Swiss Health Professionals’ activities for Managing Occupational Burnout in their Patients: Results from a nationwide cross-sectional study, STOBS-VD survey

Objective: We aimed to describe the sociodemographic and professional characteristics and current practices of Swiss health professionals who treat patients with occupational burnout (POB), namely the general practitioners (GP), psychiatrist-psychotherapists (PP), occupational physicians (OP) and psychologists...

Methods: A 48-item e-questionnaire in RedCAP was distributed via the national professional associations between April and July 2021. Data were analyzed using logistic and multinomial regression models.

Results: Among 3216 respondents, 2951 reported to consult POB, and 1130 (713 physicians and 410 psychologists) to treat them. Most respondents (n=894, 79%) work in private practice and have an average of 16.9-years of professional experience. The study showed that POB management constitutes 5 to 25% of health care professionals’ activity, with an inequal distribution of POBs across professionals’ specialties and specializations, but also across geographic regions. We found no association between age, sex, number of consultations, experience length and the treatment options prescribed to POB, which were determined by profession, specialty, and practice place. Psychologists treat POB more often than physicians [OR=1.97], and especially psychological psychotherapists compared to work psychologists [OR=6.35]. Psychiatrists treat burnout more frequently than GPs [OR=12.6] while OPs treat them less frequently than GPs [OR=0.19]. The profile of POB consulted also differs across professionals. Work psychologists see more often POB at early burnout stage, GPs have most patients with moderate burnout, while PPs report the largest proportion of patients with severe burnout.
The treatment practices depend on burnout severity. Psychiatrists [OR=3.8] and physicians with double specialty (GP-OPs and GP-PPs) [OR=5.86] treat patients with more severe burnout than GPs. Psychologists treating patients with severe burnout the most also collaborate with other health professionals and contact the POB’s employer and/or health insurance [OR=2.15]. Treatment practices and burnout severity are not associated with the proportion of relapsed patients and patients who return to work. Yet, the former is associated with professionals’ age, sex, and specialty. Physicians with waiting time >3 months have a higher proportion of relapsed patients [OR=2.5]. GPs prescribe most often sick leaves, while PPs are the most frequent prescribers of pharmacological treatment. PPs collaborate significantly more often than GPs with pharmacologists and contact POB’s employer and health insurance. Among psychologists, work psychologists differ from other psychologists by a more frequent POB (psycho)education and coaching, namely on how to negotiate with employer and family, as well as on physical exercise. They also more often contact POB’s employer. Besides profession and specialization, we observed important regional variation in treatment modalities chosen by both physicians and psychologists.

Conclusions: The current practices of Swiss professionals in POB management present important regional variations, especially in terms of interdisciplinary collaborations. Future actions should focus on the comparison of the current practices with specific professional practice guidelines and education, especially GPs’ pre-gradual and continuous education.