Integrative assessment of dentists’ psychoemotional status for preventing emergencies in outpatient dentistry: A digital solution. Part 2

Evgenia N. Anisimova; Анисимова Евгения Николаевна; Natalia Yu. Anisimova; Анисимова Наталья Юрьевна; Olga V. Khodnenko; Ходненко Ольга Владимировна; Nikita A. Ryazantsev; Рязанцев Никита Андреевич; Daniil D. Ryzhkov; Рыжков Даниил Дмитриевич

doi:10.17816/dent643308

Integrative assessment of dentists’ psychoemotional status for preventing emergencies in outpatient dentistry: A digital solution. Part 2

作者: Anisimova E.N.¹, Anisimova N.Y.¹, Khodnenko O.V.¹, Ryazantsev N.A.¹, Ryzhkov D.D.¹
隶属关系:
1. Russian Biotechnological University
期: 卷 29, 编号 1 (2025)
页面: 35-44
栏目: Experimental and Theoretical Investigations
##submission.dateSubmitted##: 23.12.2024
##submission.dateAccepted##: 27.12.2024
##submission.datePublished##: 01.03.2025
URL: https://rjdentistry.com/1728-2802/article/view/643308
DOI: https://doi.org/10.17816/dent643308
ID: 643308

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BACKGROUND: High levels of professional stress, regular interactions with patients, the necessity for quick decision-making under pressure, and physical exhaustion all contribute to occupational burnout in dentists. Integrative diagnosis approaches, such as automated online calculators, allow for the prompt assessment of physicians’ psychoemotional status and providing personalized recommendations to prevent occupational burnout.

AIM: To assess the psychoemotional status of dentists in real-world clinical practice.

MATERIALS AND METHODS: The study included dentists of three age groups: young (< 44 years, n = 348), middle (45–59 years, n = 85), and older (60–74 years, n = 22) age. A functional and psychoemotional status assessment protocol was used, with each study subject answering the questions of four validated questionnaires. Moreover, an online calculator for integrative assessment of dentists’ psychoemotional status was developed for express assessment and data interpretation, including visualization of results obtained using the questionnaires.

RESULTS: According to the emotional burnout questionnaire (by V.V. Boiko), middle-aged dentists are the most likely to experience emotional burnout. Young dentists show moderate stress levels, while older dentists achieve stability. These findings highlight the importance of prevention programs to support dentists at all phases of their careers. Moreover, the emotional burnout diagnosis questionnaire revealed differences in occupational burnout depending on age group: young dentists have a positive attitude, middle-aged dentists experience high stress levels, and older dentists are less committed. This emphasizes the importance of an age-based approach to the prevention of occupational burnout. Social communicative competence assessment aids in determining the features of each age group. Young dentists are active and cheerful, middle-aged dentists experience emotional stress, and older dentists are composed and level-headed, emphasizing the significance of age-related features in professional activities and growth. The differences between age groups reflect the changes associated with professional maturity and priorities. Young specialists are dynamic and committed, while older specialists have good communication and organizational skills, which they adapt to current responsibilities. Maintaining and improving skills in all age groups is essential for increased working efficiency.

CONCLUSION: The analysis of the psychoemotional status of dentists revealed that older specialists have good mental health, but show a decline in physical condition and commitment. Middle-aged specialists have a high risk of emotional burnout. Young specialists have good logical reasoning capabilities, but can experience stress during adaptation to work. The study emphasizes the necessity of regular psychoemotional status monitoring in dentists and support programs that improve mental well-being, workplace productivity, and the quality of dental care.

关键词

psychoemotional status, dentists, occupational burnout, stress, stress management

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BACKGROUND

The psychoemotional status of dentists is one of the key challenges in contemporary medicine. High professional workload, constant interaction with patients, the need for rapid decision-making under stressful circumstances, and physical fatigue make dentists particularly vulnerable to occupational burnout. The emotional burnout syndrome (EBS) is one of the most serious threats to medical workers’ health , affecting their efficiency and quality of health care provided.

According to the World Health Organization, approximately 50% of health care workers experience burnout symptoms , which causes decreased motivation, depersonalization, and emotional exhaustion [1]. This problem is particularly pronounced among dentists: high responsibility for patient health, the demand for precise manual performance, and limited treatment time amplify psychoemotional strain [2].

