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RESUMEN Introducción: el clima educacional (CE) de posgrado en el ambiente hospitalario puede determinar la manera en como los médicos residentes (MR) se adaptan a su nueva etapa, durante el cual el sindrome agotamiento profesional (SAP) es altamente probable de producirse en algún momento. Objetivo: determinar la relación entre el clima educacional y el agotamiento profesional en médicos de los programas de residencias médicas del Hospital Nacional 2023-2024. Metodología: estudio observacional transversal de una muestra por conveniencia de MR de ambos sexos de todas las especialidades médicas del Hospital Nacional entre noviembre 2023 y enero 2024, se excluyeron MR con rotación externa y/o vacaciones. Calculo muestral; 136 MR. Se envió un formulario en línea de Google al correo electrónico del MR solicitando la participación voluntaria. El SAP fue medido con el método estándar Maslach Burnout Inventory (MBI) con subescalas; agotamiento emocional (AE), despersonalización (DESP), realización personal (RP), existiendo SAP con puntuaciones altas de AE, DESP y bajas de RP. El CE fue valorado con la medida del entorno educativo de posgrado hospitalario (PHEEM) con subescalas; percepción autonomía de roles (PAR), percepción enseñanza (PE), percepción soporte social (PSS), a mayor puntaje mejor CE. Se recopiló variables demográficos, académicos, puntajes del MBI y PHEEM, el SAP fue considerado dependiente, como resultado principal la relación predictiva del PHEEM sobre el SAP. Se compararon datos con χ², prueba t o U de Mann-Whitney, ANOVA y regresión lineal (p-valor significativo =<0,05). Resultados: de 233 participantes, la edad media fue de 28,75 (± 2,20), el 63,94 % (149) mujeres, la prevalencia general del SAP; 70,38 % (164/233), SAP en hombres 75 % (63/84) y mujeres 67,78 % (101/149) p=0,0014, los 2 primeros años con mayor frecuencia de SAP; 65 (85,52 %), 59 (86,76 %) repectivamente p=0,0009, de especialidades quirúrgicas 63 (90 %) p=0,0071. Las subescalas del MBI el AE;79,82 % (186) con un promedio de 35,39 (± 11,61) puntos. El PHEEM de los MR con SAP; 107,9(ï± 19,6) puntos y sin SAP; 136,3(ï± 12,1) puntos IC 95 % 18,125,0 p= 0,0001. El PHEEM predijo el AE con R2=0,619, PPS; B= -0,18 (±0,009) p=0,001, y la DESP; R2= 0,385, PPS; B= -0,001 (±0,004) p=0,009 siendo PSS predictor significativo con correlación inversa en ambas. Conclusión: existe relación inversa entre el clima educativo y el sindrome de agotamiento profesional en la población estudiada, con alta prevalencia de este en residentes hombres de especialidades quirúrgicas, siendo el soporte social del ambiente educativo hospitalario un predictor significativo para el desarrollo del sindrome de agotamiento profesional.
ABSTRACT Introduction: the postgraduate educational climate (CE) in the hospital environment can determine the way in which resident physicians (MRs) adapt to their new stage, during which professional burnout syndrome (PAS) is highly likely to occur at some point. Objective: to determine the relationship between the educational climate and professional burnout in physicians in the medical residency programs of the National Hospital 2023-2024. Methodology: cross-sectional observational study of a sample of MR convenience of both sexes from all medical specialties of the National Hospital between November 2023 and January 2024, MR with external rotation and/or vacations were excluded. Sample calculation; 136 MR. An online form from Google was sent to the MR email requesting voluntary participation. The SAP was measured with the standard Maslach Burnout Inventory (MBI) method with subscales; emotional exhaustion (EA), depersonalization (DESP), personal fulfillment (PR), with PAS with high scores of AE, DESP and low RP. The EC was assessed with the measure of the hospital postgraduate educational environment (PHEEM) with subscales; perception of role autonomy (PAR), perception of teaching (PE), perception of social support (PSS), the higher the score, the better the EC. Demographic and academic variables, MBI and PHEEM scores were collected, and the SAP was considered dependent, as the main result was the predictive relationship of the PHEEM on the SAP. Data were compared with χ², t-test or Mann-Whitney U, ANOVA and linear regression (p-significant value =<0.05). Results: of 233 participants, the mean age was 28.75 (±2.20), 63.94 % (149) women, the general prevalence of PAS; 70.38 % (164/233), PAS in men 75 % (63/84) and women 67.78 % (101/149) p=0.0014, the first 2 years with the highest frequency of PAS; 65 (85.52 %), 59 (86.76 %) respectively p=0.0009, 63 (90 %) p=0.0071 surgical specialties. The subscales of the MBI, the AE; 79.82 % (186) with an average of 35.39 (± 11.61) points. The CE of MRs with SAP; 107.9 (19.6) dots and without PAS; 136.3 (12.1) dots 95 % CI 18.125.0 p= 0.0001. The PHEEM predicted the AE with R2=0.619, B= -0.18 (±0.009) p=0.001, and the DESP; R2= 0.385, B= -0.001(0.004) p=0.009, PSS being a significant predictor with inverse correlation in both. Conclusion: there is an inverse relationship between the educational climate and burnout syndrome in the population studied, with a high prevalence of burnout in male residents of surgical specialties, with the social support of the hospital educational environment being a significant predictor for the development of burnout syndrome.
