The role of self-compassion and compassion toward others in burnout syndrome in a sample of medical students

Abstract

Burnout produces negative effects on academic performance, and, in turn, feelings of inefficiency that are detrimental to students' psychosocial well-being. The aim of this research is to determine the effects that self-compassion and compassion toward others have on various burnout dimensions in a sample of medical students. A total of 235 medical students (61.7% women) aged between 16 and 32 years old (M = 19.82; SD = 2.37) belonging to a Colombian university participated. A cluster analysis to segment the population according to burnout was carried out along with nonparametric contrasts to identify differences in the levels of self-compassion and compassion toward others between each profile. A series of regression analyses was designed to find out how each type of compassion was associated with burnout on each profile. The cluster analysis allowed us to identify three profiles. The low-involvement profile (n = 51) is characterized by low depersonalization, intermediate levels of emotional exhaustion and personal accomplishment and exhibits low levels of self-compassion and compassion fatigue compared with the other profiles. The positive-adaptation profile (n = 104) is characterized by low depersonalization levels, intermediate degrees of emotional exhaustion and high levels of personal accomplishment and exhibits the highest levels of self-compassion and compassion fatigue compared with the other profiles. The high-demand profile (n = 104) is characterized by intermediate depersonalization levels, medium–high levels of emotional exhaustion and high levels of personal accomplishment and exhibits intermediate levels of self-compassion and low levels of compassion fatigue. Establishing profiles based on burnout allows students to be segmented and for precise knowledge to be acquired about the effects that both types of compassion have on the dimensions of burnout.

Keywords

burnout / cluster analysis / compassion fatigue / compassion toward others / medical students / self-compassion

References

[1] Beaumont, E., Durkin, M., Hollins, C. J., & Carson, J. (2016). Measuring relationships between self-compassion, compassion fatigue, burnout and well-being in student counsellors and student cognitive behavioral psychotherapists: A quantitative survey. Counselling and Psychotherapy Research, 16(1), 15–23.

[2] Bianchi, R., Schonfeld, I. S., & Laurent, E. (2015). Is burnout separable from depression in cluster analysis? A longitudinal study. Social Psychiatry and Psychiatric Epidemiology, 50, 1005–1011.

[3] Boni, R. A. D. S., Paiva, C. E., De Oliveira, M. A., Lucchetti, G., Fregnani, J. H. T. G., & Paiva, B. S. R. (2018). Burnout among medical students during the first years of undergraduate school: Prevalence and associated factors. PLoS One, 13(3), e0191746.

[4] Borgen, F. H., & Barnett, D. C. (1987). Applying cluster analysis in counseling psychology research. Journal of Counseling Psychology, 34(4), 456–468.

[5] Caballero, C., Hederich, C., & Palacio, J. (2010). El burnout académico: delimitación del síndrome y factores asociados a su aparición. Revista Latinoamericana Psicología, 42(1), 131–146.

[6] Clarkson, M., Heads, G., Hodgson, D., & Probst, H. (2019). Does the intervention of mindfulness reduce levels of burnout and compassion fatigue and increase resilience in pre-registration students? A pilot study. Radiography, 25(1), 4–9.

[7] Clatworthy, J., Buick, D., Hankins, M., Weinman, J., & Horne, R. (2005). The use and reporting of cluster analysis in health psychology: A review. British Journal of Health Psychology, 10(3), 329–358.

[8] Coaston, S. C. (2017). Self-care through self-compassion: A balm for burnout. Professional Counselor, 7(3), 285–297.

[9] Córdoba, L., Tamayo, J. A., González, M. A., Martínez, M. I., Rosales, A., & Barbato, S. H. (2012). Adaptation and validation of the Maslach burnout inventory-human services survey in Cali, Colombia. Colombia Médica, 42(3), 286–293.

[10] Cortina, J. M. (1993). What is coefficient alpha? An examination of theory and applications. Journal of applied psychology, 78(1), 98–104.

[11] Dahlin, M. E., & Runeson, B. (2007). Burnout and psychiatric morbidity among medical students entering clinical training: A three year prospective questionnaire and interview-based study. BMC Medical Education, 7, 1–8.