Research indicates that 64% of health care workers in Russia have neurotic disorders or borderline mental conditions, while 68% suffer from burnout syndrome [3]. These conditions increase the incidence of cardiovascular diseases, depression, anxiety, and other psychosomatic problems [4]. Moreover, dentists may experience considerable physical strain due to prolonged work in uncomfortable postures, which exacerbates general fatigue and worsens their psychoemotional status [5].

Modern technologies offer new opportunities for stress assessment and management. Integrative diagnostic methods, such as automated online calculators, make it possible to rapidly assess medical workers’ psychoemotional status and develop personalized recommendations [6]. These tools have become critical in fighting occupational burnout, allowing for diagnosis during progressive stress and for risk identification at early stages.

Occupational burnout is particularly common among older dentists, who are more vulnerable to physiological and emotional stressors [7]. This underscores the need for an individualized approach to the prevention of emotional exhaustion, including regular monitoring of psychoemotional status, optimized work schedules, and the implementation of stress management programs [8].

One of the most significant stressors for dentists is constant interaction with patients, which requires emotional support and empathy. Workload combined with insufficient time for recovery results in chronic stress that requires systematic prevention [9].

Attention to the psychoemotional status of dentists is crucial for maintaining their professional health and strengthening the overall resilience of the health care system. Stable mental health of health care providers ensures high-quality medical services, directly influencing patient satisfaction and treatment outcomes [10].

A systemic approach to the prevention of occupational burnout should include 3 key components [11]:

Diagnosis: regular stress monitoring using innovative technologies such as automated programs and integrative questionnaires.
Education: development and implementation of training programs that provide dentists with self-regulation skills, stress management techniques, and burnout prevention strategies.
Prevention: scheduled breaks, modified work schedules, and creation of conditions for physical and emotional recovery.

Thus, the study of the psychoemotional status of dentists is a pressing task of contemporary medicine. The introduction of integrative approaches to stress monitoring and prevention can reduce burnout, improve quality of life for specialists, and enhance the quality of dental care.

This work aimed to perform an integrative assessment of the dentists’ psychoemotional status in clinical practice.

METHODS

The study included male and female dentists representing 3 age groups (as classified by the World Health Organization): young (< 44 years, n = 348), middle-aged (45–59 years, n = 85), and elderly (60–74 years, n = 22). All participants were employed at municipal dental polyclinics in the Moscow Region. Their professional experience ranged from 2 to 55 years, with a mean of 15.5 years and an additional variance of 10.5 years. Various dental specialties were represented among the participants. All dentists who participated in the survey provided voluntary informed consent for the use of the obtained data for research purposes.

The results allowed for a comprehensive analysis of the functional and psychoemotional status of the above-mentioned 3 age groups.

Inclusion criteria: dentists working in their specialty and belonging to one of the designated age groups within the study range.

Exclusion criteria: refusal to participate in the study; pregnancy; dentists outside the selected age groups; presence of severe decompensated systemic condition.

To ensure a comprehensive assessment of dentists’ psychoemotional status, 4 validated psychological questionnaires were used, each focusing on specific aspects of health and professional resilience.

Questionnaire for the Assessment of Communicative and Organizational Skills (COS-1 test). This test consists of 40 questions, 20 for each scale, and assesses communicative and organizational tendencies. Responses are scored on a 2-point scale, with “Yes” equal to 1 point and “No” equal to 0 points. The final coefficient is calculated as the ratio of positive responses to the total number of questions. The results are interpreted as follows: 0.7–1.0 indicates a high level of abilities; 0.4–0.6 indicates a moderate level; and 0–0.3 indicates a low level [12].
Questionnaire for the Diagnosis of Communicative Social Competence (CSC test). This test contains 100 statements that assess such scales as sociability/introversion, logical reasoning, emotionality, cheerfulness/lightheartedness, artistic/rational type, independence/dependence, level of control, truthfulness, and tendency toward antisocial behavior. Responses are scored from 0 to 2 points. The total score for each scale determines the degree of competence: low (0–7 points), moderate (8–12 points), and high (13–16 points) [13].
Maslach Burnout Inventory (MBI) (C. Maslach, S. Jackson; adapted by N.E. Vodopyanova). This inventory consists of 22 questions grouped into 3 subscales: emotional exhaustion (9 questions), depersonalization (5 questions), and reduced personal accomplishment (8 questions). Responses are rated on a 7-point scale ranging from 0 (never) to 7 (every day), and subscale scores are summed. High scores on the emotional exhaustion and depersonalization subscales indicate pronounced occupational burnout. Scores on reduced personal accomplishment are interpreted inversely: low scores suggest decreased professional satisfaction [14].
Specialized Questionnaire for the Assessment of Emotional Burnout (V.V. Boiko). This test consists of 84 statements grouped into 3 stages: psychoemotional tension, resistance, and exhaustion. Each statement is rated on a 2-point scale, with “Yes” equal to 1 point and “No” equal to 0 points. Subscale scores allow assessment of burnout severity: up to 20% of the maximum indicate low level; 21%–55% indicate moderate level; > 56% indicate high level [15].

