{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T18:32:23Z","timestamp":1783708343731,"version":"3.55.0"},"reference-count":39,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To detect the combined effects of lifestyle factors on work-related burnout (WB) and to analyse the impact of the number of weekend catch-up sleep hours on burnout risk in a medical workplace.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross-sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Hospital-based survey in Taiwan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>In total, 2746 participants completed the hospital\u2019s Overload Health Control System questionnaire for the period from the first day of January 2016 to the end of December 2016, with a response rate of 70.5%. The voluntary participants included 358 physicians, 1406 nurses, 367 medical technicians and 615 administrative staff.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>All factors that correlated significantly with WB were entered into a multinomial logistic regression after adjustment for other factors. The dose\u2013response relationship of combined lifestyle factors and catch-up sleep hours associated with WB was explored by logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Abnormal meal time (adjusted OR 2.41, 95%\u2009CI 1.85 to 3.15), frequently eating out (adjusted OR 1.49, 95%\u2009CI 1.12 to 1.97), lack of sleep (adjusted OR 5.13, 95%\u2009CI 3.94 to 6.69), no exercise (adjusted OR 1.41, 95%\u2009CI 1.10 to 1.81) and &gt;40 work hours (adjusted OR 2.72, 95%\u2009CI 2.08\u20133.57) were independently associated with WB (for high level compared with low level). As the number of risk factors increased (1\u20135), so did the proportion of high severity of WB (adjusted OR 1.39, 95%\u2009CI 0.45 to 4.27, to adjusted OR 32.98, 95%\u2009CI 10.78 to 100.87). For those with more than 7\u2009hours\u2019 sleep on workdays, weekend catch-up sleep (\u22640\/&gt;0\u2009and \u22642\/&gt;2\u2009hours) was found to be related to an increase of burnout risk (adjusted OR 4.91, 95%\u2009CI 2.24 to 10.75\/adjusted OR 4.94, 95%\u2009CI 2.54 to 9.63\/adjusted OR 6.74, 95%\u2009CI 2.94 to 15.46).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>WB in the medical workplace was affected by five unhealthy lifestyle factors, and combinations of these factors were associated with greater severity of WB. Weekend catch-up sleep was correlated with lower burnout risk in those with a short workday sleep duration (less than 7\u2009hours). Clinicians should pay particular attention to medical staff with short sleep duration without weekend catch-up sleep.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2019-032779","type":"journal-article","created":{"date-parts":[[2019,11,18]],"date-time":"2019-11-18T15:25:16Z","timestamp":1574090716000},"page":"e032779","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Modifiable risk factors related to burnout levels in the medical workplace in Taiwan: cross-sectional study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1165-139X","authenticated-orcid":false,"given":"Yu-Li","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cing-Hua","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Min","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Yuan","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Sheng","family":"Liou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chien","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Tse","family":"Tsan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,11,18]]},"reference":[{"key":"2020050713435510000_9.11.e032779.1","doi-asserted-by":"crossref","unstructured":"Salvagioni DAJ , Melanda FN , Mesas AE , et al . Physical, psychological and occupational consequences of job burnout: a systematic review of prospective studies. PLoS One 2017;12:e0185781.doi:10.1371\/journal.pone.0185781","DOI":"10.1371\/journal.pone.0185781"},{"key":"2020050713435510000_9.11.e032779.2","doi-asserted-by":"crossref","unstructured":"Chou L-P , Li C-Y , Hu SC . Job stress and burnout in hospital employees: comparisons of different medical professions in a regional hospital in Taiwan. BMJ Open 2014;4:e004185.doi:10.1136\/bmjopen-2013-004185","DOI":"10.1136\/bmjopen-2013-004185"},{"key":"2020050713435510000_9.11.e032779.3","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12752"},{"key":"2020050713435510000_9.11.e032779.4","doi-asserted-by":"crossref","first-page":"294","DOI":"10.4300\/JGME-D-16-00372.1","article-title":"Efficacy of interventions to reduce resident physician burnout: a systematic review","volume":"9","author":"Busireddy","year":"2017","journal-title":"J Grad Med Educ"},{"key":"2020050713435510000_9.11.e032779.5","doi-asserted-by":"crossref","unstructured":"Molina-Praena J , Ramirez-Baena L , G\u00f3mez-Urquiza J , et al . Levels of burnout and risk factors in medical area nurses: a meta-analytic study. Int J Environ Res Public