The DOI matches its Crossref record; 5 of the 6 references it cites were found in a registry or an index.
The causal links between stress and burnout in a longitudinal study of UK doctors
Abstract
Burnout and stress are common, linked problems in health-care workers. We aimed to clarify their causal associations. We assessed stress and the three components of burnout (emotional exhaustion, depersonalisation, and low personal accomplishment) using structural equation modelling in a 3-year longitudinal study of a representative sample of 331 UK doctors. Emotional exhaustion and stress showed reciprocal causation: high levels of emotional exhaustion caused stress (beta=0 189), and high levels of stress caused emotional exhaustion (beta=0 175). High levels of personal accomplishment increased stress levels (beta=0 080), whereas depersonalisation lowered stress levels (beta=-0 105).
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“Another large-scale, longitudinal study of 331 doctors conducted over three years provides further evidence for rejecting the simple one-way relationship between stress and burnout (McManus, Winder & Gordon, 2002).”
From Too Stressed to Teach? Teaching Quality, Student Engagement, and IEP Outcomes (2017) · cites this paper as McManus, Winder & Gordon, 2002
In the citing paper
“Instead, emotional exhaustion and stress demonstrated reciprocal causation.”
From Too Stressed to Teach? Teaching Quality, Student Engagement, and IEP Outcomes (2017) · cites this paper as McManus et al., 2002
In the citing paper
“Moreover, low levels of personal accomplishment led to increased levels of stress, whereas high levels of depersonalization led to decreased levels of stress.”
From Too Stressed to Teach? Teaching Quality, Student Engagement, and IEP Outcomes (2017) · cites this paper as McManus et al., 2002
In the citing paper
“Stress is intended to measure the immediate effect of stressors on the individual, whereas burnout is intended to measure the chronic effect of such stressors.”
From Too Stressed to Teach? Teaching Quality, Student Engagement, and IEP Outcomes (2017) · cites this paper as McManus et al., 2002
Citations
Cites
Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001) · Annual Review of Psychology · doi:10.1146/annurev.psych.52.1.397 · Cited by 12,852
The Validity of Two Versions of the GHQ in the WHO Study of Mental Illness in General Health Care
GOLDBERG, D. P., GATER, R., SARTORIUS, N., USTUN, T. B., PICCINELLI, M., GUREJE, O., & RUTTER, C. (1997) · Psychological Medicine · doi:10.1017/s0033291796004242 · Cited by 3,657
Duties of a doctor: UK doctors and Good Medical Practice
McManus, I. C., Gordon, D., & Winder, B. (2000) · BMJ Quality & Safety · doi:10.1136/qhc.9.1.14 · Cited by 50
Self-citationAre UK doctors particularly stressed?
McManus, I. C., Winder, B., & Gordon, D. (1999) · The Lancet · doi:10.1016/s0140-6736(99)02112-1 · Cited by 38
Self-citationUK doctors' attitudes to the General Medical Council's Performance Procedures, 1997-99
McManus, I. C., Winder, B., & Gordon, D. (2001) · Medical Education · doi:10.1046/j.1365-2923.2001.0350s1060.x · Cited by 10
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Cited by
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Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & Andrade, S. M. D. (2017) · PLOS ONE · doi:10.1371/journal.pone.0185781 · Cited by 1,508
Medical Student Distress: Causes, Consequences, and Proposed Solutions
Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2005) · Mayo Clinic Proceedings · doi:10.4065/80.12.1613 · Cited by 1,142
Discrimination, abuse, harassment, and burnout in surgical residency training
Hu, Y.-Y., Ellis, R. J., Hewitt, D. B., Yang, A. D., Cheung, E. O., Moskowitz, J. T., Potts, J. R., Buyske, J., Hoyt, D. B., Nasca, T. J., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmsa1903759 · Cited by 928
Burnout syndrome among critical care healthcare workers.
Embriaco, N., Papazian, L., Kentish-Barnes, N., Pochard, F., & Azoulay, E. (2007) · Current Opinion in Critical Care · doi:10.1097/mcc.0b013e3282efd28a · Cited by 569
McManus, I. C., Keeling, A. N., & PAICE, E. W. (2004) · BMC Medicine · doi:10.1186/1741-7015-2-29 · Cited by 558
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Metadata
- Authors
- McManus, I., Winder, B., & Gordon, D.
- Affiliations
- University College London (GB)
- The Royal Free Hospital (GB)
- Corresponding author
- McManus, IC
- ORCID
- McManus, IC
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2002-06
- Volume
- 359
- Issue
- 9323
- Pages
- 2089-2090
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2020710864
- Cited by
- 376
- References
- 6
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 13 · 2023: 23 · 2022: 26 · 2021: 31 · 2020: 27 · 2019: 23 · 2018: 20 · 2017: 25 · 2016: 11 · 2015: 17 · 2014: 21 · 2013: 11 · 2012: 16
- FWCI
- 21.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Nottingham Trent University's Institutional Repository (Nottingham Trent Repository) (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
- Keywords
- burnout, occupational stress, physicians, emotional exhaustion, depersonalization, personal accomplishment, reciprocal causation, healthcare workers, physician well-being
- MeSH terms
- Adult, Attitude of Health Personnel, Burnout, Professional, Family Practice, Female, United Kingdom, Humans, Longitudinal Studies, Male, Middle Aged, Surveys and Questionnaires, Incidence
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