Síndrome de burnout em enfermeiros de estratégia saúde da família do sul do Brasil / Síndrome de burnout en enfermeras de las estrategias de salud de la familia en el sur de Brasil / Burnout syndrome in nurses of the family health strategies in southern Brazil

Objetivo: identificar a prevalência da Síndrome de Burnout e as características sociodemográficas e ocupacionais associadas em enfermeiros de ESFs de municípios da 28ª Região de Saúde do Rio Grande do Sul. Método: trata-se de um estudo transversal, incluindo enfermeiros de Estratégia Saúde da Família de 13 municípios de uma região do sul do Brasil que responderam um questionário online com aspectos sociodemográficos e ocupacionais e o Maslach Burnout Inventory para mensurar o desfecho de SB no período de março a agosto de 2018. Resultados: um total de 47 enfermeiros respondeu o instrumento. A prevalência de Síndrome de Burnout foi de 57,4%. Os enfermeiros que possuem interesse em trocar de profissão, assim como aqueles que trabalhavam na zona urbana apresentaram associação com a Síndrome de Burnout (p≤0,05). Conclusão: o estudo demonstrou alta prevalência de Síndrome de Burnout entre os enfermeiros que atuam em ESFs da 28ª Região de Saúde, indicando predisposição em desenvolvê-la(AU)

Objective: To identify the prevalence of Burnout Syndrome and AS associated sociodemographic and occupational characteristics in nurses of FHTs from municipalities of the 28th Health Region of Rio Grande do Sul. Methods: This is a crosssectional study, including Family Health Strategy nurses from 13 municipalities of a region of southern Brazil that answered an online questionnaire with sociodemographic and occupational aspects and the Maslach Burnout Inventory to measure the SB outcome from March to August 2018. Results: A total of 47 nurses answered the instrument. The prevalence of SB was 57.4%. Nurses with an interest in changing jobs, as well as those working in the urban area, had an association with SB (p≤0.05). Conclusions: The study demonstrated a high prevalence of SB among nurses who work in FHSs of the 28th Health Region, indicating a predisposition to develop it.(AU)

Objetivo: Identificar la prevalencia de Sindome de Burnout y características sociodemográficas y ocupacionales asociadas en enfermeras de ESFs de municipios de la 28ª Región Sanitaria de Rio Grande do Sul. Métodos: Se trata de un estudio transversal, que incluye enfermeras de la Estrategia de Salud de la Familia de 13 municipios de una región del sur de Brasil. Quienes respondieron un cuestionario en línea con aspectos sociodemográficos y ocupacionales y el Maslach Burnout Inventory para medir el resultado de SB de marzo a agosto de 2018. Resultados: Un total de 47 enfermeras respondieron al instrumento. La prevalencia de BS fue del 57,4%. Las enfermeras que tienen interés en cambiar de profesión, así como las que trabajaban en el área urbana, se asociaron con BS (p≤0.05). Conclusiones: El estudio demostró una alta prevalencia de BS entre las enfermeras que trabajan en ESFs de la 28ª Región de Salud, lo que indica una predisposición a desarrollarla(AU)

Síndrome de Burnout em trabalhadores da atenção primária à saúde de um município no interior do estado de São Paulo / Burnout syndrome in primary health care workers in a municipality in the interior of the state of São Paulo