Health 2018;15:2800.doi:10.3390\/ijerph15122800","DOI":"10.3390\/ijerph15122800"},{"key":"2020050713435510000_9.11.e032779.6","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.socscimed.2019.05.007","article-title":"Occupational variation in burnout among medical staff: evidence for the stress of higher status","volume":"232","author":"Grace","year":"2019","journal-title":"Soc Sci Med"},{"key":"2020050713435510000_9.11.e032779.7","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1093\/occmed\/kqy088","article-title":"Do age and gender contribute to workers\u2019 burnout symptoms?","volume":"68","author":"Marchand","year":"2018","journal-title":"Occup Med"},{"key":"2020050713435510000_9.11.e032779.8","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1097\/JOM.0000000000000715","article-title":"The associations between long working hours, physical inactivity, and burnout","volume":"58","author":"Hu","year":"2016","journal-title":"J Occup Environ Med"},{"key":"2020050713435510000_9.11.e032779.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2014.09.003"},{"key":"2020050713435510000_9.11.e032779.10","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1007\/s00420-016-1143-5","article-title":"Burnout and health behaviors in health professionals from seven European countries","volume":"89","author":"Alexandrova-Karamanova","year":"2016","journal-title":"Int Arch Occup Environ Health"},{"key":"2020050713435510000_9.11.e032779.11","doi-asserted-by":"crossref","unstructured":"Bonaccio M , Di Castelnuovo A , Costanzo S , et al . Impact of combined healthy lifestyle factors on survival in an adult general population and in high\u2010risk groups: prospective results from the Moli\u2010sani study. J Intern Med 2019.doi:10.1111\/joim.12907","DOI":"10.1111\/joim.12907"},{"key":"2020050713435510000_9.11.e032779.12","doi-asserted-by":"crossref","unstructured":"Karavasiloglou N , Pestoni G , Wanner M , et al . Healthy lifestyle is inversely associated with mortality in cancer survivors: results from the third National health and nutrition examination survey (NHANES III). PLoS One 2019;14:e0218048.doi:10.1371\/journal.pone.0218048","DOI":"10.1371\/journal.pone.0218048"},{"key":"2020050713435510000_9.11.e032779.13","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.1007\/s11606-019-05061-z","article-title":"Combined healthy lifestyle behaviors and Disability-Free survival: the Ohsaki cohort 2006 study","volume":"34","author":"Zhang","year":"2019","journal-title":"J Gen Intern Med"},{"key":"2020050713435510000_9.11.e032779.14","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.jad.2018.05.038","article-title":"Prospective association between combined healthy lifestyles and risk of depressive symptoms in the French NutriNet-Sant\u00e9 cohort","volume":"238","author":"Adjibade","year":"2018","journal-title":"J Affect Disord"},{"key":"2020050713435510000_9.11.e032779.15","doi-asserted-by":"crossref","unstructured":"Oh YH , Kim H , Kong M , et al . Association between weekend catch-up sleep and health-related quality of life of Korean adults. Medicine 2019;98:e14966.doi:10.1097\/MD.0000000000014966","DOI":"10.1097\/MD.0000000000014966"},{"key":"2020050713435510000_9.11.e032779.16","doi-asserted-by":"crossref","unstructured":"Gupta N , Maranda L , Gupta R . Differences in self-reported weekend catch up sleep between children and adolescents with and without primary hypertension. Clin Hypertens 2018;24.doi:10.1186\/s40885-018-0092-6","DOI":"10.1186\/s40885-018-0092-6"},{"key":"2020050713435510000_9.11.e032779.17","doi-asserted-by":"crossref","unstructured":"HJ I , Baek SH , Chu MK , et al . Association between weekend catch-up sleep and lower body mass: population-based study. Sleep 2017;40.doi:10.1093\/sleep\/zsx089","DOI":"10.1093\/sleep\/zsx089"},{"key":"2020050713435510000_9.11.e032779.18","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1080\/07420528.2018.1439500","article-title":"Late chronotype and high social jetlag are associated with burnout in evening-shift workers: Assessment using the Chinese-version MCTQ shift","volume":"35","author":"Cheng","year":"2018","journal-title":"Chronobiol Int"},{"key":"2020050713435510000_9.11.e032779.19","doi-asserted-by":"publisher","DOI":"10.1080\/02678370500297720"},{"key":"2020050713435510000_9.11.e032779.20","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1037\/1072-5245.11.3.282","article-title":"Comparing two measures of burnout among dentists in Australia","volume":"11","author":"Winwood","year":"2004","journal-title":"Int J Stress Manag"},{"key":"2020050713435510000_9.11.e032779.21"},{"key":"2020050713435510000_9.11.e032779.22","first-page":"349","article-title":"Development and validation of an occupational burnout inventory","volume":"27","author":"Yeh","year":"2008","journal-title":"Taiwan J Public Health"},{"key":"2020050713435510000_9.11.e032779.