Document Type : Original Article

Authors

1 Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

2 Undergraduate Student, Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background and aims: The aim of the current study was to assess the construct validity of the Persian version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) among dentists and burnout rate and its related factors among general dentists in Shiraz during the coronavirus disease-19 (COVID-19) pandemic.
 
Methods: This cross-sectional study was performed among 385 general dentists in Shiraz. Multiple stage sampling was performed for sample selection. In addition to a questionnaire containing demographic and job-related characteristics, the burnout rate was assessed using the MBI-HSS. The MBI-HSS consists of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) dimensions. The Pearson correlation coefficient, independent t-test, and multiple regression analysis were applied for statistical analysis. Finally, confirmatory factor analysis (CFA) was used to test the model’s fitness.
 
Results: A total of 385 dentists participated in the study, including 213 (55.3%) males and 172 (44.7%) females with a mean age of 32.89 ( ± 6.29) years. The mean years of activity, the number of patients per week, and working hours per week were 9.15 years, 31.55 patients, and 39.50 hours, respectively. Most dentists showed low to moderate burnout in terms of EE (86%) and moderate to high burnout with regard to DP (90.9%) and PA (96.6%). Regarding the association between demographic factors and burnout dimensions, EE had a significant association with gender (B = 0.26, P < 0.001), age (B = -0.04, P = 0.044), marital status (B = -0.42, P < 0.001), and years of practice (B = -0.26, P < 0.001). Further, DP was significantly associated with gender (B = 0.13, P = 0.043), marital status (B = -0.32, P < 0.001), working hours per week (B = 0.01, P = 0.047), and the number of working clinics (B = -0.17, P = 0.047). In addition, PA represented a significant association with marital status (B = -0.34, P < 0.001). The three-dimensional model showed appropriate fitness in the current study.
 
Conclusion: Most general dentists in Shiraz demonstrated low to moderate burnout regarding EE, most dentists had moderate to high burnout regarding DP and PA. Accordingly, gender, marital status, years of practice, the number of working clinics, and working hours should be considered burnout-associated factors by policymakers.

Keywords

1. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52:397-422. doi: 10.1146/annurev. psych.52.1.397. 
2. Torabi Parizi M, Eskandarizadeh A, Karimi Afshar M, Asadi Shekaari M, Jangjoo A. The frequency of job burnout among dentists of Kerman city. Health and Development Journal. 2015;3(4):333-40. [Persian]. 
3. Gorter RC, Eijkman MA, Hoogstraten J. Burnout and health among Dutch dentists. Eur J Oral Sci. 2000;108(4):261-7. doi: 10.1034/j.1600-0722.2000.108004261.x. 
4. Varela-Centelles PI, Fontao Valcárcel LF, Martínez González AM, Pita Babío A, Valín Liz MC. [Professional burnout in dentists and stomatologists of the Galician Health Service]. Aten Primaria. 2005;35(6):301-5. doi: 10.1157/13073416. 
5. Myers HL, Myers LB. ‘It’s difficult being a dentist’: stress and health in the general dental practitioner. Br Dent J. 2004;197(2):89-93. doi: 10.1038/sj.bdj.4811476. 
6. Theresa RM, Safira L, Nugrohowati N. Burnout in health workers in Pasar Minggu Hospital: associated risk factors during the COVID-19 pandemic. Ann Romanian Soc Cell Biol. 2021;25(1):4329-35. 
7. Ranka MS, Ranka SR. Survey of mental health of dentists in the COVID-19 pandemic in the UK. J Int Soc Prev Community Dent. 2021;11(1):104-8. doi: 10.4103/jispcd.JISPCD_401_20. 
8. Al-Rawi NH, Yacoub A, Zaouali A, Salloum L, Afash N, Shazli OA, et al. Prevalence of burnout among dental students during COVID-19 lockdown in UAE. J Contemp Dent Pract. 2021;22(5):538-44. 
9. Humphris G, Knights J, Beaton L, Araujo M, Yuan S, Clarkson J, et al. Exploring the effect of the COVID-19 pandemic on the dental team: preparedness, psychological impacts and emotional reactions. Front Oral Health. 2021;2:669752. doi: 10.3389/froh.2021.669752. 
10. Mahendran K, Patel S, Sproat C. Psychosocial effects of the COVID-19 pandemic on staff in a dental teaching hospital. Br Dent J. 2020;229(2):127-32. doi: 10.1038/s41415-020-1792- 3. 
11. West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-29. doi: 10.1111/joim.12752. 
12. Singh P, Aulak DS, Mangat SS, Aulak MS. Systematic review: factors contributing to burnout in dentistry. Occup Med (Lond). 2016;66(1):27-31. doi: 10.1093/occmed/kqv119. 
13. Jin MU, Jeong SH, Kim EK, Choi YH, Song KB. Burnout and its related factors in Korean dentists. Int Dent J. 2015;65(1):22- 31. doi: 10.1111/idj.12142. 
14. Divaris K, Polychronopoulou A, Taoufik K, Katsaros C, Eliades T. Stress and burnout in postgraduate dental education. Eur J Dent Educ. 2012;16(1):35-42. doi: 10.1111/j.1600- 0579.2011.00715.x. 
15. Bastami E, Sayehmiri K, Bastami T, Cheraghizadegan B. Prevalence of burnout in Iran: a systematic review and meta-analysis. J Health Saf Work. 2020;10(3):39-45. 
16. Basirat M, Kia SJ, Malek Shoar M, Safarieh M, Javanshir B. Prevalence of occupational burnout and its related factors among dentists in Semnan, Iran. J Occup Hyg Eng. 2019;6(2):45-51. doi: 10.52547/johe.6.2.45. [Persian]. 
17. Bolbolian M, Mirkeshavarz M, Sefidi F, Mir A. The prevalence of burnout syndrome among general dentists in Qazvin, Iran in 2017. J Craniomaxillofacial Res. 2019;5(4):148-56. 
18. Azizi L, Feyzabadi Z, Salehi M. Exploratory and confirmatory factor analysis of Maslach Burnout Inventory among Tehran University employees. Psychol Stud. 2008;4(3):73-92. 
19. Maslach C, Jackson SE, Schwab RL. MBI Educators Survey. The Maslach Burnout Inventory; 1986. 
20. Lheureux F, Truchot D, Borteyrou X, Rascle N. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS): factor structure, wording effect and psychometric qualities of known problematic items. Trav Hum. 2017;80(2):161-86. 
21. Moalemi S, Kavosi Z, Beygi N, Deghan A, Karimi A, Parvizi MM. Evaluation of the Persian version of Maslach Burnout Inventory-Human Services Survey among Iranian nurses: validity and reliability. Galen Med J. 2018;7:e995. doi: 10.22086/gmj.v0i0.995. 
22. Schaufeli WB, Bakker AB, Hoogduin K, Schaap C, Kladler A. On the clinical validity of the Maslach Burnout Inventory and the Burnout Measure. Psychol Health. 2001;16(5):565-82. doi: 10.1080/08870440108405527. 
23. Maslach C, Jackson SE, Leiter MP. MBI: Maslach Burnout Inventory. Sunnyvale, CA: CPP, Incorporated; 1996. 
24. Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory. Scarecrow Education; 1997. 
25. Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling. 1999;6(1):1-55. doi: 10.1080/10705519909540118. 
26. Kline RB. Principles and Practice of Structural Equation Modeling. Guilford Publications; 2015.