ntrodução: O trabalho é considerado indispensável ao seguimento social; satisfaz necessidades comunitárias, intermedia a relação entre homem e natureza, transforma e produz bens utilitários à sociedade. Entretanto, há incongruência entre o trabalho como algo necessário e as limitações físicas e/ou psíquicas que os campos laborais podem propiciar ao trabalhador, uma vez que expõe o ser humano à situações adversas à saúde. O processo de trabalho pode relacionar-se com a ocorrência de transtornos como a Síndrome de Burnout, que é uma resposta à prolongada exposição do trabalhador à situações estressoras que levam ao sofrimento, exaustão emocional, despersonalização e redução da realização pessoal. Portanto, a compreensão das condições da saúde mental institucional e a valorização do relato dos trabalhadores podem ser compreendidas como ferramentas que permitem o alcance de melhorias na saúde laboral. Objetivos: Avaliar a Síndrome de Burnout em trabalhadores da Atenção Primária à Saúde de um município no interior do estado de São Paulo e associá-la às variáveis sociodemográficas e laborais. Método: estudo transversal, analítico, descritivo e quantitativo realizado com 74 trabalhadores no período de 28 de julho de 2020 a 05 de outubro de 2020, por meio da utilização de um questionário com questões relacionadas a variáveis sociodemográficas e laborais e da escala de Oldenburg Burnout Inventory. Realizou-se estatísticas descritivas, frequência e percentual para as variáveis qualitativas e medidas de tendência central (média e mediana) e dispersão (desvio padrão) para as variáveis numéricas. Utilizouse o Teste Exato de Fisher para verificar a associação entre as variáveis sociodemográficas e laborais e a Síndrome de Burnout, sendo considerado o nível de significância p< 0,05. Resultados: os participantes tinham entre 19 e 66 anos de idade, a maioria era do sexo feminino (87,0 %), referiu possuir companheiro (48,6%), possuía de um a dois filhos (54,1%) e ensino superior para o nível de escolaridade (40,5%). Dos pesquisados, 45% foram classificados com Síndrome de Burnout; 20% sem Síndrome de Burnout; 19% na fase de distanciamento e 16% na fase de exaustão. A variável unidade de trabalho apresentou significância estatística (p=0,014). Conclusão: dentre os achados neste estudo, destaca-se a presença importante de distanciamento, exaustão e Síndrome de Burnout já instalados entre os trabalhadores da Atenção Primária à Saúde em questão. Estudar a respeito das condições de saúde mental desses trabalhadores é de suma importância, uma vez que eles se expõem à situações de riscos psicossociais constantemente quando prestam acolhimento às famílias diante dos numerosos cenários sociais e suas instabilidades. Este estudo contribui para que fatores relacionados à saúde mental dos trabalhadores sejam conhecidos, favorecendo a criação de cenários compatíveis com melhores condições de trabalho e para que o tema da saúde mental na Atenção Primária à Saúde seja visualizado. A elaboração e divulgação de material educativo na forma de infográfico pode facilitar a compreensão do agravo à saúde mental e estimular a promoção da saúde laboral

Introduction: The work is considered essential for social follow-up; it meets community needs, mediates the relationship between man and nature, transforms and produces utilitarian goods for society. However, there is an incongruity between work as something necessary and the physical and/or psychological limitations that the labor fields can provide to the worker, since it exposes the human being to adverse health situations. The work process can be related to the occurrence of disorders such as Burnout Syndrome, which is a response to the worker's prolonged exposure to stressful situations that lead to suffering, emotional exhaustion, depersonalization and reduced personal fulfillment. Therefore, understanding the institutional mental health conditions and valuing the workers' reports can be understood as tools that allow the achievement of improvements in occupational health. Objectives: To evaluate the Burnout Syndrome in Primary Health Care workers in a municipality in the interior of the state of São Paulo and to associate it with sociodemographic and work variables. Method: cross-sectional, analytical, descriptive and quantitative study carried out with 74 workers from July 28, 2020 to October 5, 2020, using a questionnaire related to sociodemographic and labor variables and the Oldenburg Burnout scale Inventory. Descriptive statistics, frequency and percentage were applied to qualitative variables and measures of central tendency (mean and median) and dispersion (standard deviation) to numerical variables. Fisher's exact test was applied to check the association between sociodemographic and labor variables and the Burnout Syndrome, considering the significance level of p<0.05. Results: participants were between 19 and 66 years old, most were women (87.0%), reported having a partner (48.6%), had one to two children (54.1%) and higher education (40.5%). Of those surveyed, 45% were classified as having Burnout Syndrome; 20% without Burnout Syndrome; 19% in the distancing phase and 16% in the exhaustion phase. The variable unit of work was statistically significant (p=0.014). Conclusion: among the findings in this study, there is an important presence of distancing, exhaustion and Burnout Syndrome already installed among the workers of the Primary Health Care in question. Studying the mental health conditions of these workers is of paramount importance, since they are constantly exposed to psychosocial risk situations when they provide care to families in the face of numerous social scenarios and their instabilities. This study identified factors related to workers' mental health, favoring the creation of scenarios compatible with better working conditions and so that the theme of mental health in Primary Health Care is visualized. The development and dissemination of educational material as an infographic can facilitate the understanding of mental health problems and encourage the promotion of occupational health

Ad honorem exhaustion: Burnout prevalence in residents from a Colombian university / Agotamiento ad honorem: prevalencia de burnout en residentes de una universidad colombiana

