among radiologists. Radiol Med 114(8):1330–1344

    Article  CAS  Google Scholar 

  • Maslach C, Jackson SE (1981) The measurement of experienced burnout. J Occup Behav 2:99–113

    Article  Google Scholar 

  • Maslach C, Leiter MP (2016) Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry 15(2):103–111

    Article  Google Scholar 

  • Maslach C, Jackson SE, Leiter MP (1996) Maslach Burnout Inventory manual, 3rd edn. Consulting Psychologists Press, Palo Alto, CA

    Google Scholar 

  • Meijman TF, Mulder G (1998) Psychological aspects of workload. In: Drenth PJD, Thierry H, de Wolff CJ (eds) Handbook of work and organizational psychology. Psychology Press: Hove, vol 2, pp 5–33

  • Newman DB, Tay L, Diener E (2014) Leisure and subjective well-being: a model of psychological mechanisms as mediating factors. J Happiness Stud 15(3):555–578

    Article  Google Scholar 

  • Ngoo YT, Tey NP, Tan EC (2015) Determinants of life satisfaction in Asia. Soc Indic Res 124(1):141–156

    Article  Google Scholar 

  • Pavot W, Diener E, Colvin CR, Sandvik E (1991) Further validation of the satisfaction with life scale: evidence for the cross-method convergence of well-being measures. J Pers Assess 57:149–161

    Article  CAS  Google Scholar 

  • Peiro A (2006) Happiness, satisfaction and socio-economic conditions: some international evidence. J Soc Econ 35:348–365

    Article  Google Scholar 

  • Plouffe RA, Tremblay PF (2017) The effect of income on life satisfaction: does religiosity play a role? Pers Individ Dif 109:67–71

    Article  Google Scholar 

  • Poulsen MG, Poulsen AA, Khan A, Poulsen EE, Khan SR (2015a) Recovery experience and burnout in cancer workers in Queensland. Eur J Oncol Nurs 19(1):23–28

    Article  Google Scholar 

  • Poulsen AA, Sharpley CF, Baumann KC, Henderson J, Poulsen MG (2015b) Evaluation of the effect of a 1-day interventional workshop on recovery from job stress for radiation therapists and oncology nurses: a randomised trial. J Med Imaging Radiat Oncol 59(4):491–498

    Article  Google Scholar 

  • Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40(3):879–891

    Article  Google Scholar 

  • Ragsdale JM, Beehr TA (2016) A rigorous test of a model of employees' resource recovery mechanisms during a weekend. J Organ Behav 37(6):911–932

    Article  Google Scholar 

  • Rook JW, Zijlstra FRH (2006) The contribution of various types of activities to recovery. Eur J Work Organ Psy 15:218–240

    Article  Google Scholar 

  • Rotenstein LS, Torre M, Ramos MA, Rosales RC, Guille C, Sen S, Mata DA (2018) Prevalence of burnout among physicians: a systematic review. JAMA 320(11):1131–1150

    Article  Google Scholar 

  • Schwerdtfeger A, Gaisbachgrabner K, Traunmüller C (2017) Life satisfaction and hemodynamic reactivity to mental stress. Ann Behav Med 51(3):464–469

    Article  Google Scholar 

  • Selim S (2008) Life satisfaction and happiness in Turkey. Soc Indic Res 88(3):531–562

    Article  Google Scholar 

  • Shanafelt TD, Mungo M, Schmitgen J, Storz KA, Reeves D, Hayes SN, Sloan JA, Swensen SJ, Buskirk SJ (2016) Longitudinal study evaluating the association between physician burnout and changes in professional work effort. Mayo Clin Proc 91:422–431

    Article  Google Scholar 

  • Shin DC, Johnson DM (1978) Avowed happiness as an overall assessment of the quality of life. Soc Indic Res 5:475–492

    Article  Google Scholar 

  • Siahpush M, Spittal M, Singh GK (2008) Happiness and life satisfaction prospectively predict self-rated health, physical health, and the presence of limiting, long-term health conditions. Am J Health Promot 23:18–26

    Article  Google Scholar 

  • Sianoja M, Syrek CJ, de Bloom J, Korpela K, Kinnunen U (2018) Enhancing daily well-being at work through lunchtime park walks and relaxation exercises: recovery experiences as mediators. J Occup Health Psychol 23(3):428–442

    Article  Google Scholar 

  • Smyth JM, Zawadzki MJ, Juth V, Sciamanna CN (2017) Global life satisfaction predicts ambulatory affect, stress, and cortisol in daily life in working adults. J Behav Med 40(2):320–331

    Article  Google Scholar 

  • Sonnentag S (2018) The recovery paradox: Portraying the complex interplay between job stressors, lack of recovery, and poor well-being. Res Organ Behav 38:169–185

    Google Scholar 

  • Sonnentag S, Fritz C (2007) The recovery experience questionnaire: development and validation of a measure for assessing recuperation and unwinding from work. J Occup Health Psych 12(3):204–221

    Article  Google Scholar 

  • Sonnentag S, Fritz C (2015) Recovery from job stress: the stressor-detachment model as an integrative framework. J Organ Behav 36:S72–S103

    Article  Google Scholar 

  • Sonnentag S, Kuttler I, Fritz C (2010) Job stressors, emotional exhaustion, and need for recovery: a multi-source study on the benefits of psychological detachment. J Vocat Behav 76:355–365