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Humanos , Saúde Mental , Esgotamento Psicológico , Descanso , Estudantes de Medicina , Educação MédicaRESUMO
Despite the societal progress made in recent years, gender discrimination is still common in healthcare, especially in some surgical specialties such as orthopaedics. In Brazil, where the participation of women in the medical profession has been increasing, little is known about women's perceptions on the issue of gender discrimination. This study aims to examine women orthopaedic surgeons' experiences in dealing with conflict in the workplace and contextualize the impact that gender discrimination has had or currently has on their careers and well-being. As a secondary objective, the work seeks to understand whether there are differences in the perception of the issue among practicing women orthopaedic surgeons and those in training. For a cross-sectional qualitative study, a survey was distributed exclusively to 300 practicing orthopaedic surgeons and orthopaedists in training (residents and fellows). A total of 99 women participated in the survey, of whom 66 were practicing orthopaedic surgeons and 33 were orthopaedists in training. The study showed that women orthopaedic surgeons in training in Brazil have a lower number of publications and a moderate level of involvement in academic society activity. In addition, orthopaedic surgeons in training experience a statistically significantly higher number of conflicts in the workplace. The comments from the questionnaires highlighted the physical and psychological consequences arising from these situations of professional conflict, most frequently occurring with orthopaedic surgeons who are men. Our findings indicate that respondents expressed a feeling of inequality towards women in the workplace, ultimately reducing the level of job satisfaction among female orthopaedic surgeons, which may contribute to disinterest and abandonment of the specialty. The results of this work support recent evidence that there is an implicit and often overlooked bias against the participation of women and ethnic minorities in the orthopaedic community in Brazil.
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BACKGROUND: A meta-analysis of randomized controlled trials has suggested a bidirectional relationship between sleep problems and mental health issues. Despite these findings, there is limited conclusive evidence on the relationship between sleep quality, depression, anxiety, and burnout. OBJECTIVE: The current study aimed to evaluate the relationships between sleep quality symptoms, anxiety, depression, and burnout in samples of adult individuals from two Latin American countries, Peru and El Salvador, through network analysis and to identify key symptoms that reinforce the correlation and intensify the syndromes. METHODS: A total of 1012 individuals from El Salvador and Peru participated, with an average age of 26.5 years (SD = 9.1). Symptom networks were constructed for both countries based on data from the Jenkins Sleep Scale, Patient Health Questionnaire-2, General Anxiety Disorder-2, and a single burnout item. RESULTS: The results indicated that Depressed Mood, Difficulty Falling Asleep, and Nervousness were the most central symptoms in a network in the participating countries. The strongest conditional associations were found between symptoms belonging to the same construct, which were similar in both countries. Thus, there is a relationship between Nervousness and Uncontrollable Worry, Anhedonia and Depressed Mood, and Nighttime Awakenings and Difficulty in Staying Asleep. It was observed that burnout is a bridge symptom between both countries and presents stronger conditional associations with Tiredness on Awakening, Depressed Mood, and Uncontrollable Worry. Other bridge symptoms include a Depressed Mood and Nervousness. The network structure did not differ between the participants from Peru and El Salvador. CONCLUSION: The networks formed by sleep quality, anxiety, depression, and burnout symptoms play a prominent role in the comorbidity of mental health problems among the general populations of Peru and El Salvador. The symptom-based analytical approach highlights the different diagnostic weights of these symptoms. Treatments or interventions should focus on identifying central and bridge symptoms.
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AIM AND OBJECTIVES: To analyse the levels of anxiety, depression, post-traumatic stress, and burnout among nursing professionals working in the Imbabura region of Ecuador during the COVID-19 pandemic and identify the contributing socio-occupational factors. BACKGROUND: The high demand for care of COVID-19 patients led to increased work pressure on nurses, owing to increased demands for care and shortages of medical supplies and protective equipment. DESIGN: A cross-sectional study was conducted from September to December 2022 using a self-administered questionnaire addressed to nursing professionals who cared for COVID-19 patients. METHODS: The questionnaire included socio-demographic characteristics, the Spanish adaptation of Hospital Anxiety and Depression Scale (HADS-Spanish), Impact of Event Scale-Revised (IES-R) for the evaluation of post-traumatic stress disorder (PTSD), and the Spanish adaptation of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS-Spanish) for burnout assessment. Univariate and multivariate analyses were performed. RESULTS: Of the 782 participants, 88.6% had a high level of burnout (MBI-HSS-Spanish scale score > 27). Female nurses, nurses with eight-hour work shifts, and older professionals exhibited high levels of anxiety and depression. Prolonged working hours in COVID-19 patient care services were found to be a risk factor for burnout and post-traumatic stress. CONCLUSIONS: Participating nurses presented with a high level of chronic work stress and exhibited signs of anxiety and depression during the period under consideration. Providing nurses with psychological support measures and performing liaison consultations will alleviate the psychological burden on nurses. RELEVANCE TO CLINICAL PRACTICE: The study has shown that accounting for the environments where the emotional impact is greatest and how to reduce it would not only reduce anxiety, depression, and burnout in nurses but also improve the quality of care, not only in pandemic. PATIENT OR PUBLIC CONTRIBUTION: Nurses contributed to the conduct of the study by participating in the data collection via questionaries.