Abstract Introduction: The number of health professionals diagnosed with burnout syndrome is constantly increasing. Currently, in Colombia, health care institutions are not obliged to pay residents for their work during their training. Besides their living expenses, residents must also pay tuition fees, which constitutes a stressor that may contribute to the development of burnout syndrome. Objective: To measure burnout syndrome prevalence and to identify its possible association with several socioeconomic factors in residents enrolled in 2019 in the residency programs offered by the school of medicine of a public university. Materials and methods: Cross-sectional study conducted in 269 residents that had been enrolled for at least 6 months, and who were classified into two groups according to their residency program: clinical and surgical specialties. Participants were administered a survey to collect their demographic and socioeconomic data, and the Spanish version of the Maslach Burnout Inventory - Human Services Survey for Medical Personnel instrument to determine whether they had burnout syndrome or not. Data were analyzed using descriptive statistics, and associations between socioeconomic data and MBI scores were determined using the chi-squared test. Results: Burnout prevalence was 39.78%. Likewise, the presence of burnout was positively associated with lacking enough funds to pay medical specialty training associated costs (OR: 3.45, CI:2.04-5.82); having experienced recent life changing events in the last 6 months (OR: 1.84, CI: 1.07-3.14); and having had any health issue in the last 6 months (OR: 1.81, CI:1.09-3.01). Conclusion: Burnout is a prevalent condition in the study population. So, until the obligation to pay residents for their work comes fully into force in Colombia, residency programs should be aware of burnout in residents and undergo several modifications aimed at ensuring their well-being.

Resumen Introducción. El número de profesionales de la salud diagnosticados con síndrome de burnout es cada día mayor. En la actualidad, en Colombia las instituciones de salud no están obligadas a pagarles salarios durante su entrenamiento. Además, aparte de sus gastos de manutención, los residentes deben pagar matrícula, lo que puede constituir un factor de estrés que contribuye al desarrollo de burnout. Objetivo. Medir la prevalencia de síndrome de burnout e identificar su posible asociación con diversos factores socioeconómicos en residentes matriculados en programas de residencia ofrecidos por la facultad de medicina de una universidad pública en 2019. Materiales y métodos. Estudio transversal realizado en 269 residentes con un tiempo mínimo de matrícula de 6 meses, y que, según su residencia, fueron clasificados en dos grupos: especialidades clínicas y quirúrgicas. Los datos demográficos y socioeconómicos se recolectaron mediante un cuestionario diseñado para tal fin; además, para el diagnóstico de burnout se utilizó la versión en español del instrumento Maslach Burnout Inventory - Human Services Survey for Medical Personnel (MBI-HSS MP). Los datos se analizaron mediante estadística descriptiva y las asociaciones entre los datos socioeconómicos y los puntajes obtenidos en el MBI se determinaron con la prueba de chi-cuadrado. Resultados. La prevalencia de burnout fue de 39.78%. De igual forma, se observó que su ocurrencia se asoció positivamente con no tener fondos suficientes para costear los gastos asociados con la formación médica de la residencia (OR: 3.45, IC:2.04-5.82), y con haber experimentado eventos de gran importancia o haber presentado problemas de salud en los últimos seis meses (OR: 1.84, IC:1.07-3.14; y OR: 1.81, IC:1.09-3.01, respectivamente). Conclusión. El síndrome de burnout es una condición prevalente en la población estudiada. De esta forma, hasta que la obligación de pagar un salario a los residentes entre en vigencia en Colombia, los programas de residencia deben estar al tanto de este problema y realizar varias modificaciones dirigidas a asegurar su bienestar.

Avaliação da susceptibilidade da síndrome de burnout em enfermeiros oncohematológicos / Syndrome of susceptibility assessment in burnout nurses acting in oncohematologia / Evaluación de la vulnerabilidad del síndrome de burnout en enfermeros oncohematologícos

Objetivo: Investigar a ocorrência da Síndrome de Burnout em enfermeiros da unidade de oncohematologia no serviço de referência do Hospital de Urgência de Sergipe. Método: trata-se de um estudo descritivo quantitativo, realizado com 16 enfermeiros voluntários. Utilizou-se um questionário validado, estruturado e autoaplicável, acrescido do instrumento MaslachBurnoutInventory. A análise dos dados foi feita por meio da ferramenta Epiinfo 7.2. Resultados: evidenciou-se que 43,75% dos enfermeiros encontram-se na fase inicial da Síndrome de Burnout. Outros 37,5% encontram-se com a possibilidade de desenvolver a mesma, e que 18,75% dos enfermeiros participantes apresentam sinais do sofrimento caracterizado por tal agravo. Conclusão: a academia representa uma parcela mobilizadora da sociedade. Faz-se importante, que pesquisas venham discutir e apresentar resultados que sensibilizem a necessidade urgente de tratativa dessa temática, a partir de ações conjuntas que possam intervir no sentido da saúde desses trabalhadores

