Exploring burnout and uncertainty in healthcare professionals: a path analysis within the context of rare diseases

Burnout among physicians has gained increasing attention in recent years. This issue arises not only from stressful working conditions and individual factors but also from the correlation between burnout and physicians' tolerance of uncertainty. This association could be particularly important in the context of rare diseases, which inherently present greater uncertainty. To date, no studies have explored this topic. Our exploratory study aimed to investigate the associations between uncertainty and burnout scores among physicians while considering secondary factors associated with rare diseases and COVID-related stress. Although not the primary focus, we included COVID-related stress due to its impact during the ongoing pandemic. We conducted an online survey using the Physicians' Reaction to Uncertainty Scale (PRU) and the Oldenburg Burnout Inventory (OLBI). Experience with rare diseases was quantified by assessing the weekly working hours devoted to patients with such conditions. We conducted a path analysis, initially using a fully recursive model and subsequently eliminating non-significant paths. 128 physicians (n = 73 female) participated in the survey, with 31% of them displaying significant burnout scores. Notably, significant associations were found between the PRU subscale anxiety and both dimensions of burnout, as well as between the PRU subscale disclosure to patients and the burnout dimension of exhaustion. COVID-related stress was also significantly associated with exhaustion, while experience with rare diseases was significantly associated with disengagement. No correlation was observed between experience with rare diseases and uncertainty scores. The model demonstrated an excellent fit (RMSEA = 0.055). Our results show that physician burnout is a pressing issue and confirm the association between anxiety due to uncertainty and increased burnout scores.