Différents travaux suggèrent que les professionnels de soins frappés de burnout, notamment les médecins, pourraient adapter des stratégies d’évitement ou de retrait psychologique vis-à-vis de leurs patients. En fondant notre argumentation sur la théorie de la conservation des ressources, nous avançons que ce retrait psychologique sera d’autant plus intense que le patient est non compliant.

Notre échantillon est composé de 270 médecins généralistes qui ont réagi au cas d’une patiente âgée devenue invalide et présentée selon deux modalités : compliante vs non compliante. Les médecins devaient indiquer dans quelle mesure ils prendraient chacune des cinq solutions qui leur étaient proposées (e.g., soins à domicile, maison de retraite). Ces solutions variaient selon leur degré d’engagement/retrait psychologique. Nous avons également recueilli le degré de burnout des participants.

Les résultats montrent en particulier que lorsqu’ils ont un degré élevé de burnout, les médecins adhèrent davantage aux solutions de retrait psychologique et moins aux solutions engageantes lorsque la patiente est non compliante.

When GPs are afflicted by burnout, patients’ demands are perceived to create a relational imbalance. It can be supposed that in this situation, GPs will react by distancing themselves from the patient. Effectively, various studies suggest that health professionals who are suffering from burnout adapt withdrawal strategies towards their patients: less implication, etc. In the present study, we make the assumption that when the GP is suffering from burnout, the withdrawal will be even more important with a noncompliant patient.

Two hundred and seventy GPs responded to the case of an 84 year-old female patient who lives alone and falls regularly. After having broken the neck of the thighbone, she leaves the hospital and remains dependent for the next months. The patient is presented in two ways: compliant vs. non compliant. The GPs were asked to indicate the degree to which they would choose each of the solutions that were proposed. These solutions vary according to their degree of implication. Information on the participants’ level of burnout was also gathered.

When the patient is compliant, the implicating solutions (home assistance and home care) are chosen equally as much by the participants, whatever their level of emotional exhaustion. But when the patient is noncompliant, these solutions are always chosen as much by the participants with a low level of emotional exhaustion, but are significantly less chosen by those with a high level of emotional exhaustion. The opposite is found for withdrawal solutions (independent living residence, medium term hospital stay, retirement home). When the patient is compliant, the choice of these solutions does not vary in function of the level of exhaustion. However, when the patient is noncompliant, these solutions attract the GPs significantly more if they are exhausted (but not if they are slightly exhausted).