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The state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress, known as Burnout Syndrome (BS), is not only affecting the medical workforce but medical students in training. Gender, race, ethnicity, and potentially other variables can serve as significant risk factors contributing to BS among medical students. Despite the importance of understanding these disparities, very few studies in the U.S. have analyzed race or ethnicity amongst their cohorts. However, there exists extensive information on burnout in students from Latin America, which serves as the primary focus of this review. A systematic literature search was conducted using pertinent terms in English and Spanish. Our review found that the prevalence of BS in Latin American countries varies widely, ranging from 4.3 to 43.90% pre-COVID-19 pandemic. Variability in the educational environment and the complex interplay of cultural, academic, and systemic factors appear to contributing to burnout among students. Post-pandemic investigations reveal even higher prevalences, particularly among women. High rates of depression and anxiety are also reported during the COVID-19 pandemic. The reviewed data showed that BS can become further exacerbated and complicated by existing psychiatric comorbidities amongst Latin American medical students. It is possible that we may observe continued upward trajectories in burnout trends among both healthcare workers and medical students in this post-COVID-19 pandemic era. These insights call for tailored interventions addressing not only burnout but also the interconnected mental health challenges faced by medical students in Latin America.
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OBJECTIVE: Communication between patients and mental health professionals by means of messaging platforms in the interval between synchronous encounters became a kind of asynchronous teleconsultation (AT) whose usefulness and effect on providers' workload have not been explored. Method: Mental health providers working in Argentina were invited to answer a survey exploring the intensity and usefulness of AT, and the resulting overload. RESULTS: A total of 527 responses from professionals working throughout the country were received. As much as 69% of respondents exchanged messages with a mean of 1-10 patients/day and 31% with more than 10 patients/day; 75% answered messages over mobile phones on weekends. While 68% rated these interactions as positive for clinical follow-up, 47% considered them as a source of work overload. CONCLUSIONS: The generalized adoption of AT may require additional self-regulation by clinicians and regular monitoring of overload levels (particularly, among psychiatrists) to make their daily clinical practice efficient and sustainable.
OBJETIVOS: La comunicación entre pacientes y profesionales de la salud mental mediante plataformas de mensa- jería en el intervalo entre encuentros presenciales o virtuales se convirtió en una modalidad de teleconsulta asincrónica (TA) cuya utilidad y efecto en la carga de trabajo de los profesionales de salud mental no se han explorado. Método: Profesionales del campo de la salud mental que trabajan en Argentina fueron invitados a responder a una encuesta que exploraba la intensidad y utilidad de la TA, y la sobrecarga resultante. RESULTADOS: Se recibieron un total de 527 respuestas de profesionales que trabajan en todo el país. El 69 % de los encuestados mensajes con un promedio de 1-10 pacientes/día y el 31 % con más de 10 pacientes/día; el 75 % respondió mensajes por teléfono móvil los fines de semana. Mientras que el 68 % calificó estas interacciones como positivas para el seguimiento clínico, el 47 % las consideró una fuente de sobrecarga laboral. CONCLUSIONES: La adopción generalizada de la TA puede requerir una autorregulación adicional por parte de los profesionales y un seguimiento regular de los niveles de sobrecarga (especialmente, entre los psiquiatras) para que su práctica clínica diaria sea eficiente y sostenible.
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Psiquiatria , Psicologia , Argentina , Humanos , Aplicativos Móveis , Masculino , Feminino , Adulto , Serviços de Saúde Mental , Pesquisas sobre Atenção à Saúde , Pessoa de Meia-Idade , PsiquiatrasRESUMO
Background: The COVID-19 pandemic has impacted the residency experience for physicians across all specialties. There have been studies examining resident perspectives on changes in curriculum and clinical experiences due to the pandemic; however, little research has been conducted on how residents in different specialties interpreted their educational experience and rates of burnout during the pandemic. Methods: We extended surveys to 281 residents across 15 separate residency programs between November 17, 2020, and December 20, 2020. The questions pertained to burnout and the effects of the pandemic on their careers. Differences between general and specialty medicine resident responses were analyzed using descriptive statistics and the Mann-Whitney U test. Results: The final analysis included 105 responses (40% response rate). We received 62 surveys (59%) from general medicine residents and 43 surveys (41%) from specialty medicine residents, with a higher response rate from junior level trainees in both groups. We found no significant differences between general and specialty residents on the level of burnout, impact on clinical experience, or future career due to COVID-19, though there was a significant difference between resident groups on the perceived impact of COVID-19 on learning. Conclusion: Specialty medicine residents reported a negative perception of the pandemic's impact on their learning during residency suggesting a greater impact on training than was perceived by the general medicine residents. Residents from general and specialty medicine programs reported similar levels of burnout and similar perceptions of the pandemic's impact on their clinical experience and future career prospects. Understanding the impacts of the COVID-19 pandemic on resident education and well-being should serve graduate medical education administrators well and prepare them for future interruptions in the traditional learning process.
