A Cross-Sectional Survey on Burnout Prevalence and Profile in the Sicilian Population of Ambulance Driver-Rescuers

Introduction: Burnout is present at a high rate in emergency medicine. The ambulancedriver-rescuers, who furnish first aid to the victims, are the non-medical part of theItalian 118-service staff. There is a lack of research on burnout risk in Italian EmergencyMedical Services and, particularly, for this category of workers. The two Italian studies,including a little group of ambulance driver-rescuers, reported inconsistent findings.Hypothesis: This survey investigated for the first time the prevalence and exact profile ofburnout in a large sample of Italian driver-rescuers. As a secondary aim, the study describedhow the items of the Italian version of the Maslach Burnout Inventory-Human ServicesSurvey (MBI-HSS) cluster in components in this sample.Methods: This cross-sectional census survey was conducted from June 2015 through May2016 and involved all the driver-rescuers operating in Sicily, the biggest and most southernregion of Italy. The subjects received a classification according to different profiles of burnout by using the Italian version of the MBI-HSS (burnout, engagement, disengagement,over-extension, and work-inefficacy). In order to explore the existence of independentfactors, a Principal Component Analysis (PCA) was conducted on the survey to obtaineigenvalues >one for each component in the data.Results: The final sample comprised 2,361 responders (96.6% of the initial sample). Of them,29.8% were in burnout (95% confidence interval [CI], 27.8% to 31.8%) and 1.7% presented asevere form (95% CI, 1.1% to 2.3%); 30.0% were engaged in their work (95% CI, 21.0% to34.8%), 24.7% of responders were disengaged (95% CI, 22.9% to 26.5%), 1.2% presented anover-extension profile (95% CI, 0.8% to 1.7%), and 12.6% felt work-inefficacy (95% CI,11.3% to 14.1%). The factors loaded into a five-factor solution at PCA, explaining 48.1%of the variance and partially replicating the three-factor structure. The EmotionalExhaustion (EE) component was confirmed. New dimensions from PersonalAccomplishment (PA) and Depersonalization (DP) sub-scales described empathy and disengagement with patients, respectively, and were responsible for the increased risk of burnout.Conclusions: These results endorse the importance of screening and psychological interventions for this population of emergency workers, where burnout could manifest itself moreinsidiously. It is also possible to speculate that sub-optimal empathy skills could be related tothe disengagement and work-inefficacy feelings registered.