Relation of residents' knowledge and attitudes about defensive medicine with levels of work related strain and burn out

ABSTRACT Introduction and Aim: The present study was conducted in order to reveal the factors which influence the work-related strain and burnout levels of the residents who work at the surgical and internal medical departments of Dicle University Medical Faculty and their knowledge and attitudes about defensive medicine applications. Material and Methods: The sample of this descriptive cross sectional study was designed with proportionate stratified sampling method. The questionnaire including sociodemographic data form, Defensive Medicine Applications Attitude Scale, Work-related Strain Inventory and Maslach Burnout Inventory was applied to 200 physcians. The analyis of the data was carried out by using SPSS 18 (Statistical Package for the Social Sciences) . Results: Of all the participants, 70,5 % were male, 29,5 % were female and 56 % were married. The mean age was 29,41. The frequency of positive and negative defensive medicine was 98 % and 92 % respectively. Defensive medicine points were significantly high among the ones working at surgical departments, the ones in the first two years of their assistantship, the ones sued for malpractice and smokers. The level of work-based strain was significantly high in the ones working at surgical departments, the ones on call for eight times or more in a month, the ones sued for malpractice, smokers and alcohol users. Average points which the physicians got from Maslach Burnout Inventory were determined as 31,57± 11,67 for emotional exhaustion, 11,75± 6,49 for desensitization and 29,46± 7,72 for personal accomplishment. Conclusion: Physicians apply defensive medicine in the high rate in this study. The physicians were experiencing high burnout in the sub-dimensions of emotional exhaustion and personal accomplisment whereas they were experiencing medium level burnout in the sub-dimension of desensitization. It was seen that the levels of work-related strain and burnout were higher for the ones who apply defensive medicine more than the others. There is a limited number of studies about this topic. More comprehensive researches from different centers are needed. We are of the opinion that new legislative regulations, media's being more sensitive, giving educations about legal applications and stress management to physicians, improvement in the working conditions will decrease defensive medicine, the work-based strain and burnout.