[12] Duarte, J., & Pinto-Gouveia, J. (2017). The role of psychological factors in oncology nurses' burnout and compassion fatigue symptoms. European Journal of Oncology Nursing, 28, 114–121.

[13] Elices, M., Carmona, C., Pascual, J. C., Feliu-Soler, A., Martin-Blanco, A., & Soler, J. (2017). Compassion and self-compassion: Construct and measurement. Mindfulness & Compassion, 2(1), 34–40.

[14] Erschens, R., Keifenheim, K. E., Herrmann-Werner, A., Loda, T., Schwille-Kiuntke, J., Bugaj, T. J., Nikendei, C., Huhn, D., Zipfel, S., & Junne, F. (2019). Professional burnout among medical students: Systematic literature review and meta-analysis. Medical Teacher, 41(2), 172–183.

[15] Evans, W. D. (2016). Social marketing research for global public health: Methods and technologies. Oxford University Press.

[16] Faye-Dumanget, C., Carré, J., Le Borgne, M., & Boudo Ukha, P. A. H. (2017). French validation of the Maslach burnout inventory-student survey (MBI-SS). Journal of Evaluation in Clinical Practice, 23(6), 1247–1251.

[17] Fernández-Suárez, I., García-González, M. A., Torrano, F., & García-González, G. (2021). Study of the prevalence of burnout in university professors in the period 2005–2020. Education Research International, 7810659, 1–10.

[18] Figley, C. R. (Ed.). (1995). Compassion fatigue: Coping with secondary traumatic stress disorder. Brunner/Mazel.

[19] Figley, C. R. (Ed.). (2002). Treating compassion fatigue. Brunner/Routledge.

[20] Frajerman, A., Morvan, Y., Krebs, M. O., Gorwood, P., & Chaumette, B. (2019). Burnout in medical students before residency: A systematic review and meta-analysis. European Psychiatry, 55, 36–42.

[21] Fraley, C., & Raftery, A. E. (1998). How many clusters? Which clustering method? Answers via model-based cluster analysis. The Computer Journal, 41(8), 578–588.

[22] Freudenberger, H. J. (1974). Staff burn-out. Journal of Social Issues, 30(1), 159–165.

[23] Galiana, L., Sansó, N., Muñoz-Martínez, I., Vidal-Blanco, G., Oliver, A., & Larkin, P. J. (2022). Palliative care professionals' inner life: Exploring the mediating role of self-compassion in the prediction of compassion satisfaction, compassion f atigue, burnout and wellbeing. Journal of Pain and Symptom Management, 63(1), 112–123.

[24] Gerber, Z., & Anaki, D. (2021). The role of self-compassion, concern for others, and basic psychological needs in the reduction of caregiving burnout. Mindfulness, 12, 741–750.

[25] Gilbert, P. (2009). The compassionate mind. Constable.

[26] Gilbert, P., Catarino, F., Duarte, C., Matos, M., Kolts, R., Stubbs, J., Ceresatto, L., Duarte, J., Pinto-Gouveia, J., & Basran, J. (2017). The development of compassionate engagement and action scales for self and others. Journal of Compassionate Health Care, 4(1), 1–24.

[27] Hardy, A. (1996). On the number of clusters. Computational Statistics & Data Analysis, 23(1), 83–96.

[28] Harr, C. (2013). Promoting workplace health by diminishing the negative impact of compassion fatigue and increasing compassion satisfaction. Social Work and Christianity, 40(1), 71–88.

[29] Hashem, Z., & Zeinoun, P. (2020). Self-compassion explains less burnout among healthcare professionals. Mindfulness, 11, 2542–2551.

[30] Iacovides, A., Fountoulakis, K. N., Moysidou, C., & Ierodiakonou, C. (1999). Burnout in nursing staff: Is there a relationship between depression and burnout? The International Journal of Psychiatry in Medicine, 29(4), 421–433.

[31] Jiménez-Gómez, L., Yela, J. R., Crego, A., Melero-Ventola, A. R., & Gómez-Martínez, M. Á. (2022). Effectiveness of the mindfulness-based stress reduction (MBSR) vs. the mindful self-compassion (MSC) programs in clinical and health psychologist trainees. Mindfulness, 13(3), 584–599.