Objective:To investigate the occurrence of Burnout Syndrome in nurses of the oncohematology unit in the referral service of Sergipe Emergency Hospital. Method: this is a quantitative descriptive study performed with 16 volunteer nurses. A validated, structured and self-administered questionnaire was used, plus the Maslach Burnout Inventory. Data analysis was performed using the Epiinfo tool 7.2. Results: according to the score obtained after data analysis, it was evidenced that 43.75% of the nurses are in the initial phase of Burnout Syndrome. Another 37.5% have the possibility of developing it, and that 18.75% of the participating nurses show signs of suffering characterized by such an injury. Conclusion: the academy represents a mobilizing part of society. It is important that researches discuss and present results that sensitize the urgent need to deal with this issue, based on joint actions that may intervene towards the health of these workers

Objetivo: Investigar la aparición del síndrome de Burnout en enfermeros de la unidad de oncohematología en el servicio del Hospital de Emergencias de Sergipe. Método: este es un estudio cuantitativo descriptivo realizado con 16 enfermeros voluntarios. Se utilize un cuestionario validado, estructurado y autoadministrado, más el Inventario de agotamiento de Maslach. El análisis de los datos se realizó utilizando la herramienta Epiinfo 7.2. Resultados: se evidenció que el 43.75% de los enfermeros se encuentran en la fase inicial del síndrome de Burnout. Otros 37.5% tienen la posibilidad de desarrollarlo, 18.75% de los enfermeros participantes muestran señales de sufrimiento caracterizado por una lesión de este tipo. Conclusión: la academia representa una parte movilizadora de la sociedad. Esimportante que las investigaciones discutan y presenten resultados que sensibilicen la necesidad urgente de abordar este problema, sobre la base de acciones conjuntas que pueden intervenir en la salud de estos trabajadores

Assessment of the Relationship between Nurses' Perception of Ethical Climate and Job Burnout in Intensive Care Units.

OBJECTIVES: To determine the relationship between ethical climate and burnout in nurses working in Intensive Care Units (ICUs). METHODS: This cross-sectional and multi-center study was conducted among 212 nurses working in adult ICUs of six hospitals affiliated to Shiraz University of Medical Sciences, Iran in 2019. The participants were selected using systematic random sampling technique. Data was collected using valid instruments of Olson's Hospital Ethical Climate Survey (HECS) and Maslach Burnout Inventory (MBI). RESULTS: Ethical climate was favorable (3.5±0.6). The intensity (32.2±12.4) and frequency (25.5±12.4) of burnout were high. Ethical climate had significant and inverse relationships with frequency of burnout (r =-0.23, p=0.001) and with intensity of burnout (r=-0.186, p=0.007). Ethical climate explained 5.9% of burnout. Statistically significant relationships were also found between these factors: age with ethical climate (p=0.001), work shifts with burnout (p=0.02), and gender and with intensity frequency of burnout in ICU nurses (p=0.038). The results of Spearman correlation coefficient showed significant and inverse relationships between ethical climate and job burnout (r=-0.243, p < 0.001). CONCLUSIONS: Nurses in ICUs perceived that ethical climate was favorable however, burnout was high. Therefore, burnout can be affected by many factors and it is necessary to support ICU nurses since they undertake difficult and complicated task. It is recommended to assess factors that increase burnout and adopt specific measures and approaches to relieve nursing burnout.

Psychosocial factors and Burnout Syndrome among mental health professionals / Fatores psicossociais e Síndrome de Burnout entre os profissionais dos serviços de saúde mental / Factores psicosociales y Síndrome de Burnout entre los profesionales de servicios de salud mental

Objective: to identify biopsychosocial factors at work associated with the Burnout Syndrome in mental health professionals. Method: a cross-sectional study with a quantitative approach conducted with a sample of 293 mental health service workers from the public network of a municipality in the inland of the state of São Paulo, Brazil. An instrument composed of three self-administered questionnaires was applied, namely: biosocial data form, the Job Stress Scale (JSS) and the Maslach Burnout Inventory (MBI- HSS). The data were analyzed through the application of the Chi-squared and logistic regression tests, with the adoption of a 5% significance level. Results: Burnout Syndrome prevalence was 7% with a predominance of nursing professionals and was associated with the work sector, the use of psychotropic drugs, low satisfaction with the manager and with the low control over the work activity. Among the professionals with Burnout Syndrome, twelve performed functions considered of high wear, six performed passive work and two were in low wear activity. Conclusion: low control was the main psychosocial factor at work associated with Burnout Syndrome, making it necessary to develop actions that promote worker autonomy and improve the management of stress-triggering psychosocial factors.