    Article  Google Scholar 

  • Tak HJ, Curlin FA, Yoon JD (2017) Association of intrinsic motivating factors and markers of physician well-being: a national physician survey. J Gen Intern Med 32(7):739–746

    Article  Google Scholar 

  • Tian Y, Hua LJ, Chao WM (2008) Chinese doctors' salaries. Lancet 371:1576–1577

    Article  Google Scholar 

  • Tyssen R, Hem E, Gude T, Grønvold NT, Ekeberg O, Vaglum P (2009) Lower life satisfaction in physicians compared with a general population sample: a 10-year longitudinal, nationwide study of course and predictors. Soc Psychiatry Psychiatr Epidemiol 44(1):47–54

    Article  Google Scholar 

  • Uchmanowicz I, Manulik S, Lomper K, Rozensztrauch A, Zborowska A, Kolasińska J, Rosińczuk J (2019) Life satisfaction, job satisfaction, life orientation and occupational burnout among nurses and midwives in medical institutions in Poland: a cross-sectional study. BMJ Open 9(1):e024296

    Article  Google Scholar 

  • Ugwu FO, Ugwu C, Njemanze VC, Nwosu I (2019) Family cohesion and family size moderating burnout and recovery connection. Occup Med (Lond) 69(1):28–34

    Article  CAS  Google Scholar 

  • Umberson D (1992) Gender, marital status and the social control of health behavior. Soc Sci Med 34:907–917

    Article  CAS  Google Scholar 

  • Wallace JE, Lemaire JB, Ghali WA (2009) Physician wellness: a missing quality indicator. Lancet 374(9702):1714–1721

    Article  Google Scholar 

  • Wang Y, Liu L, Wang J, Wang L (2012) Work-family conflict and burnout among Chinese doctors: the mediating role of psychological capital. J Occup Health 54(3):232–240

    Article  Google Scholar 

  • West CP, Dyrbye LN, Erwin PJ, Shanafelt TD (2016) Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet 388(10057):2272–2281

    Article  Google Scholar 

  • Williams ES, Manwell LB, Konrad TR, Linzer M (2007) The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study. Health Care Manage Rev 32(3):203–212

    Article  Google Scholar 

  • World Health Organization (2019) Burn-out an “occupational phenomenon”: International Classification of Disease. Retrieved from https://www.who.int/mental_health/evidence/burn-out/en/.

  • Wu H, Liu L, Wang Y, Gao F, Zhao X, Wang L (2013) Factors associated with burnout among Chinese hospital doctors: a cross-sectional study. BMC Public Health 13:786

    Article  Google Scholar 

  • Wu LX, Qi L, Li Y (2016) Challenges faced by young Chinese doctors. Lancet 387(10028):1617

    Article  Google Scholar 

  • Xanthopoulou D, Sanz-Vergel AI, Demerouti E (2014) Reconsidering the daily recovery process: new insights and related methodological challenges. In: Leka S, Sinclair RR (eds) Contemporary occupational health psychology: Global perspectives on research and action, 1st edn. Wiley, Chichester, vol 3, pp 51–67

  • Xu W (2014) Violence against doctors in China. Lancet 384(9945):745

    Article  Google Scholar 

  • Xu J, Roberts RE (2010) The power of positive emotions: It’s a matter of life or death—subjective well-being and longevity over 28 years in a general population. Health Psychol 29:9–19

    Article  CAS  Google Scholar 

  • Yu P, Yang X, Qi Z (2017) Evaluation of doctors in China: imperative changes are required. Lancet 390(10090):121

    Article  Google Scholar 

  • Zhao D, Zhang Z (2019) Changes in public trust in physicians: empirical evidence from China. Front Med 13(4):504–510

    Article  Google Scholar 

  • Zheng H, Shao H, Zhou Y (2018) Burnout among Chinese adult reconstructive surgeons: incidence, risk factors, and relationship with intraoperative irritability. J Arthroplasty 33(4):1253–1257

    Article  Google Scholar 

  • Zijlstra FR, Cropley M, Rydstedt LW (2014) From recovery to regulation: an attempt to reconceptualize ‘recovery from work’. Stress Health 30(3):244–252

    Article  CAS  Google Scholar 

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Acknowledgements

The authors would like to express their sincere gratitude to Professor Sonnentag and Professor Fritz who authorize the Recovery Experience Questionnaire and all the physicians who participated in this survey. The authors are also very grateful to the editors and the reviewers for their valuable comments and constructive suggestions that would greatly improve the quality of this paper.

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Authors and Affiliations

  1. Department of English, School of Fundamental Sciences, China Medical University, Shenyang, 110122, People’s Republic of China

    Yang Song

  2. Department of Social Medicine, School of Public Health, China Medical University, Shenyang, 110122, People’s Republic of China

    Yajing Jia, Jialin Ding & Xiaoshi Yang

  3. Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, 17033, USA

    Kristin Sznajder

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  1. Yang Song
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Correspondence to Xiaoshi Yang.

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The procedures followed were approved by the administrative departments and corresponding department directors of the selected hospitals and conforming to the ethical standards of the institutional and national Committee on Human Experimentation.

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Song, Y., Jia, Y., Sznajder, K. et al. Recovery experiences mediate the effect of burnout on life satisfaction among Chinese physicians: a structural equation modeling analysis. Int Arch Occup Environ Health 94, 31–41 (2021). https://doi.org/10.1007/s00420-020-01554-1

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