[32] Kemper, K. J., McClafferty, H., Wilson, P. M., Serwint, J. R., Batra, M., Mahan, J. D., & Pediatric Resident Burnout-Resilience Study Consortium. (2019). Do mindfulness and self-compassion predict burnout in pediatric residents? Academic Medicine, 94(6), 876–884.

[33] Klein, C. J., Riggenbach-Hays, J. J., Sollenberger, L. M., Harney, D. M., & McGarvey, J. S. (2018). Quality of life and compassion satisfaction in clinicians: A pilot intervention study for reducing compassion fatigue. American Journal of Hospice and Palliative Medicine®, 35(6), 882–888.

[34] Kocalevent, R., Pinnschmidt, H., Selch, S., Nehls, S., Meyer, J., Boczor, S., Scherer, M., & van den Bussche, H. (2020). Burnout is associated with work-family conflict and gratification crisis among German resident physicians. BMC Medical Education, 20(1), 1–8.

[35] Kruskal, W. H., & Wallis, W. A. (1952). Use of ranks in one-criterion variance analysis. Journal of the American Statistical Association, 47(260), 583–621.

[36] Kusurkar, R. A., van der Burgt, S. M., Isik, U., Mak-van der Vossen, M., Wilschut, J., Wouters, A., & Koster, A. S. (2021). Burnout and engagement among PhD students in medicine: The BEeP study. Perspectives on Medical Education, 10, 110–117.

[37] Lyndon, M. P., Henning, M. A., Alyami, H., Krishna, S., Zeng, I., Yu, T. C., & Hill, A. G. (2017). Burnout, quality of life, motivation, and academic achievement among medical students: A person-oriented approach. Perspectives on Medical Education, 6(2), 108–114.

[38] Madigan, D. J., & Curran, T. (2021). Does burnout affect academic achievement? A meta-analysis of over 100,000 students. Educational Psychology Review, 33(2), 387–405.

[39] Martínez, J. P., Méndez, I., Ruiz-Esteban, C., Fernández-Sogorb, A., & García-Fernández, J. M. (2020). Profiles of burnout, coping strategies and depressive symptomatology. Frontiers in Psychology, 11, 591.

[40] Martínez-Rubio, D., Martínez-Brotons, C., Monreal-Bartolomé, A., Barceló-Soler, A., Campos, D., Pérez-Aranda, A., Colomer-Carbonell, A., Cervera-Torres, S., Solé, S., Moreno, Y., & Montero-Marín, J. (2021). Protective role of mindfulness, self-compassion and psychological flexibility on the burnout subtypes among psychology and nursing undergraduate students. Journal of Advanced Nursing, 77(8), 3398–3411.

[41] Maslach, C. (1978). The client role in staff burn-out. Journal of Social Issues, 34(4), 111–124.

[42] Maslach, C. (1997). Burnout in health professionals. In Cambridge handbook of psychology, health and medicine (pp. 427–430). Cambridge University Press.

[43] Maslach, C., & Jackson, S. E. (1981). The Maslach burnout inventory. Consulting Psychologists Press.

[44] Maslach, C., Jackson, S. E., & Leiter, M. P. (1997). Maslach burnout inventory. Scarecrow Education.

[45] Maslach, C., & Leiter, M. P. (2016). Burnout. In Stress: Concepts, cognition, emotion, and behavior (pp. 351–357). Academic Press.

[46] Maslach, C., & Schaufeli, W. B. (2018). Historical and conceptual development of burnout. In Professional burnout: Recent developments in theory and research (pp. 1–16). CRC Press.

[47] McCann, I. L., & Pearlmann, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3, 131–149.

[48] McLachlan, G. J. (1992). Cluster analysis and related techniques in medical research. Statistical Methods in Medical Research, 1(1), 27–48.

[49] Michalec, B., Diefenbeck, C., & Mahoney, M. (2013). The calm before the storm? Burnout and compassion fatigue among undergraduate nursing students. Nurse Education Today, 33(4), 314–320.

[50] Montero-Marin, J., Zubiaga, F., & Cereceda, M. (2020). Correction: Burnout subtypes and absence of self-compassion in primary healthcare professionals: A cross-sectional study. PLoS One, 15(4), e0231370.

