“Looked at the stars with my daughter” : a dual-lens study of daily recovery and burnout in senior doctors with leadership responsibilities in New Zealand : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Science in Psychology, Massey University, Albany, New Zealand

Abstract

Burnout is a pervasive problem in healthcare that has serious implications for doctors, their colleagues, the systems within which they work, and their personal lives. Anchored in Conservation of Resources (COR) theory and the Stressor-Detachment Model (SDM), this study examined how burnout levels change over time in senior doctors with leadership responsibilities, and how their non-work recovery activities relate to day-to-day recovery while continuing to work. It adopted a dual-lens approach, examining (1) organisational and social conditions that relate to burnout, and (2) individual recovery interventions in managing burnout. A two-part mixed-methods design was used (N = 43). Part 1 comprised a repeated measures component examining burnout across two time points and its relationship with organisational and social conditions and turnover intentions. Participants were also asked about their reasons for continuing in their roles despite experiencing burnout. Part 2 comprised a two-week daily diary component examining how daily work demands and non-work recovery activities, operationalised as psychological detachment, relate to daily recovery. The results showed a mixed picture. As expected, burnout levels were strongly linked between the two timepoints. Contrary to hypotheses, social support (both in life and at work) was not associated with burnout. Although more than half of participants had accessed professional support services in the three months prior to the study, support service use was unrelated to burnout. Participants also reported multiple barriers to help-seeking. Turnover intentions were also low and unrelated to burnout. In Part 2, the daily diary results showed that doctors frequently engaged in non-work recovery activities, and some, but not all, were associated with same-day and next-day psychological detachment. Overall, the study identified a paradox: despite participants’ proactive recovery efforts, strong non-work social support, and continued functioning at work and home, burnout scores were strongly related across the study period. Participants appeared able to regain sufficient resources to meet daily demands, but this did not correspond with reductions in burnout. These findings suggest that addressing prevalent, ongoing burnout amongst senior doctors cannot be an individual effort. Real change likely requires system-level interventions that address the pressures of modern healthcare.