Association between burnout, DNA methylation, and work environment among interprofessional clinical and non-clinical staff

Abstract

<p><strong>Purpose:</strong> About 35-54% of nurses and physicians in the U.S. suffer from burnout. Currently, there is a lack of an objective biologic measure of burnout. This study will assess the feasibility of using DNA methylation (DNAm) as a biomarker of healthcare provider burnout and identify work conditions, particularly during a pandemic, that would inform future implementation of targeted strategies to reduce healthcare provider burnout.</p> <p><strong>Method:</strong> Cross-sectional, feasibility study. Participants included clinicians (nurses and physicians, n=31) and non-clinicians (n=25). Burnout and the work environment were measured using the Maslach Burnout Inventory, Areas of Worklife Survey, Pandemic Experience &amp; Perceptions Survey. OGD-600 saliva collection kits were used to collect for the DNAm analysis. Bivariate analysis was conducted to assess the relationship between the work environment factors and the three subcategories of burnout. For the multivariable models, all statistically significant bivariate results (p&lt; 0.05) were included in the multivariable analysis. DNAm was analyzed via whole genome bisulfite sequencing.</p> <p><strong>Results:</strong> Clinicians reported higher emotional exhaustion (p=0.047) and depersonalization (p&lt;0.001) as compared to non-clinicians, while no significant differences were reported in personal accomplishment between the two groups. Higher workload and lower community were identified as predictors that contribute most to higher emotional exhaustion for clinicians as compared to non-clinicians. Lower control and lower resources were identified as predictors that contribute most to higher depersonalization. Analysis results on the relationship between DNAm and self-reported levels of burnout are pending.</p> <p><strong>Conclusions/Implications:</strong> Our study underscores the importance of a comprehensive and tailored program aimed at improving various aspects of the work environment that can meet the needs of both clinicians and non-clinicians alike. Targeted strategies including clinician peer support groups to improve a sense of community and shared decision-making opportunities to enhance feelings of control may be also helpful in decreasing emotional exhaustion and depersonalization among clinicians.</p>