Objetivo: identificar os fatores biopsicossociais no trabalho associados à Síndrome de Burnout em profissionais da saúde mental. Método: estudo transversal de abordagem quantitativa de uma amostra de 293 trabalhadores dos serviços de saúde de mental da rede pública de um município, no interior do estado de São Paulo, Brasil. Foi aplicado um instrumento composto por três questionários de autopreenchimento: formulário com dados biossociais, a escala Job Stress Scale (JSS) e o Maslach Burnout Inventory (MBI- HSS). Os dados foram analisados por meio da aplicação dos testes Qui-Quadrado e regressão logística, adotando-se um nível de significância de 5%. Resultados: a prevalência da Síndrome de Burnout foi de 7% com predomínio de profissionais da enfermagem, estando associada ao setor de trabalho, ao uso de psicofármacos, à baixa satisfação com a chefia e ao baixo controle sobre a atividade de trabalho. Entre os profissionais com Síndrome de Burnout, doze desempenhavam funções consideradas de alto desgaste, seis exerciam trabalho passivo e dois estavam em atividade de baixo desgaste. Conclusão: o baixo controle foi o principal fator psicossocial no trabalho associado à Síndrome de Burnout, tornando-se necessário o desenvolvimento de ações que promovam a autonomia do trabalhador e a melhoria da gestão dos fatores psicossociais desencadeantes de estresse.

Objetivo: identificar los factores biopsicosociales en el trabajo asociados con el Síndrome de Burnout (SB) en profesionales de la salud mental. Método: estudio transversal con enfoque cuantitativo de una muestra de 293 trabajadores de servicios de salud mental en la red pública de un municipio del interior del estado de São Paulo, Brasil. Se aplicó un instrumento compuesto por tres cuestionarios autoadministrados: un formulario con datos biosociales, el Cuestionario de Estrés Laboral (JSS) y el Inventario de Maslach (MBI-HSS). Los datos se analizaron mediante la aplicación de las pruebas de Chi-cuadrado y la regresión logística, adoptando un nivel de significación del 5%. Resultados: la prevalencia de Síndrome de Burnout fue del 7% con un predominio de profesionales de enfermería, hallándose asociado a factores como el entorno laboral, uso de drogas psicotrópicas, baja satisfacción con el jefe y bajo control sobre la actividad laboral. Entre los profesionales con Síndrome de Burnout, doce desempeñaron funciones consideradas de alto desgaste, seis cumplían tareas pasivas y dos realizaban una actividad de bajo desgaste. Conclusión: el bajo control fue el principal factor psicosocial asociado con el Síndrome de Burnout en el trabajo de los profesionales, por lo que es necesario desarrollar acciones que promuevan la autonomía del trabajador y el mejoramiento en la gestión de los factores psicosociales que desencadenan el estrés.

Síndrome de Burnout em Médicos de Estratégia Saúde da Família de Montes Claros, MG, e Fatores Associados / Burnout Syndrome in Family Health Strategy Physicians in Montes Claros, MG, and Associated Factors / Síndrome de Burnout en Médicos de la Estrategia Salud de la Familia de Montes Claros, MG, y Factores Asociados

Objetivo: O estudo objetivou investigar a prevalência da síndrome de Burnout em médicos da Estratégia Saúde da Família em Montes Claros, MG, e sua associação com estresse no trabalho, desequilíbrio esforço-recompensa e qualidade de vida. Métodos: Foi realizada uma pesquisa epidemiológica, quantitativa, telematizada, analítica e transversal. O questionário autoaplicável Maslach Burnout Inventory foi aplicado a 89 médicos para diagnóstico da síndrome. Os médicos também proveram dados sociodemográficos e preencheram os instrumentos Job Stress Scale, Escala Desequilíbrio-Esforço-Recompensa e WHOQOL-BREF para identificação de condições de trabalho. As variáveis categóricas foram analisadas por distribuição de frequências. A associação entre variáveis de fatores de risco e presença de síndrome de Burnout foi realizada pelo teste de Qui-quadrado de Pearson. Resultados: Houve 100% de prevalência da síndrome de Burnout moderada nos médicos avaliados. Os escores das dimensões Exaustão e Despersonalização, constituintes do instrumento avaliativo da síndrome de Burnout, tiveram correlação positiva com alta demanda psicológica e profissional, alto desgaste e esforço, comprometimento excessivo ao trabalho e desbalanço na razão esforço-recompensa. Eles também se relacionaram a atributos de qualidade de vida, tais quais má condição física, social e ambiental. Conclusão: Medidas preventivas e interventivas devem ser tomadas para a diminuição do estresse laboral dos médicos avaliados, assim reduzindo a ocorrência da síndrome de Burnout.