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Introdução: A pandemia da COVID-19 tem impactado signicativamente a saúde mental dos profissionais de saúde, especialmente dos enfermeiros que estão na linha de frente do combate à doença. Nesse contexto, a síndrome de Burnout é um fenômeno que tem recebido destaque, pois pode levar ao esgotamento físico e emocional desses profissionais. Objetivo: Este artigo tem como objetivo analisar a relação entre enfermeiros e a síndrome de Burnout diante da pandemia da COVID-19. Método: Trata-se de revisão de literatura cientíca que abordam a temática em questão. Resultados: Os resultados apontam que a pandemia da COVID-19 aumentou a sobrecarga de trabalho dos enfermeiros, que têm enfrentado condições adversas de trabalho, como falta de equipamentos de proteção individual e o medo de contaminação. Essas condições têm levado a um aumento dos níveis de estresse e ansiedade entre os enfermeiros, o que pode contribuir para o desenvolvimento da síndrome de Burnout. Portanto, é necessário que sejam implementadas medidas de proteção aos profissionais de saúde, como a oferta de suporte emocional e psicológico, além de uma carga de trabalho adequada. Conclusão: A pandemia da COVID-19 teve um impacto signicativo na saúde mental dos profissionais da equipe de enfermagem, com aumento da prevalência de sintomas de depressão, ansiedade e estresse. É essencial fornecer suporte psicológico e emocional, melhorar as condições de trabalho e garantir o acesso a equipamentos de proteção adequados. Investir na saúde mental desses profissionais é fundamental para o bem-estar individual e a qualidade do cuidado aos pacientes. Instituições de saúde, gestores e profissionais devem reconhecer essa importância e trabalhar juntos para fornecer o suporte necessário durante e após a pandemia.(AU)
ntroduction: The COVID-19 pandemic has signicantly impacted the mental health of health professionals, especially nurses who are on the front lines of ghting the disease. In this context, the Burnout syndrome is a phenomenon that has been highlighted, as it can lead to physical and emotional exhaustion of these professionals. Objective: This article aims to analyze the relationship between nurses and the Burnout syndrome in the face of the COVID-19 pandemic. Method: For this purpose, books and scientic articles that address the subject in question were consulted. Results: The results show that the COVID-19 pandemic has increased the workload of nurses, who have been facing adverse working conditions, such as lack of personal protective equipment and fear o f contamination. These conditions have led to increased levels of stress and anxiety among nurses, which may contribute to the development of the Burnout syndrome. Therefore, it is necessary to implement protective measures for health professionals, such as offering emotional and psychological support, in addition to an adequate workload. Conclusion: The COVID-19 pandemic had a signicant impact on the mental health of nursing staff, with an increased prevalence of symptoms of depression, anxiety and stress. It is essential to provide psychological and emotional support, improve working conditions and ensure access to adequate protective equipment. Investing in the mental health of these professionals is essential for individual well-being and the quality of patient care. Health institutions, managers and professionals must recognize this importance and work together to provide the necessary support during and after the pandemic.(AU)
Introducción: La pandemia de COVID-19 ha impactado signi cativamente la salud mental de los profesionales de la salud, especialmente las enfermeras que están en primera línea luchando contra la enfermedad. En este contexto, el síndrome de Burnout es un fenómeno que ha recibido atención, ya que puede provocar agotamiento físico y emocional de estos profesionales. Objetivo: Este artículo tiene como objetivo analizar la relación entre enfermeras y síndrome de Burnout ante la pandemia de COVID-19. Método: Se trata de una revisión de la literatura cientí ca que aborda el tema en cuestión. Resultados: Los resultados indican que la pandemia de COVID-19 ha aumentado la carga de trabajo de las enfermeras, quienes han enfrentado condiciones laborales adversas, como falta de equipos de protección personal y miedo a la contaminación. Estas condiciones han provocado mayores niveles de estrés y ansiedad entre las enfermeras, lo que puede contribuir al desarrollo del síndrome de Burnout. Por ello, es necesario implementar medidas de protección para los profesionales sanitarios, como ofrecer apoyo emocional y psicológico, además de una carga de trabajo adecuada. Conclusión: La pandemia de COVID-19 tuvo un impacto signi cativo en la salud mental de los profesionales del equipo de enfermería, con aumento en la prevalencia de síntomas de depresión, ansiedad y estrés. Es fundamental brindar apoyo psicológico y emocional, mejorar las condiciones laborales y garantizar el acceso a equipos de protección adecuados. Invertir en la salud mental de estos profesionales es fundamental para el bienestar individual y la calidad de la atención al paciente. Las instituciones, gestores y profesionales de la salud deben reconocer esta importancia y trabajar juntos para brindar el apoyo necesario durante y después de la pandemia. (AU)
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Saúde Mental , Pessoal de Saúde , Esgotamento Psicológico , COVID-19 , EnfermeirosRESUMO
As condições de trabalho às quais os professores são submetidos levam, muitas vezes, ao seu desgaste físico e mental. Uma consequência desse desgaste é o número crescente de casos de síndrome de burnout entre esses profissionais. Este trabalho objetiva, então, apresentar e discutir a produção científica sobre a percepção das causas da síndrome de burnout em professores. Trata-se de uma revisão integrativa de literatura, realizada em junho de 2023. A questão norteadora foi baseada na estratégia de população, interesse e contexto (PICo). A busca pelos artigos foi realizada nas bases de dados: Medical Literature Analysis and Retrieval System Online (Medline), via PubMed, e SciELO, utilizando os termos de busca: "School Teachers" AND "Burnout, Professional". O processo de seleção dos estudos foi seguido conforme as recomendações do PRISMA. Na busca, foi recuperado o quantitativo de 72 publicações e, ao final, foram selecionados sete estudos para a amostra. Os estudos evidenciaram como as principais causas da síndrome de burnout em professores: a desvalorização dos profissionais; violência; exaustão emocional; conflitos com alunos; assédio; sobrecarga; falta de suporte organizacional; e a pandemia de covid-19. Observou-se que os professores são submetidos diariamente a vários fatores que podem desencadear a síndrome de burnout. Desse modo, fica evidente a necessidade de intervenções para atenuar a problemática. Compreende-se o fortalecimento das políticas públicas como uma estratégia resolutiva, levando em consideração a importância da saúde mental dos professores.
