RESUMO
BACKGROUND AND OBJECTIVE: Collecting information from different raters is important for diagnosing ADHD, but several factors can lead to gathering discrepant information. Our aim was to determine the agreement between parent and teacher's when rating the list of ADHD symptoms (criterion A, DSM-IV) in a sample of Mexican school-age children. We explored whether inter-rater agreement varied by children's age and sex, and each symptom of inattention, hyperactivity, and impulsivity. METHODS: A total of 789 children (335 girls) from six elementary school grades grouped as G1 [grades 1-2], G2 [grades 3-4], and G3 [grades 5-6]) were rated by their parents and teachers. We identified inter-rater reliability by using Cohen's kappa coefficient by school level, sex, and ADHD symptoms. We explored the presence of symptoms considering parents' and teachers' ratings, individually and collapsed, using the AND/OR rules. RESULTS: Low inter-rater agreement was observed. Moderate levels were observed in G1, but not in G2 or G3. Both groups of informants reported that more boys than girls met these criteria, but agreement by sex was still low, as were the results of the analyses by individual symptoms. Among the children that met the ADHD criteria, an inattention symptom was the one most frequently reported by both raters, whereas among non-ADHD children, a hyperactive symptom was the one most often reported. DISCUSSION: The exclusive use of questionnaires fails to provide convergent information between raters. We highlight the importance of conducting comprehensive clinical histories when diagnosing ADHD in order to explore what these discrepancies show about the relationship symptoms/context.
RESUMO
Objetivo: El síndrome de burnout, considerado desde el año 2000 por la OMS como una enfermedad de riesgo laboral, es prevalente en anestesiólogos según diversos estudios. Nuestro objetivo fue determinar la prevalencia de este síndrome en residentes y asistentes, y a qué factores se encuentra asociado. Material y métodos: Estudio observacional y transversal. Se aplicó el cuestionario de Maslach y de factores de riesgo asociado al síndrome de burnout de manera anónima a anestesiólogos y residentes de anestesiología programados con actividades en el rol de setiembre y que aceptaron participar del estudio. Los cuestionarios se desarrollaron en sala de operaciones con entrega en sobre cerrado al terminar. Los datos se presentan en tablas de frecuencias, porcentajes y gráficos. El análisis de los datos cualitativos fue con la prueba de Chi cuadrado y correlación de Spearman. Resultados: Se encuestaron un total de 20 médicos (55%), 17 con cuestionario completo, 2 encuestados (10%) presentaron síndrome de burnout. Asociaciones agotamiento emocional: estado de salud / calidad de vida, x2 = 10.90, alfa < 0.05 / x2 = 9.24, alfa < 0.05; despersonalización: estímulos institucionales, x2 = 15.00, alfa < 0.01; realización personal: estado civil, x2 = 9.10, alfa < 0.05. Correlaciones agotamiento emocional: horas anestesia/semana, p = 0.65, alfa < 0.01; despersonalización: número de hijos/edad, p = -0.48, alfa < 0.05 / p = -0.58, alfa < 0.05, respectivamente. No hubo correlación entre componentes Maslach y factores de riesgo asociados (puntaje final). Conclusiones: El síndrome de burnout es prevalente en nuestro departamento. Salvo algunos componentes, los encuestados presentan fenómenos compensatorios protectores para el desarrollo del síndrome de burnout y también puede existir un subregistro importante.
Objective: The burnout syndrome, considered since 2000 by the WHO as an occupational hazard disease, is prevalent in anesthesiologists according to some studies. Our objective was to determine the prevalence of this syndrome in anesthesiologists and anesthesia residents and the factors related to it. Material and methods: observational and transversal study. Maslach and associated risk factors with Burnout syndrome questionnaire was applied anonymously to anesthesiologists and anesthesia residents programmed with activities in September who agreed to participate in the study. The questionnaires were developed in the operating room and delivered in sealed envelopes. The data was presented in frequency tables, percentages and graphs. The qualitative data analysis was with the Chi square test and Spearman correlation. Results: 20 physicians (55%9 were interviewed, 17 with full questionnaire. 2 respondents (10%) presented burnout syndrome. Associations emotional exhaustion: health status / quality of life, x2 = 10.90, alpha < 0.05 / x2 = 9.24, alpha < 0.05; depersonalization: institutional incentives, x2 = 15.00, alpha < 0.01, personal realization: marital status, x2 = 9.10, alpha < 0.05. Correlations emotional exhaustion: anesthesia hours/week, p = 0.65, alpha < 0.01; depersonalization: number of children/age, p=-0.48, alpha < 0.05 / p = -0.58, alpha < 0.05, respectively. There was no correlation between Maslach components and associated risk factors (final score). Conclusions: The burnout syndrome is prevalent in our department. Except for some components, interviewees have compensatory phenomena protective for the development of burnout syndrome and may also be significant underreporting.