Objective: The study aimed to investigate the prevalence of Burnout syndrome in physicians of the Family Heath Strategy at Montes Claros, MG, and the association with work stress, effort-reward imbalance and quality of life. Methods: Epidemiologic, quantitative, web-based, analytical and cross-sectional research. The self-administered questionnaire Maslach Burnout Inventory was applied to 89 physicians to diagnose the syndrome. The physicians also provided sociodemographic data and responded the Job Stress Scale, the Imbalance-Effort-Reward scale and the WHOQOL-BREF for identification of work conditions. The categoric variables were analyzed by frequency distribution. The association between variables of risk factors and the presence of Burnout syndrome was tested by the Pearson's chi-square test. Results: 100% of the physicians evaluated exhibited moderate Burnout syndrome. The scores for the Exhaustion and Depersonalization dimensions, which are components of the inventory for Burnout Syndrome assessment, were positively correlated with high psychological and professional demands, high strain and effort, excess commitment to the job and imbalanced effort-reward ratio. They were also associated with attributes of quality of life such as poor physical, social and environmental conditions. Conclusion: Preventive and intervention actions are required to decrease work-related stress of the evaluated physicians, thereby decreasing Burnout syndrome prevalence.

Objetivo: El estudio objetivó investigar la prevalencia del síndrome de Burnout en médicos de la Estrategia Salud de la Familia en Montes Claros, MG, y su asociación con estrés en el trabajo, desequilibrio esfuerzo-recompensa y calidad de vida. Métodos: Se realizó una investigación epidemiológica, cuantitativa, por medio de la web, analítica y transversal. El cuestionario autoaplicable Maslach Burnout Inventory se aplicó a 89 médicos para el diagnóstico del síndrome. Los médicos también proporcionaron datos sociodemográficos y llenaron los instrumentos Job Stress Scale, Escala Desequilibrio-Esfuerzo-Recompensa y WHOQOL-BREF para identificación de condiciones de trabajo. Las variables categóricas fueron analizadas por distribución de frecuencias. La asociación entre variables de factores de riesgo y presencia de síndrome de Burnout fue realizada por la prueba de chi-cuadrado de Pearson. Resultados: Hubo un 100% de prevalencia de la Síndrome de Burnout moderada en los médicos evaluados. Los escores de las dimensiones Agotamiento y Despersonalización, constituyentes del instrumento evaluativo del síndrome de Burnout, tuvieron correlación positiva con alta demanda psicológica y profesional, alto desgaste y esfuerzo, comprometimiento excesivo al trabajo y desbalance en la razón esfuerzo-recompensa. También se relacionaron con atributos de calidad de vida tales como mala condición física, social y ambiental. Conclusión: Se deben tomar medidas preventivas y de intervenciones para disminuir el estrés laboral de los médicos evaluados, reduciendo así la incidencia del síndrome de Burnout.

Burnout e fatores associados entre profissionais de enfermagem de hospital municipal no Rio de Janeiro / Burnout and associated factors among nursing professionals of municipal hospital in Rio de Janeiro

