RESUMO
Justificación y objetivo: determinar las características sociodemográficas del síndrome de desgaste en médicos residentes en Costa Rica durante el 2007 y validar localmente la escala de Maslach. Metodología: investigación aplicada, descriptiva y de corte transversal, en la que participaron 121 sujetos que cursaban primer y tercer año de las siguientes especialidades que imparte el CENDEISSS: anestesiología y recuperación, especialidades médicas y quirúrgicas, ginecología y obstetricia, pediatría y psiquiatría. Se aplicó el Maslach Burnout Inventory-Human Services Survey (versión validada en español) y una ficha de datos sociodemográfica que incluía especialidad médica, sede de residencia, sexo, estado civil, número de hijos, edad de los participantes, frecuencia mensual de guardias y año cursado de residencia. Resultados: El análisis final detectó alto agotamiento emocional en mujeres y en residentes de pediatría; bajo agotamiento emocional en quienes realizan en promedio 4 guardias por mes y en residentes de geriatría y psiquiatría; alta despersonalización en hombres; baja despersonalización en residentes de geriatría y medicina familiar así como en personas unidas; bajos niveles de realización personal en personas unidas; el síndrome de desgaste como tal fue mayor en mujeres, que cursaban el tercer año, sujetos unidos, personas con hijos, menores de 30 años y residentes de las especialidades médicas. Adicionalmente se validó la utilización de la escala en Costa Rica. Conclusión: existen subgrupos de médicos residentes que se encuentran en riesgo de presentar el síndrome de desgaste profesional o elevadas puntuaciones en algunas de sus 3 dimensiones. Algunos de ellos podrían ser propios del personal que mantiene una carga académica y laboral al mismo tiempo. Este hecho debe ser tomado en cuenta cuando se planifican las estrategias de bienestar mental en el sector salud.
Background and aim: to determine the socio-demographic characteristics of the burnout syndrome in residency trainees in Costa Rica in 2007 and to validate the Maslach Burnout Inventory-Human Services Survey (Spanish version). Materials and methods: The present is a descriptive and cross-sectional study. One hundred and 21 subjects were interviewed during the first and third year of specialization in anesthesiology, surgery and medical disciplines, gynecology and obstetrics, pediatrics and psychiatry. All of them completed the Maslach Burnout Inventory Human Services Survey (Spanish validated) and a socio-demographic questionnaire which included: medical specialty, residency center, sex, marriage status, number of children, age, number of on-call assignments per month and year of residency. Results: high levels of emotional exhaustion were found in women and pediatrics trainees; however the opposite was seen in those on-call 4 times a month on average, as well as in geriatrics and psychiatry residents. Depersonalization was elevated in men, but low in those living with someone, geriatrics and family medicine residents. Negative personal accomplishment was seen in those who lived with someone else. The Burnout Syndrome by itself was more frequent in women, third year residents, people living with someone else and with children, those below 30 years and those undergoing training in medical subspecialties. The inventory was validated for use its in Costa Rica. Conclusion: Subgroups undergoing residency training are at risk of developing Burnout Syndrome. Some of them could be related to the academic and occupational burden. When planning mental health strategies, this fact must be considered.
Assuntos
Humanos , Esgotamento Profissional , Costa Rica , Corpo Clínico Hospitalar/tendênciasRESUMO
OBJECTIVE: The understanding of complex heritable psychiatric disorders such as schizophrenia could be clarified by examining endophenotypes within genetically isolated populations, such as the one found in the Central Valley of Costa Rica. The reduction of familial variability within a sample could allow the relationship between the cognitive and symptomatic manifestations of the illness and the genetic underpinnings to become more observable. This study investigates the neuropsychological test performances of 41 family members from four extended multiplex families within the Spanish origin population of the Central Valley of Costa Rica as potential endophenotypes for genetic studies. METHODS: Individuals with a diagnosis of schizophrenia or schizoaffective disorder were compared with unaffected relatives and 15 unrelated controls with no family history of schizophrenia. RESULTS: Although the sample size is small, the results confirm previous reports in the literature of deficits in working memory, executive function, processing speed, and verbal fluency in individuals with schizophrenia compared with controls and intermediate performance in nonpsychotic family members compared with controls. We also found several suggestive quantitative cognitive trait loci with log of the odds greater than 1.75. CONCLUSION: These findings suggest that the cognitive deficits in schizophrenia are consistent aspects of the illness, although their usefulness as endophenotypes for genetic studies remains unclear.