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Research Questions

  1. How is burnout defined and conceptualized in relation to other related concepts?
  2. What is the prevalence and incidence of burnout in U.S. health care providers?
  3. Which risk factors can reliably predict burnout in U.S. health care providers?
  4. What are the characteristics and contexts of successful burnout interventions applied to military health care professionals?
  5. Which burnout interventions have been evaluated in research studies?

The provision of mental health treatment is affected by the strength, health, and well-being of the health care workforce. Health care provider burnout—defined as chronic occupational-related stress, emotional exhaustion, disengagement, depersonalization, anhedonia, and hopelessness—poses a critical threat to mental and behavioral health care. This series of literature reviews addresses several aspects of burnout. Of over 14,000 screened citations, 469 studies met inclusion criteria. The authors document what is known about the concept of burnout, show burnout prevalence in health care facilities, evaluate the presence and absence of evidence for suggested risk factors of burnout, outline approaches for addressing burnout among military health care providers, and provide an overview of organizational interventions that have been suggested to prevent or mitigate workforce burnout.

Key Findings

The definition of burnout remains consistent, but prevalence varies widely

  • Although there have been significant developments and expansions of initial conceptual models of burnout, the preeminent model has remained fairly consistent.
  • There is wide variation in prevalence estimates of burnout among U.S.-based health care providers. This variation might reflect reality, or it might be the byproduct of using a variety of different measures to assess burnout.

Workplace factors have the greatest associations with burnout

  • Workplace factors—such as workload, work/life balance, job autonomy, and perceived support from leadership—show associations with risk for burnout.
  • Mental health problems (such as anxiety) and health risks (such as physical health problems and lack of sleep) might also be associated with risk of burnout, although it is unclear whether burnout exacerbates health issues or vice versa.
  • Factors such as exercise, perceptions of control, and social support appear to have a protective effect.

The effects of interventions to prevent burnout varied widely

  • The evidence base on interventions to prevent or mitigate burnout is vast, and numerous approaches have been suggested. However, it is significantly more limited within military contexts.

This research was sponsored by the Psychological Health Center of Excellence and conducted within the Forces and Resources Policy Center of the RAND National Security Research Division (NSRD).

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