Behaviour-based functional and dysfunctional strategies of medical students to cope with burnout

Figures & data

Figure 1. Illustration of hypothesised functional and dysfunctional coping strategies and their association with burnout. The use of functional coping strategies should be associated with a low probability of being burnt out. The use of dysfunctional coping strategies should be associated with a high probability of being burnt out.

Table 1. Characteristics of study population and subgroups.

	Total sample	3^rd semester	6^th semester	9^th semester	Final year students	p
N/n	N = 597	n = 143	n = 123	n = 154	n = 177	p < .01**
Response rate	70.7%	79.4%	79.4%	85.6%	58.1%	p < .01**
gender
female	N = 372, 62.3%	n = 90, 62.9%:	n = 67, 54.5%	n = 98, 63.6%	n = 117, 66.1%	p > .05
male	N = 225, 37.7%	n = 53, 37.1%	n = 56, 45.5%	n = 56, 36.4%	n = 60, 33.9%	p > .05
Age (years)	M = 25.6, SD = 4.4	M = 22.28, SD = 3.57	M = 23.05, SD = 4.00	M = 26.42, SD = 3.92	M = 27.77, SD = 4.10	p < .01**
[Min-Max]	[16–60]	[16–38]	[21–52]	[21–47]	[23–60]	p < .01**

Table 2. Results for sub dimensions of the Maslach Burnout Inventory (MBI-SS).

Dimension	Means and frequencies	3^rd semester	6^th semester	9^th semester	final year students	Total sample	p^6
Emotional Exhaustion (EE)	Msum^1(SD)	13.79(5.82)	12.72(5.43)	12.19(5.61)	11.85(6.46)	12.50(5.76)	< .01**
	Mscal^2(SD)	2.75(1.16)	2.55(1.09)	2.44(1.22)	2.37(1.29)	2.52(1.15)	< .01**
	high EE^3 n,%	n = 46,% = 32.2	n = 26,% = 21.1	n = 32,% = 20.8	n = 42,% = 23.7	n = 160,% = 23.5	< .01**
Cynicism (CY)	Msum(SD)	3.49(4.40)	4.60(4.69)	6.20(5.48)	6.25(6.05)	4.91(5.38)	< .01**
	Mscal(SD)	0.872(1.10)	1.15(1.17)	1.55(1.37)	1.56(1.51)	1.13(1.31)	< .01**
	high CY^4 n,%	n = 11,% = 7.7	n = 24,% = 19.5	n = 36,% = 23.4	n = 43,% = 24.3	n = 121,% = 17.8	< .01**
Academic Efficacy (AE)	Msum(SD)	25.85(4.98)	25.51(5.45)	23.94(5.45)	24.58(7.08)	25.02(6.02)	< .01**
	Mscal(SD)	4.31(0.831)	4.25(0.912)	3.99(1.02)	3.92(1.02)	4.17(1.00)	< .01**
	Low AE^5 n,%	n = 45,% = 31.5	n = 41,% = 33.3	n = 66, % = 42.9	n = 63,% = 35.6	n = 244,% = 35.8	< .01**
Burnout^7	n,%	n = 49,% = 34.3	n = 39,% = 31.7	n = 56,% = 36.4	n = 62,% = 35.0	n = 222,% = 32.6	> .05

¹Mean value of the respective sum score for EE, CY and AE; ²Mean value of the respective scale score for EE, CY and AE; ³EE sum scores ≥16; ⁴CY sum score ≥10; ⁵AE sum score <24; ⁶ p-value for group differences with Kruskal-Wallis over all four semester groups for the respective burnout dimension in each line; ⁷EE(score ≥16) or CY (score ≥10); ** highly significant group difference

Table 3. Results of the comparison between the investigated sample of medical students and a general student reference sample.

	Current study	Reference sample^1
	medical students	students
Dimensions	Mscal^3(SD)	Mscal(SD)	z	p	d^2
Emotional Exhaustion (EE)	2.52(1.19))	2.31(1.19))	2.64	< .001*	.17
Depersonalisation (DP)	1.13(1.31))	1.31(1.34))	−.011	> .05	.00
Academic Efficacy (AE)	4.17(1.01)	3.95[1.07))	2.91	< .001*	.19

¹[22], ² effect size in accordance to cohen’s d; ³ Mean value of the respective scale score for EE, CY and AE; *significant

Table 4a. Ranking of importance of investigated functional coping strategies.

Burnout								Total use
	Yes		No
Relevant functional coping strategies^1	n	%	n	%	χ^2 value	p value	OR (95% CI]	n, %
1. seeking support from friends	182	32.5	378	67.5	16.09	<.01**	3.83 (1.91–7.70)	n = 560,% = 93.8
No use	24	64.9	13	35.1			1
2. seeking support from family	171	32.6	357	67.6	7.47	<.01**	2.15 (1.30–3.56))	n = 528,% = 88.4
No use	35	50.7	34	49.3			1
3. doing relaxing exercise	147	30.9	328	68.8	13.02	<.01**	2.09 (1.39–3.13)	n = 475,% = 79.6
No use	59	48.4	63	51.6			1
4. doing sports	153	31.7	330	68.3	8.96	<.01**	1.87 (1.24–2.84)	n = 483,% = 80.9
No use	53	46.5	61	53.5			1
5. seeking support from fellow students	142	32.1	300	67.9	4.264	<.05*	1.49 (1.02–2.17)	n = 442,% = 74.0
No use	64	41.3	91	58.7			1

Table 4b. Ranking of importance of investigated dysfunctional coping strategies.

Burnout								Total use
	Yes		No
Relevant dysfunctional coping strategies^1	n	%	n	%	χ^2 value	p value	OR (95% CI)
1. Taking tranquilizers	26	65.0	14	35.0	17.64	<.01**	3.89 (1.98–7.63)	n = 40,% = 6.7
No use	180	32.3	377	57.7			1
2. Taking stimulants	15	55.6	12	44.4	5.54	<.05*	2.48 (1.14–5.40)	n = 27,% = 4.5
No use	191	33.5	379	66.5
3. Drinking alcohol	46	51.1	44	48.9	12.93	<.01**	2.27 (1.14–3.57)	n = 90,% = 15.1
No use	160	31.6	347	68.4			1
4. withdrawal and ruminating	123	42.6	166	57.4	16.09	<.01**	2.01 (1.43–2.83)	n = 289,% = 48.4
No use	83	26.9	225	73.1			1
5. playing games on PC or mobile phone	56	46.3	65	53.7	9.31	<.01**	1.87 (1.25–2.81)	n = 121,% = 20.3
No use	150	31.5	326	68.5			1

¹The five relevant functional and dysfunctional coping strategies with their respective odds ratios and the corresponding confidence intervals are illustrated. The prevalence rates and the absolute frequencies of the relationship between coping strategy and burnout ‘yes’ and ‘no’ are also shown; *significant/**highly significant.

Figure 2. Illustration of hypothetised functional (Figure 2a) and dysfunctional (Figure 2b) coping strategies with associated odds ratios (OR). The horizontal lines represent the standard deviations and the squares are at the height of the x-axis and illustrate the respective value.

Gumz A, Erices R, Brähler E, et al. Faktorstruktur und Gütekriterien der deutschen Übersetzung des Maslach-Burnout-Inventars für Studierende von Schaufeli et al. (MBI-SS). PPmP-Psychotherapie·Psychosomatik·Medizinische Psychologie. 2013; 63(02):77–84.

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