The unfavorable working conditions faculty members are subjected to often lead to their physical and mental exhaustion, consequently increasing the prevalence of burnout syndrome among these professionals. Thus, this study presents and discusses the scientific literature on the perceived causes of burnout syndrome among faculty members. An integrative literature review was conducted in June 2023 based on a question formulated using the population, interest and context (PICo) strategy. The Medline via PubMed and Scielo databases were consulted using the search terms "School Teachers" AND "Burnout, Professional". Selection followed the PRISMA recommendations. From the 72 publications identified, seven studies were included in the final sample. According to the studies, professional devaluation, violence, emotional exhaustion, conflicts with students, harassment, overload, lack of organizational support, and the COVID-19 pandemic are the main causes of burnout among teachers. Faculty members are daily exposed to various factors that can trigger burnout syndrome evancing the need for interventions to mitigate this problem. Strengthening public policies is as a solution strategy, considering the importance of teachers' mental health.
Las condiciones laborales que enfrentan los docentes generan, muchas veces, agotamiento físico y mental en esta población. Una consecuencia de este estrés es el aumento de la prevalencia del síndrome de burnout entre estos profesionales. Este estudio tiene por objetivo presentar y discutir la producción científica sobre la percepción de las causas del síndrome de burnout entre los docentes. Este estudio es una revisión integradora de la literatura realizada en junio de 2023. La pregunta orientadora se formuló basándose en la estrategia de población, interés y contexto (PICo). Se buscaron artículos en las bases de datos Medline a través de PubMed y SciELO utilizando el término de búsqueda: "School Teachers" AND "Burnout, Professional". El proceso de selección de estudios siguió las recomendaciones de PRISMA. La búsqueda arrojó un total de 72 publicaciones, y se seleccionaron siete estudios para la muestra final. Los estudios revelaron que las principales causas del burnout entre los docentes fueron la desvalorización profesional, la violencia, el agotamiento emocional, los conflictos con los estudiantes, el acoso, la sobrecarga, la falta de apoyo organizacional y la pandemia del covid-19. Se observó que los docentes están expuestos diariamente a diversos factores que pueden desencadenar el síndrome de burnout. Por lo tanto, se hace evidente la necesidad de intervenciones para mitigar este problema. El fortalecimiento de las políticas públicas es una estrategia de solución teniendo en cuenta la importancia de la salud mental de estos profesionales.
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BACKGROUND: The demand for healthcare services during the COVID-19 pandemic was excessive for less-resourced settings, with intensive care units (ICUs) taking the heaviest toll. OBJECTIVE: The aim was to achieve adequate personal protective equipment (PPE) use in 90% of patient encounters, to reach 90% compliance with objectives of patient flow (OPF) and to provide emotional support tools to 90% of healthcare workers (HCWs). METHODS: We conducted a quasi-experimental study with an interrupted time-series design in 14 ICUs in Argentina. We randomly selected adult critically ill patients admitted from July 2020 to July 2021 and active HCWs in the same period. We implemented a quality improvement collaborative (QIC) with a baseline phase (BP) and an intervention phase (IP). The QIC included learning sessions, periods of action and improvement cycles (plan-do-study-act) virtually coached by experts via platform web-based activities. The main study outcomes encompassed the following elements: proper utilisation of PPE, compliance with nine specific OPF using daily goal sheets through direct observations and utilisation of a web-based tool for tracking emotional well-being among HCWs. RESULTS: We collected 7341 observations of PPE use (977 in BP and 6364 in IP) with an improvement in adequate use from 58.4% to 71.9% (RR 1.2, 95% CI 1.17 to 1.29, p<0.001). We observed 7428 patient encounters to evaluate compliance with 9 OPF (879 in BP and 6549 in IP) with an improvement in compliance from 53.9% to 67% (RR 1.24, 95% CI 1.17 to 1.32, p<0.001). The results showed that HCWs did not use the support tool for self-mental health evaluation as much as expected. CONCLUSION: A QIC was effective in improving healthcare processes and adequate PPE use, even in the context of a pandemic, indicating the possibility of expanding QIC networks nationwide to improve overall healthcare delivery. The limited reception of emotional support tools requires further analyses.