[51] Navarro-González, D., Ayechu-Díaz, A., & Huarte-Labiano, I. (2015). Prevalencia del síndrome del burnout y factores asociados a dicho síndrome en los profesionales sanitarios de Atención Primaria. SEMERGEN-Medicina de Familia, 41(4), 191–198.

[52] Neff, K. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85–101.

[53] Nunnally, B., & Bernstein, I. R. (1994). Psychometric theory. Oxford University.

[54] Ondrejková, N., & Halamová, J. (2022). Prevalence of compassion fatigue among helping professions and relationship to compassion for others, self-compassion and self-criticism. Health & Social Care in the Community, 30(5), 1680–1694.

[55] Ortega-Campos, E., Vargas-Román, K., Velando-Soriano, A., Suleiman-Martos, N., Cañadas-de la Fuente, G. A., Albendín-García, L., & Gómez-Urquiza, J. L. (2019). Compassion fatigue, compassion satisfaction, and burnout in oncology nurses: A systematic review and meta-analysis. Sustainability, 12(1), 72.

[56] Oviedo, H. C., & Campo-Arias, A. (2005). Aproximación al uso del coeficiente alfa de Cronbach. Revista Colombiana de Psiquiatría, 34(4), 572–580.

[57] Parola, V., Coelho, A., Cardoso, D., Sandgren, A., & Apóstolo, J. (2017). Prevalence of burnout in health professionals working in palliative care: A systematic review. JBI Evidence Synthesis, 15(7), 1905–1933.

[58] Pereira, A. T., Brito, M. J., Cabaços, C., Carneiro, M., Carvalho, F., Manão, A., Araújo, A., Pereira, D., & Macedo, A. (2022). The protective role of self-compassion in the relationship between perfectionism and burnout in Portuguese medicine and dentistry students. International Journal of Environmental Research and Public Health, 19(5), 2740.

[59] Potard, C., & Landais, C. (2021). The use of cluster analysis to identify different burnout profiles among nurses and care assistants for older adults. Geriatric Nursing, 42(5), 1135–1142.

[60] Raab, K. (2014). Mindfulness, self-compassion, and empathy among health care professionals: A review of the literature. Journal of Health Care Chaplaincy, 20(3), 95–108.

[61] Rapkin, B. D., & Luke, D. A. (1993). Cluster analysis in community research: Epistemology and practice. American Journal of Community Psychology, 21(2), 247–277.

[62] Richardson, M., Abraham, C., & Bond, R. (2012). Psychological correlates of university students' academic performance: A systematic review and meta-analysis. Psychological Bulletin, 138(2), 353–387.

[63] Román-Calderón, J. P., Krikorian, A., Ruiz, E., Romero, A. M., & Lemos, M. (2022). Compassion and self-compassion: Counterfactors of burnout in medical students and physicians. Psychological Reports.

[64] Ruiz-Fernández, M. D., Ramos-Pichardo, J. D., Ibáñez-Masero, O., Cabrera-Troya, J., Carmona-Rega, M. I., & Ortega-Galán, Á. M. (2020). Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the COVID-19 health crisis in Spain. Journal of Clinical Nursing, 29(21–22), 4321–4330.

[65] Spickard, A., Jr., Gabbe, S. G., & Christensen, J. F. (2002). Mid-career burnout in generalist and specialist physicians. Jama, 288(12), 1447–1450.

[66] Tucker, T., Bouvette, M., Daly, S., & Grassau, P. (2017). Finding the sweet spot: Developing, implementing and evaluating a burn out and compassion fatigue intervention for third year medical trainees. Evaluation and Program Planning, 65, 106–112.

[67] Vuik, S. I., Mayer, E., & Darzi, A. (2016). A quantitative evidence base for population health: Applying utilization-based cluster analysis to segment a patient population. Population Health Metrics, 14(1), 1–9.

[68] Wang, M., Guan, H., Li, Y., Xing, C., & Rui, B. (2019). Academic burnout and professional self-concept of nursing students: A cross-sectional study. Nurse Education Today, 77, 27–31.

[69] Zhang, Y. Y., Han, W. L., Qin, W., Yin, H. X., Zhang, C. F., Kong, C., & Wang, Y. L. (2018). Extent of compassion satisfaction, compassion fatigue and burnout in nursing: A meta-analysis. Journal of Nursing Management, 26(7), 810–819.

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