We would like to thank Lapa et al.1 for showing interest in our article ‘Psychological distress, burnout and personality traits in Dutch anaesthesiologists’2 and for acknowledging in their letter to the editor our efforts to raise awareness about burnout in anaesthesiologists through our work. They came forward with some interesting contributions, which we would like to address in this response.
Indeed our results show a lower prevalence of burnout in Dutch anaesthesiologists compared with other European countries. Our study pointed out that the prevalence of burnout in the general Dutch population is among the lowest in Europe.3 It would be mere speculation to discuss explanations, which could be as miscellaneous as research methodological reasons, like the questionnaires or sample selection bias, or social or organisational factors. As to the latter it would certainly be interesting to compare work-related stressors and factors causing satisfaction (which are protective against burnout4) between countries in a multinational study. We recently submitted a second study that includes an analysis of the importance of work-related stressors and factors causing satisfaction in the daily life of the anaesthesiologist. Job satisfaction was related to good relationships with patients and families, and being appreciated by colleagues.
Lapa et al. argue that personality traits may not be written in stone, as once thought in psychological theory, and that individuals can evolve during their work life. They further state that for this reason, individuals should not be excluded on the basis of personality tests indicating they may be at risk for developing burnout. Indeed it is known that, for example, the general personality trait of neuroticism tends to gradually diminish over life.5 Also people experience personal growth and develop during their professional life, but the ease in which they naturally adopt stress-relieving strategies or learn psychological means to regulate stress will be dependent on the type of person they are to begin with.6,7 So individual susceptibility remains an important factor in the development of burnout. Of course, as an instrument of selection, the ‘Big Five’ personality trait model may be too general to use in the selection of future anaesthesiologists, let alone exclude them from the training programme. More refined personality constructs are needed in that respect. Identifying those constructs is a field of research that may yield results we can use, together with other instruments, to select people best suited for the inherent and unique characteristics that make anaesthesia stressful.
We endorse the positive effects Mindfulness-based Stress Reduction programmes can have on stress management and burnout development. Training in holistic self-care activities such as the introduction of life coaches and mindfulness meditation can be most valuable. The same holds for managerial interventions such as limited case loads and restructuring organisations to optimally support human development.8
In conclusion, burnout management depends, as Lapa et al. also indicate, both on organisational and on individual factors. To address the important problem of burnout in our profession, we see three possible points of engagement: first, adequate selection of people who fit the demands of the job, in which personality assessment may contribute; second, analysis and consequent adaption of work-related stressors and factors causing satisfaction; and third, teaching anaesthesiologists stress relieving and burnout-preventing strategies.
We look forward to future publications from our colleagues in this important field of research and would be willing to participate in a multinational endeavour to identify personal and organisational risk factors which can be used in the battle against burnout.
Acknowledgements relating to this article
Assistance with the reply: none.
Financial support and sponsorship: none.
Conflicts of interest: none.
1. Lapa TA, Carvalho SA, Pinto-Gouveia J. Psychological distress, burnout and personality traits in Dutch anaesthesiologists. Eur J Anaesthesiol
2. van der Wal RA, Bucx MJ, Hendriks JC, et al. Psychological distress, burnout and personality traits in Dutch anaesthesiologists: a survey. Eur J Anaesthesiol
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