Burnout é definida como estresse crônico experimentado pelo indivíduo em seu contexto de trabalho, principalmente, no âmbito das profissões cuja característica essencial é o contato direto com pessoas como os profissionais de enfermagem. Objetivo: descrever a prevalência e possíveis fatores associados à síndrome de burnout entre profissionais de enfermagem de setores fechados. Método: a pesquisa se deu por meio de estudo epidemiológico observacional, descritivo seccional. A população foi composta por amostra de 85 profissionais da equipe de enfermagem dos setores de terapia intensiva de hospital de grande porte, no município do Rio de Janeiro. O instrumento utilizado foi questionário estruturado com perguntas fechadas, contendo a versão traduzida e validada para o português do Maslach Burnout Inventory. O estudo foi aprovado por comitês de ética de duas instituições. A coleta de dados ocorreu no mês de janeiro de 2018. Foi realizada análise estatística descritiva com medidas de tendência central, de dispersão e análise de frequência. Realizou-se a pontuação de cada subescala do instrumento, acrescidos de desvio-padrão. Para análise dos dados, foi utilizado o software Statistical Package for the Social Sciences® 21. Resultados: a prevalência global de suspeição da síndrome de burnout encontrada foi de 40%, onde 24,7% apresentaram esgotamento emocional alto, 18,8% com a despersonificação elevada, e 08,2% com realização profissional baixa. Entre as variáveis sociodemográficas, ter cursado ensino superior (p=0,028) apresentou associação com a síndrome, assim como as laborais: categoria profissional enfermeiro (p=0,009), e sentir-se estressado no trabalho (p=0,001). Conclusão: é necessário adotar medidas preventivas para o controle de doenças mentais, para evitar prejuízos desnecessários à saúde do profissional de enfermagem, à sua qualidade de vida, à instituição, e até mesmo ao setor previdenciário. O estresse por si é um fator de estímulo a novos desafios, o que remete a ideia de que a organização e características do trabalho da enfermagem acabam por favorecer o surgimento insidioso do burnout

Burnout is defined as chronic stress experienced by the individual in their work context, mainly within the professions whose essential characteristic is the direct contact with people like the nursing professionals. Objective: to describe the prevalence and possible factors associated with burnout syndrome among nursing professionals from closed sectors. Method: the research was done through observational, sectional descriptive epidemiological study. The population was composed of 85 professionals from the nursing team of the intensive care units of a large hospital in the city of Rio de Janeiro. The instrument used was a structured questionnaire with closed questions, containing the translated and validated Portuguese version of the Maslach Burnout Inventory. The study was approved by ethics committees of two institutions. Data collection took place in the month of January, 2018. A descriptive statistical analysis was performed with measures of central tendency, dispersion and frequency analysis. The scoring of each subscale of the instrument was performed, plus standard deviation. Results: The overall prevalence of suspected burnout syndrome was 40%, where 24.7% had high emotional exhaustion, 18.8% with the high disqualification, and 08.2% with low professional achievement. Among the sociodemographic variables, having attended higher education (p = 0.028) had an association with the syndrome, as well as the workrelated ones: professional nurse category (p = 0.009) and feeling stressed at work (p = 0.001). Conclusion: it is necessary to adopt preventive measures for the control of mental diseases, to avoid unnecessary damages to the health of the nursing professional, their quality of life, the institution, and even the social security sector. Stress itself is a stimulus to new challenges, which points to the idea that the organization and characteristics of nursing work end up favoring the insidious onset of burnout

Evaluation of Job-Related Anxiety Symptoms Among Brazilian Social Security Medical Experts

OBJECTIVES: The function of a medical expert within the scope of the Brazilian social security system consists of medically evaluating the examinee to draw a conclusive opinion on the person's working ability capacity and to characterize the disability for social security and assistance purposes. Forensic decisions inevitably converge on two opposite outcomes: concession or refusal. Rejection is against the interests of the candidates, who can direct their disappointment and dissatisfaction at the professional, exposing the latter to potentially stressful situations. The present study aimed to determine whether the prevalence of stress and anxiety symptoms is higher among social security medical experts than among medical experts in other public service careers. The study was also intended to propose organizational changes aimed at the preservation and recovery of the mental health of medical experts. METHODS: The evaluation was conducted using a specific, previously validated job-related stress questionnaire and a series of questions about subjective perceptions of work performance, labor stressors and emotional status. RESULTS: We found an overwhelming and alarming prevalence of stress and dissatisfaction related to occupational aspects among social security experts, often culminating in emotional exhaustion, a characteristic feature of burnout syndrome. CONCLUSION: There is a high prevalence of job-related stress among social security doctors in Brazil, warranting implementation of specific measures to ensure the adequate provision of social security services to the population, thus avoiding social injustice and financial damage.

Factors influencing professional life satisfaction among neurologists.