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COVID-19 , Unidades de Terapia Intensiva , Melhoria de Qualidade , SARS-CoV-2 , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Argentina , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Feminino , Equipamento de Proteção Individual/estatística & dados numéricos , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Atenção à Saúde/normas , Adulto , Saúde Pública/métodos , Pessoal de Saúde/estatística & dados numéricos , Pessoal de Saúde/psicologia , Análise de Séries Temporais Interrompida/métodosRESUMO
BACKGROUND: During the pandemic, many police dentists had the crucial responsibility of ensuring law and order while providing dental care by taking government-approved health measures to stop the spread of the coronavirus. The aim of this study was to assess the association between the fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the National Police of Peru (PNP), taking into account possible confounding variables. METHODS: This cross-sectional and analytical study included 182 PNP dentists. The Fear COVID-19 Scale assessed fear of COVID-19 and the Maslach Burnout Inventory Test assessed burnout syndrome. The association between the fear of COVID-19 and Burnout syndrome (self-fulfilment) was analyzed using Spearman's Rho. A multivariable Poisson regression model with a robust variance estimation method was employed to evaluate the impact of fear of COVID-19 on the various dimensions of Burnout syndrome, considering possible confounding variables. The statistical significance level was set at p < 0.05. RESULTS: Under bivariate analysis, fear of COVID-19 was significantly linked with low direct intensity toward emotional exhaustion (Rho = 0.325, p < 0.001), very low direct intensity toward depersonalization (Rho = 0.180, p = 0.015), and very low inverse intensity toward self-fulfilment (Rho =-0.186, p = 0.012). Under multivariable analysis, it was observed that dentists who exhibited fear of COVID-19 were 3.4 and 3.7 times more likely to experience emotional exhaustion and depersonalization, respectively (APR = 3.40, 95% CI: 1.74-6.63 and APR = 3.68, 95% CI: 1.31-10.37), as compared to those who did not display fear of COVID-19. Moreover, none of the potential confounding factors were found to have a significant impact on emotional exhaustion (p > 0.05), depersonalization (p > 0.05), and self-fulfilment (p > 0.05). CONCLUSION: Fear of COVID-19 was significantly associated with emotional exhaustion and depersonalization, and inversely associated with self-fulfilment. PNP dentists who exhibited fear of COVID-19 were at greater risk for emotional exhaustion and depersonalization. In developing Burnout syndrome, no significant impact was observed from factors such as age, gender, marital status, children, hierarchy, years of service, work area, private practice, work over 40 h per week, type of service, work performed, sport practice and daily exercise time.
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Esgotamento Profissional , COVID-19 , Odontólogos , Medo , Polícia , Humanos , Estudos Transversais , COVID-19/psicologia , COVID-19/epidemiologia , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Masculino , Feminino , Odontólogos/psicologia , Odontólogos/estatística & dados numéricos , Adulto , Peru/epidemiologia , Polícia/psicologia , Medo/psicologia , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: There is growing concern about the occurrence burnout syndrome in university students worldwide. This systematic review aimed to estimate the prevalence of burnout syndrome and its associated factors among health sciences students (HSS) from Spain. METHODS: Five databases (MEDLINE/PubMed, PsycINFO, EMBASE, Dialnet and MEDES) were searched up to January 5, 2023, adhering to PRISMA guidelines. Quantitative studies reporting the prevalence of burnout syndrome among HSS from Spanish universities were considered. The reference lists of the selected studies were hand searched. Data were extracted from peer-reviewed articles. RESULTS: Twenty-six studies with a total of 14,437 HSS were included (11 nursing, 8 Medicine, five Psychology, two Dentistry, one Physiotherapy, one Pharmacy students). Overall, study quality was fair. The most widely used instrument was the Maslach Burnout Inventory. The mean prevalence of burnout was 35.3% (k=11 studies). However, rates varied widely across the studies, which may result from methodological differences. Inconsistent associations were found with gender and year of study. The relationship of burnout with academic-and mental-health related variables was consistent across studies. Personal attributes such as higher resilience, are likely protective from burnout. CONCLUSIONS: Burnout seems to be prevalent among HSS in Spain, and can be affected by academic, mental health-related and personality factors. The identification of risk and protective factors of burnout could help develop preventive and management strategies, to ultimately reduce its negative consequences in this population.
