Female health care professionals experience higher levels of stress, burnout vs. males

Key takeaways:

• Researchers noted a negative association between poor work-life integration and a general sense of well-being.
• They noted a positive association between well-being and personal relationships inside/outside work.

Women in medicine experience significantly higher levels of stress and burnout compared with men in medicine, according to a literature review published in Global Advances in Integrative Medicine and Health.

“Many people think that in 2024 women and men will be treated equally, but this is still not entirely true in every instance,” Leigh A. Frame, PhD, MHS, associate director of the George Washington University Resiliency and Well-being Center, told Healio. “Subconscious and conscious discrimination against women — such as how a woman in scrubs is often assumed to be a nurse, while a man is assumed to be a physician — is coupled with differing societal and personal expectations. Women continue to provide disproportionate amounts of unpaid work in the home, which increases the demand on women and elevates their risk for harmful stress and burnout.”

Literature review

Growth in the health care workforce has been largely driven by women, and health care professionals are at a higher risk for harmful stress and burnout, according to Frame.

“We, therefore, wanted to see if women were affected differently and what interventions might be most beneficial to this population,” she said. “This will ultimately inform how the George Washington University Resiliency and Well-being Center serves this population and is applicable to health care systems, globally. It is likely that the basic principles identified will also apply to non-health care workforces.”

Researchers sought to examine how well-being is defined, the instruments used to measure it, and correlation between professional and personal gender-specific factors that impact the well-being — quality of life, stress, burnout, resiliency and wellness — of women in medicine.

The comprehensive literature review included 71 studies published across 26 countries between 1979 and 2022 that enrolled adult women health care professionals, including nurses, physicians, clinical social workers and mental health providers.

“The COVID-19 pandemic laid bare and magnified a growing problem with burnout among health care professionals,” Frame said. “We are losing well-trained health care professionals, which is leading to a workforce shortage. Something has to change, and we wanted to do so in an evidence-driven manner.”

Key contributing factors

Results showed several key factors contributing to a higher prevalence of job dissatisfaction, emotional turmoil and a lack of work-life integration.

Researchers found that only 10% of assessment tools used in the literature review measured individual characteristics — hope, optimism, resiliency, self-acceptance, self-esteem — or the impact of the lived experience — positive work-life integration, personal and professional growth, meaningful social support, religiousness/spirituality or having a sense of purpose.

“Given this, to further bring clarity to the definition of well-being, our study will require a substantially greater utilization and dependence on assessment tools that are anchored in a complete approach to holistic well-being and not solely isolating pathology,” the researchers wrote.

Moreover, approximately 25% of published studies showed a negative association between poor work-life integration and a general sense of well-being among women.

Results also showed that nearly one-fourth of studies suggested deficient working conditions and limited professional autonomy as contributors to women experiencing burnout at greater rates compared with men.

Of note, 22% of studies indicated an association between the propensity of general satisfaction and decreased burnout rates in the workplace and a supportive environment and flexible schedules that accommodate childcare and other contributors to well-being.

In addition, 21% of studies indicated an association between well-being and personal relationships inside and outside of the workplace.

“Support and belonging are a key element of whole-person well-being and in our research findings,” Frame said. “The saying, ‘empowered women, empower women,’ is apt here. This includes mentoring, sponsorship, modeling and communication. Each woman must also remember that she must ‘put her oxygen mask on first,’ including regularly setting aside time to recharge her batteries.”

Researchers also found that 16% of studies showed instances of implicit bias in the workplace, such as unequal pay for equal work, refusal to acknowledge women clinicians by their title and fewer opportunities for professional advancement for women, as a significant factor of mental distress among women in health care.

Only 15% of studies focused on the positive association between well-being and intentional mindfulness, nutrition and exercise, and restorative sleep.

“These studies add to the growing body of knowledge that lifestyle interventions can reduce compassion fatigue, stress and burnout with yoga, prayer, meditation, a balanced diet (non-specific) and quality sleep,” researchers wrote. “The correlation between active coping mechanisms and stress management in the literature engenders discussions for future well-being research and the specific challenges of women in health care. At our center, this will be a key component of our interventions.”

Potential solutions

“While gender inequity in health care professionals’ well-being is disappointing, it also allows us to see potential solutions — work-life integration, professional autonomy, supportive work environments, personal relationships, mindfulness and self-care, and professional development opportunities,” Frame said. “Many of these are incumbent upon the health care system to adopt as part of a well-being culture, which must include institutional-, work-unit- and individual-level policy, interventions, and evaluation coupled with strategic planning.”

Frame and colleagues are now using the information from the current study to design and implement solutions for health care professionals at George Washington University.

“We will be measuring the effects of the proposed solutions and publishing on them so that others can learn from our experience and help their own populations,” she said. “More research is needed on how to best measure well-being — thriving — instead of only the lack of well-being — burnout. We want to see women who are thriving, not just surviving.”

For more information:

Leigh A. Frame, PhD, MHS, can be reached at leighframe@gwu.edu.