To record the obtained results, we developed a protocol for a multicenter, prospective, observational study aimed at assessing the functional and psychoemotional status of dentists, as well as evaluating the effectiveness and feasibility of diagnostic approaches in accordance with international and Russian standards of dental care.

For the convenience of data registration, a special educational and methodological manual called Assessment of the Functional and Psychoemotional Status of Dentists was created, which includes the main diagnostic stages for determining functional and psychoemotional status [16].

The functional status of dentists had been previously assessed and analyzed [17].

For rapid assessment and interpretation of data, a computer program (Online Calculator for Integrative Assessment of Dentists’ Psychological Status) was developed. This tool integrates the results of several questionnaires with outcome visualization [18]. The program is based on psychological questionnaires, each analyzing different aspects of mental health. These include: the Communicative and Organizational Skills (COS test), assessing personality traits critical for successful interaction with patients and colleagues; the Communicative Social Competence (CSC test), highlighting the importance of social skills in the profession; the Maslach Burnout Inventory (MBI), diagnosing occupational burnout; and the Emotional Burnout Questionnaire (V.V. Boiko), identifying critical levels of fatigue and loss of professional engagement. After summing the scores, the overall psychological status of a dentist is determined (see Fig. 1).

Fig. 1. Computer program Online Calculator for Integrative Assessment of Dentists’ Psychological Status.

Statistical analysis was performed using SPSS Statistics v.24 (IBM, USA). For comparison of numerical data (after testing for normal distribution), Student t-test for independent samples was applied. Differences between measurements within one group at different time points were assessed using the Wilcoxon test, applicable to ordinal and numerical data.Results and discussion

Questionnaire on the Assessment of Communicative and Organizational Skills

In the COS-1 questionnaire (see Table 1), young dentists demonstrated stronger abilities to establish interpersonal contacts, actively engage in the professional environment, and display communication flexibility . As age increases, communicative skills tend to decline, which may be associated with accumulated professional fatigue or reduced involvement in active interaction. However, this trend does not indicate a sharp decline, as specialists continued to demonstrate stability in social interaction.

Table 1. Results of dentists’ survey across age groups on the Communicative Skills Scale (COS-1)

Scale (COS-1)	Age
Scale (COS-1)	Young	Middle-aged	Older
COS Communicative Skills Scale coefficient	0.6	0.5	0.4
COS Organizational Skills Scale coefficient	0.6	0.6	0.5

The scale of organizational abilities demonstrated that young and middle-aged specialists share similar skills in managing work, reflecting their active professional stance. With age, organizational abilities showed a slight decrease, which may be explained by the transition of older specialists to less demanding roles, such as consulting or mentoring.

Questionnaire on the Diagnosis of Communicative Social Competence

The analysis of CSC scores across age groups (see Table 2) revealed several important trends. Sociability barely differs, suggesting that basic communication skills are preserved throughout the professional career. Logical reasoning also remained high, with a slight decline among middle-aged specialists, partially compensated by recovery in older specialists.