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We present the case of a physician who engages with a peer response team and discloses suicidal ideation while himself seeing patients in the hospital. Top experts in consultation-liaison psychiatry provide guidance for this clinical case based on their experience and a review of the available literature. Key teaching topics include a general approach to suicide risk assessment, peer response programs for healthcare workers, and ethical and clinical considerations in treating colleagues. Consultation-liaison psychiatrists should be familiar with suicide risk management, take a pro-active approach to addressing modifiable risk factors, and keep in mind unique challenges of treating colleagues referred for care.
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Background/Objectives: The burnout syndrome in nurses has been related to the development of mental health problems. On the contrary, resilience is related to adequately coping with stressful situations and better mental health. The objective was to analyze the relationship between resilience and mental health problems in nurses and estimate the proportion mediated by burnout in the association. Methods: In 2021, a total of 1165 Spanish nurses were selected through a stratified random sampling method. Participants anonymously filled in the Resilience Scale (RS-14), the Maslach Burnout Inventory Survey, and the General Health Questionnaire. To test the hypothesis proposed and explain the mediating effect of burnout empirically, structural equation modeling (SEM) was applied. A latent mediation model was computed. Results: Resilience was negatively related to burnout and mental health problems. The direct relationship between burnout and the latent health variable was positive. In addition, in view of the total effect of resilience on mental health problems and the magnitude of the indirect effect, we stated that the proportion of this effect mediated by burnout ranged from 0.486 to 0.870. Conclusions: This study reveals that fostering resilience in nurses directly and indirectly reduces burnout and improves their mental health. The implementation of resilience programs and supportive institutional policies is recommended to improve working conditions and the quality of patient care.
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Rapid changes in medical education are being fueled by advancements in science, technology, and societal structures. However, the traditional medical curriculum often struggles to keep pace with the evolving demands of medical practice in light of these advancements. Neurology presents distinctive challenges in modern medicine, requiring innovative solutions to improve patient care and support the well-being of healthcare providers. This essay delves into the intricate issues encountered by neurologists, such as the diminishing interpersonal connections in the medical field and the prevalent issue of burnout among professionals, exacerbated by outdated educational programs. This research advocates for a comprehensive approach to enhancing neurology practice through the perspectives of Medical Humanities (MH) and neurobiology, within the evolving realm of Neurohumanities. By integrating stateof-the-art neurobiological findings, MH/Neurohumanities, and a focus on empathy, the article proposes practical strategies to rejuvenate clinical practice and bolster the resilience of neurology practitioners. Furthermore, it underscores the untapped potential of artificial intelligence and machine learning while examining how the digital ecosystem could revolutionize neurology medical education. Grounded in evidence-based research and practical insights, this article offers valuable guidance for navigating the complexities of contemporary neurology practice and cultivating a workforce of healthcare professionals who possess both technological acumen and compassion.
Mudanças rápidas na educação médica estão sendo impulsionadas pelos avanços na ciência, tecnologia e estruturas sociais. No entanto, o currículo médico tradicional frequentemente luta para acompanhar as exigências em constante evolução da prática médica diante desses avanços. A neurologia apresenta desafios distintos na medicina moderna, exigindo soluções inovadoras para melhorar o cuidado ao paciente e apoiar o bemestar dos profissionais de saúde. Este ensaio explora as questões complexas enfrentadas pelos neurologistas, como a diminuição das conexões interpessoais no campo médico e o problema prevalente do esgotamento entre os profissionais, exacerbado por programas educacionais desatualizados. Esta pesquisa defende uma abordagem abrangente para aprimorar a prática da neurologia por meio das perspectivas das Humanidades Médicas (HM) e da neurobiologia, dentro do campo em evolução das Neuro- Humanidades. Ao integrar descobertas neurobiológicas de ponta, HM/Neuro-Humanidades e um foco na empatia, o artigo propõe estratégias práticas para rejuvenescer a prática clínica e fortalecer a resiliência dos profissionais de neurologia. Além disso, destaca o potencial inexplorado da inteligência artificial e da aprendizagem de máquina ao examinar como o ecossistema digital poderia revolucionar a educação médica em neurologia. Fundamentado em pesquisas baseadas em evidências e insights práticos, este artigo oferece orientações valiosas para navegar pelas complexidades da prática contemporânea da neurologia e cultivar uma força de trabalho de profissionais de saúde que possuam tanto acuidade tecnológica quanto compaixão.
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Background: Burnout syndrome, characterized by physical, mental, and emotional exhaustion due to continuous exposure to high-stress work conditions, has been increasingly recognized as a serious occupational phenomenon, especially amongst healthcare professionals. Recent studies indicate that illegitimate tasks-activities unrelated to one's role are a significant factor contributing to burnout. However, given the variability of work environments across regions, these findings may not apply universally. Objective: To investigate the behavior of the relationship between burnout and illegitimate tasks among healthcare professionals in Guayaquil, Ecuador. Methods: We conducted a survey of 562 healthcare professionals, including physicians, nurses, and medical/nursing interns, employing the Copenhagen Burnout Inventory and Bern Illegitimate Task Scale. Regression models were developed to predict burnout levels based on multiple factors, including demographic characteristics, professional roles, and perceptions of illegitimate tasks. Results: We revealed a statistically significant positive correlation between burnout and illegitimate tasks, with correlation coefficients ranging from 0.320 to 0.588, with higher levels of illegitimate tasks leading to increased burnout. Interestingly, we also found that age and length of service were negatively correlated with burnout, suggesting that these factors may serve as protective elements against burnout. Conclusions: Illegitimate tasks had an impact on burnout amongst healthcare professionals and emphasized the need for organizational strategies aimed at better task management to mitigate burnout risk.