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"2020050713435510000_9.11.e032779.24","doi-asserted-by":"crossref","unstructured":"Chambers CNL , Frampton CMA , Barclay M , et al . Burnout prevalence in New Zealand's public hospital senior medical workforce: a cross-sectional mixed methods study. BMJ Open 2016;6:e013947.doi:10.1136\/bmjopen-2016-013947","DOI":"10.1136\/bmjopen-2016-013947"},{"key":"2020050713435510000_9.11.e032779.25","doi-asserted-by":"crossref","first-page":"421","DOI":"10.23938\/ASSN.0114","article-title":"Occupational and life style factors on the levels of burnout in palliative care health professionals","volume":"40","author":"Fernandez Sanchez","year":"2017","journal-title":"An Sist Sanit Navar"},{"key":"2020050713435510000_9.11.e032779.26","doi-asserted-by":"crossref","unstructured":"Armenta-Hern\u00e1ndez O , Maldonado-Mac\u00edas A , Garc\u00eda-Alcaraz J , et al . Relationship between burnout and body mass index in senior and middle managers from the Mexican manufacturing industry. Int J Environ Res Public Health 2018;15:541.doi:10.3390\/ijerph15030541","DOI":"10.3390\/ijerph15030541"},{"key":"2020050713435510000_9.11.e032779.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2015.08.014"},{"key":"2020050713435510000_9.11.e032779.28","doi-asserted-by":"crossref","unstructured":"Lennartsson A-K , Sj\u00c3\u00b6rs A , W\u00c3\u00a4hrborg P , et al . Burnout and Hypocortisolism \u00e2\u20ac\u201c A Matter of Severity? A Study on ACTH and Cortisol Responses to Acute Psychosocial Stress. Front. Psychiatry 2015;6.doi:10.3389\/fpsyt.2015.00008","DOI":"10.3389\/fpsyt.2015.00008"},{"key":"2020050713435510000_9.11.e032779.29","first-page":"24","article-title":"Public health and burnout: a survey on lifestyle changes among workers in the healthcare sector","volume":"90","author":"Petrelli","year":"2018","journal-title":"Acta Biomed"},{"key":"2020050713435510000_9.11.e032779.30","doi-asserted-by":"crossref","unstructured":"Vinnikov D , Dushpanova A , Kodasbaev A , et al . Occupational burnout and lifestyle in Kazakhstan cardiologists. Arch Public Health 2019;77:13.doi:10.1186\/s13690-019-0345-1","DOI":"10.1186\/s13690-019-0345-1"},{"key":"2020050713435510000_9.11.e032779.31","first-page":"261","article-title":"Prevalence and correlates of substance use among clinical nurses in Kaohsiung City","volume":"17","author":"Yang","year":"2001","journal-title":"Kaohsiung J Med Sci"},{"key":"2020050713435510000_9.11.e032779.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2008.04.008"},{"key":"2020050713435510000_9.11.e032779.33","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1097\/ACM.0000000000001540","article-title":"Healthy exercise habits are associated with lower risk of burnout and higher quality of life among U.S. medical students","volume":"92","author":"Dyrbye","year":"2017","journal-title":"Academic Medicine"},{"key":"2020050713435510000_9.11.e032779.34","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s40596-016-0526-y","article-title":"Inadequate sleep and exercise associated with burnout and depression among medical students","volume":"41","author":"Wolf","year":"2017","journal-title":"Acad Psychiatry"},{"key":"2020050713435510000_9.11.e032779.35","doi-asserted-by":"crossref","unstructured":"Drenowatz C , Gribben N , Wirth MD , et al . The association of physical activity during weekdays and weekend with body composition in young adults. J Obes 2016;2016:8236439 doi:10.1155\/2016\/8236439","DOI":"10.1155\/2016\/8236439"},{"key":"2020050713435510000_9.11.e032779.36","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.annepidem.2015.10.010","article-title":"Weekend-weekday differences in diet among U.S. adults, 2003\u20132012","volume":"26","author":"An","year":"2016","journal-title":"Ann Epidemiol"},{"key":"2020050713435510000_9.11.e032779.37","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.jand.2017.01.012","article-title":"Diet quality is lower and energy intake is higher on weekends compared with weekdays in midlife women: a 1-year cohort study","volume":"117","author":"Jahns","year":"2017","journal-title":"J Acad Nutr Diet"},{"key":"2020050713435510000_9.11.e032779.38","doi-asserted-by":"crossref","unstructured":"Lee CHJ , Sibley CG . Sleep duration and psychological well-being among new Zealanders. Sleep Health 2019.doi:10.1016\/j.sleh.2019.06.008","DOI":"10.1016\/j.sleh.2019.06.008"},{"key":"2020050713435510000_9.11.e032779.39","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-2073"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-032779","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T23:13:12Z","timestamp":1665011592000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-032779"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":39,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11,25]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1136\/bmjopen-2019-032779"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-032779","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]}}}