Table 2. Results of dentists’ survey across age groups on the Communicative Social Competence (CSC) Scale

Scale (CSC)	Age
Scale (CSC)	Young	Middle-aged	Older
Sociability/Introversion	11.2	10.8	11.1
Logical Thinking	12.1	11.1	11.5
Emotionality	11.0	11.4	11.0
Cheerfulness/Carelessness	9.4	9.0	7.0
Artistic/Rational Type	11.1	10.9	12.6
Independence/Dependence	10.7	10.8	11.6
Level of Control	12.8	12.9	13.0
Truthfulness Scale	8.0	9.1	9.6
Tendency Toward Antisocial Behavior	15.1	15.9	14.6

Emotionality remained stable, indicating consistent emotional regulation and the ability to respond adequately to external stimuli regardless of age. Cheerfulness, however, tended to decrease, particularly among older specialists, which may be linked to age-related changes and accumulated professional experience. Independence/dependence demonstrated a steady positive trend, possibly reflecting increasing professional confidence and the ability to make independent decisions.

Self-control increased with age, reaching its peak among older specialists, which reflects their ability to manage their actions and emotions effectively. The truthfulness scale showed an age-related increase in self-assessment honesty, likely related to greater experience and maturity.

The tendency toward antisocial behavior was most pronounced among middle-aged specialists, possibly due to high professional workload and accumulated stress, whereas this indicator decreased in older specialists, reflecting adaptation and reduced strain.

Maslach Burnout Inventory (MBI)

The analysis of the MBI results (see Table 3) revealed important aspects of occupational burnout among dentists of different age groups. Emotional exhaustion scores were the highest in middle-aged specialists, which may be related to peak professional workload and responsibilities characteristic of this career stage. Young specialists were less affected by emotional exhaustion, likely reflecting enthusiasm and energy associated with the early career stage. In older specialists, emotional exhaustion scores were the lowest, indicating greater adaptation to professional demands and reduced emotional involvement.

Table 3. Results of dentists’ survey across age groups on the Maslach Burnout Inventory (MBI)

Scale (MBI)	Age
Scale (MBI)	Young	Middle-aged	Older
Emotional Exhaustion	21.6	22.5	21.2
Depersonalization	10.2	9.8	10.7
Reduced Personal Accomplishment	29.5	31.5	28.0
Overall Burnout Index	0.4	0.4	0.4

Depersonalization, understood as detachment from patients and colleagues, was most pronounced among older specialists. This may reflect their shift toward a more rational and less emotionally involved approach to practice. Among middle-aged specialists, depersonalization scores were the lowest, likely reflecting active engagement and higher professional involvement. Young specialists occupied an intermediate position, showing moderate levels of depersonalization.

Reduced personal accomplishment, reflecting the satisfaction with one’s work, peaked among middle-aged specialists. This may be associated with high stress levels and awareness of potential professional limitations. Young specialists showed lower scores, suggesting greater optimism and satisfaction with their achievements. In older specialists, the decrease in this indicator may reflect a shift toward less ambitious professional goals and focus on mentoring and knowledge transfer.

The composite burnout index remained stable across all age groups, indicating a generally moderate severity of burnout without significant intergroup differences. This suggests that despite variations in individual dimensions of burnout, the overall burden on specialists remained approximately the same.

Emotional Burnout Questionnaire (V.V. Boiko)

The analysis of the Boiko Emotional Burnout Questionnaire (see Table 4) revealed significant differences in burnout levels among dentists of different age groups. Indicators were grouped into 3 stages of burnout: psychoemotional tension (Stage 1), resistance (Stage 2), and exhaustion (Stage 3), each reflecting specific aspects of occupational strain and emotional status.

Table 4. Results of dentists’ survey across age groups on the Specialized Questionnaire for the Assessment of Emotional Burnout (V.V. Boiko)

Emotional burnout stage	Age
Emotional burnout stage	Young	Middle-aged	Older
Stage 1: Experiencing Circumstances	12.2	12.0	7.1
Stage 1: Dissatisfaction with Oneself	9.1	10.5	8.4
Stage 1: Feeling of Being “Caged In”	7.8	9.1	4.3
Stage 1: Anxiety and Depression	11.0	11.5	6.0
Stage 2: Inadequate Response	15.0	12.4	11.3
Stage 2: Emotional Disorientation	11.4	13.0	8.3
Stage 2: Expansion of the Sphere of Economy	13.4	11.8	6.6
Stage 2: Reduction of Professional Responsibilities	13.6	14.9	7.5
Stage 3: Emotional Deficit	11.7	11.0	4.3
Stage 3: Emotional Withdrawal	12.3	12.8	8.9
Stage 3: Personal Withdrawal	10.7	12.7	5.8
Stage 3: Psychosomatic Disorders	10.3	10.3	8.0

At the stage of psychoemotional tension (Stage 1), young and middle-aged specialists demonstrated similar scores, indicating a considerable influence of work-related circumstances and self-perception. Middle-aged specialists reported slightly higher levels of dissatisfaction with themselves and anxiety, which may be related to increased workload and personal expectations. Older specialists demonstrated substantially lower scores, reflecting adaptation to professional activity and reduced emotional strain.