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Background: Musculoskeletal disorders (MSDs) pose a pervasive concern among nursing professionals due to the high physical workload. Simultaneously, the complex relationship between MSDs and mental health outcomes in this population remains an area of significant interest and importance. Objective: This study aimed to investigate the occurrence of MSDs and their relationships with burnout and psychological suffering within the nursing workforce. Methods: A cross-sectional study was conducted in 2020 involving 291 nursing professionals in Brazil. Standardized questionnaires were employed to gather information on MSDs, mental health outcomes, and pertinent work-related factors. Robust statistical analyses were conducted to ascertain the prevalence of MSDs, establish associations between MSDs and mental health outcomes, and delineate the influence of work-related factors on these associations. Statistical analysis was performed using the R software. Results: The study revealed a significant prevalence of musculoskeletal injuries (MSIs) among nursing workers, focusing on regions that include the lower back, upper back, neck, and shoulders. Individuals with MSIs in the lower back showed a marked increase in emotional exhaustion (p = 0.02), as did those with MSIs in the upper back (p <0.01) and depersonalization (p = 0.07). On the other hand, nursing professionals who reported MSIs in the neck and shoulders had considerably higher scores in emotional exhaustion (p <0.01 and p = 0.01, respectively) and depersonalization (p = 0.05 and p = 0.05, respectively). However, no significant correlations emerged between MSIs and depression or work-related factors. Conclusions: This study highlights the urgency of implementing proactive measures to prevent and manage MSDs within the nursing profession. Moreover, it emphasizes the critical need to enhance working conditions and provide robust support mechanisms to safeguard the mental health of nursing professionals.Open AccessOpen Access.
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BACKGROUND: The Job Demands-Resources (JD-R) theory suggests that an imbalance between job demands and available resources can lead to burnout, negatively affecting job satisfaction. Physical activity is recognized for its positive effects on psychological well-being and could play a crucial role in mitigating burnout and improving job satisfaction, especially in high-demand professions such as nursing. OBJECTIVE: This study investigates the relationship between burnout, physical activity, and job satisfaction in Peruvian nurses, using the JD-R theory as a theoretical framework. METHODS: A cross-sectional and explanatory analysis was conducted on a sample of 420 Peruvian nurses, using a Structural Equation Modeling (SEM) design to analyze the relationships between burnout, physical activity, and job satisfaction. The instruments included the Ultra-Short Burnout Measure (IUB), the General Job Satisfaction Scale NTP 394, and the International Physical Activity Questionnaire (IPAQ). RESULTS: The findings showed a significant negative correlation between burnout and physical activity (ß = -.40, P < .001) and between burnout and job satisfaction (ß = -.46, P < .001). Physical activity exhibited a significant positive correlation with job satisfaction (ß = .22, P < .001). Moreover, mediation analysis confirmed that physical activity mediates the relationship between burnout and job satisfaction (ß = -.106, P < .001). CONCLUSIONS: The findings emphasize the importance of physical activity as a mediator in the relationship between burnout and job satisfaction among Peruvian nurses, highlighting the need to promote physical activity as a strategy to improve workplace well-being. It is suggested that enhancing access to and promotion of physical activity could mitigate the effects of burnout and improve job satisfaction, which is essential for the quality of care and the well-being of nursing staff. These findings underscore the need for organizational and public health strategies that promote a healthy work environment and balance between the demands and resources available.
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Esgotamento Profissional , Exercício Físico , Satisfação no Emprego , Humanos , Esgotamento Profissional/psicologia , Esgotamento Profissional/epidemiologia , Peru , Feminino , Adulto , Exercício Físico/psicologia , Estudos Transversais , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
Objective: To determine the prevalence of anxiety, depression and burnout in residents of Gynecology and Obstetrics during COVID-19 pandemic in Brazil and its associated factors. Methods: Cross-sectional study involving all regions of Brazil, through the application of a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale (HAD) and the Maslach Burnout Inventory (MBI-HSS) instrument. Multivariate analysis was performed after adjusting the Poisson model. Results: Among the 719 participating medical residents, screening was positive for anxiety in 75.7% and for depression in 49.8% of cases. Burnout syndrome was evidenced in 41.3% of the physicians studied. Those with depression are more likely to have anxiety (OR 0.797; 95%CI 0.687 - 0.925) and burnout syndrome (OR 0.847 95%CI 0.74 - 0.97). Residents with anxiety (OR 0.805; 95%CI 0.699 - 0.928) and burnout (OR 0.841; 95%CI 0.734 - 0.963) are more likely to have depression. Conclusion: High prevalence of anxiety, depression and burnout were found in residents of Gynecology and Obstetrics in Brazil, in addition to important correlations between anxiety-depression and depression-burnout.