At the stage of resistance (Stage 2), middle-aged specialists showed the highest values on the scales of emotional disorientation and reduction of professional duties. This may be associated with high levels of responsibility and accumulated fatigue. Young specialists demonstrated moderate scores, indicating preserved adaptive resources. In older specialists, the values were significantly lower, suggesting a transition to a calmer and more rational approach to professional activity.

At the stage of exhaustion (Stage 3), emotional deficit and both emotional and personal detachment were the most pronounced among middle-aged specialists. Young specialists had moderate scores, reflecting their readiness to maintain involvement in work processes. Older specialists demonstrated minimal values, which may be related to reprioritization and reduced overall emotional burden.

Psychosomatic disorders were found at similar levels in young and middle-aged dentists, indicating a substantial influence of stress on physical health. In older specialists, this indicator was slightly lower, suggesting a greater ability to cope with professional challenges.

In one publicly funded dental clinic in the Moscow Region, an experimental project was conducted involving 87 dentists. Using the developed computer program, participants underwent integrative assessment of their psychoemotional status. Key patterns across age groups were identified. Young specialists demonstrated a moderate level of psychological resilience combined with active professional engagement. Their adaptation to professional demands was accompanied by moderate stress, which did not substantially affect overall well-being. Middle-aged specialists maintained a relatively high level of psychological status, but with clear signs of burnout and emotional exhaustion due to occupational workload. Despite reduced physical activity and emotional involvement, stability was observed among older specialists, owing to accumulated experience and a rational approach to work. The findings showed that younger specialists retained enthusiasm and energy to fulfill their duties but may require additional support in stress management. For middle-aged specialists, programs aimed at reducing workload and strengthening psychoemotional resilience are of critical importance. Older specialists benefit from involvement in consulting and mentoring, which allows them to use accumulated knowledge effectively and maintain professional satisfaction. These data highlight the need for strategies designed to support dentists at every stage of their careers.

Fig. 2 shows the obtained results.

Fig. 2. Comparative assessment of the integrative psychological status score of dentists by age group.

Thus, occupational burnout remains a critical concern for dentists. The study confirmed that the most vulnerable group consists of specialists with more than 10 years of experience, who showed increased depersonalization and emotional exhaustion.

The analysis demonstrated that the use of innovative online tools enables the assessment of dentists’ current status and effective stress management through personalized recommendations. However, further research is required to investigate additional factors influencing stress resilience, such as marital status and employment type.

CONCLUSION

The analysis of dentists’ psychological status showed that older specialists exhibited high levels of social functioning, rational decision-making, and mental health, but their physical condition and engagement in communication decreased. Middle-aged specialists faced the highest risks of emotional burnout and reduced personal accomplishment, requiring targeted preventive measures. Young specialists showed strong logical reasoning and communication skills but were prone to anxiety and emotional exhaustion during adaptation to professional activity.

Thus, it is necessary to regularly monitor dentists’ psychoemotional status to prevent occupational burnout. The implementation of support programs, including stress management training and the use of online self-assessment tools, can enhance dentists’ psychological well-being. These measures may improve not only their professional performance but also the overall quality of dental care.

ADDITIONAL INFORMATION

Funding sources: No funding.

Disclosure of interests: The authors have no relationships, activities, or interests (personal, professional, or financial) with third parties (for-profit, not-for-profit, or private entities) whose interests may be affected by the content of this article. The authors also report no other relevant relationships, activities, or interests within the past three years.

Author contributions: E.N. Anisimova: conceptualization, writing—review & editing; N.Yu. Anisimova: conceptualization, methodology; O.V. Khodnenko: investigation, formal analysis; N.A. Ryazancev: formal analysis, writing—review & editing; D.D. Ryzhkov: resources, writing—original draft. All authors approved the version of the manuscript to be published and agreed to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.