BACKGROUND: Predicted shortages in the supply of neurologists may limit patients' access to and quality of care for neurological disorders. Retaining neurologists already in practice provides one opportunity to support the overall supply of practicing neurologists. Understanding factors associated with professional life satisfaction (and dissatisfaction) and implementing policies to enhance satisfaction may encourage neurologists to remain in clinical practice. In this paper, we present results from the first study examining factors associated with professional life satisfaction among a large sample of U.S, neurologists. METHODS: We collaborated with the AAN to survey a sample of U.S. neurologists about their professional life satisfaction. Analyses examined the association of physician and practice characteristics with aspects of professional life satisfaction, including satisfaction with their career in medicine, medical specialty, current position, relationship with colleagues, relationship with patients, work/life balance, and pay. RESULTS: The study population consisted of 625 neurologists. In multivariate regression analyses, no single group or population stratum indicated high (or low) responses to all aspects of satisfaction. Older neurologists reported higher satisfaction with career, specialty, and relationship with patients than younger neurologists. Female neurologists had significantly lower satisfaction with pay than male neurologists. Neurologists who spent more time in research and teaching had greater satisfaction with specialty, relationship with colleagues, and relationship with patients than those spending no time in research. Neurologists who practiced in small cities/rural areas reported lower satisfaction across multiple dimensions than those practicing in large urban areas. Neurologists in solo practice had greater satisfaction with the relationship with their patients, but lower satisfaction with pay. CONCLUSIONS: Satisfaction is a multidimensional construct that is associated with physician and practice characteristics. Enhancing professional life satisfaction among neurologists requires multiple strategies, such as promoting comparable wages for men and women, providing collaboration and research opportunities, and providing resources for small and rural practices.

Precariedad en las condiciones de trabajo y salud de los trabajadores del sector bananero del Ecuador / Precarious working conditions and health of workers in the banana sector of Ecuador

El objetivo de la presente investigación fue determinar la influencia de las condiciones y organización del trabajo en el proceso salud enfermedad de los trabajadores bananeros en el Ecuador. El recorte empírico del trabajo se sitúo en la provincia de Los Ríos la cual es considerada la nueva capital bananera, ya que allí se ubican la mayoría de compañías bananeras del país. La orientación metodológica fue un enfoque cualitativo que incluyó observaciones, encuestas y entrevistas en profundidad a trabajadores, delegados y dirigentes gremiales de los cantones de Babahoyo (La Unión); Buena Fe (San Pedro de la Y) y Quevedo. Entre los hallazgos del trabajo se han identificado las principales políticas y estrategias patronales para gestionar el trabajo, y cuáles son las diversas expresiones que adoptan la flexibilización y precarización laboral. En tal sentido, se destaca la ausencia de normas contractuales sobre el modo de contratación, despido, salarios, imposición de tareas, condiciones de trabajo, entre otras, las cuales expresan la situación de gran vulnerabilidad de los trabajadores. Por otro lado, se registran problemáticas de salud vinculadas con diferentes factores de riesgo, entre los que se ubica la presencia de agrotóxicos, combinado con un trabajo intensivo, de ritmo alto, rutinario, de producción masiva que permiten un control mínimo del trabajador sobre el proceso productivo. También la presencia de jornada (especialmente en las fases de cosecha y postcosecha)(AU)

The objective of this study was to determine the influence of working conditions and work organization on the health-disease process of banana workers in Ecuador. The empirical component of our research was located in the province of Los Ríos, considered the new banana capital of Ecuador, where most of the banana companies of that country are located. The qualitative methodology included in-depth interviews with workers, representatives and union leaders from the cantons of Babahoyo (La Unión); Good Faith (San Pedro de la Y) and Quevedo. Among the main results, we identified the main employer policies and strategies to manage the work, and the different manifestations reflected by job flexibilization and precariousness. In this sense, the absence of contractual rules on hiring, dismissal, wages, job tasks, working conditions, among others, underscore a great degree of vulnerability of the workers. On the other hand, there are health problems associated with different risk factors, including the presence of agrochemicals, combined with intensive, highpaced, routine, mass-production work that allowslittle control of the production process by the workers. Also observed was the presence of strenuous and stressful work shifts, with high demands, with minimum rest breaks and days off (especially in the harvest and post-harvest seasons)(AU)

Interaction between demand-control and social support in the occurrence of common mental disorders / Interação entre demanda-controle e apoio social na ocorrência de transtornos mentais comuns

ABSTRACT OBJECTIVE To analyze the interaction between the psychosocial aspects of work and the occurrence of common mental disorders among health workers. METHODS This is a cross-sectional study conducted with a representative sample of workers of the primary health care of five municipalities of the State of Bahia, Brazil, in 2012. The variable of outcome were the common mental disorders evaluated by the SRQ-20, and the variables of exposure were high demand (high psychological demand and low control over the work) and low social support in the workplace. Interaction was checked by the deviation of the additivity of the effects for the factors studied from the calculation of excess risk from interaction, proportion of cases attributed to interaction, and the synergy index. RESULTS The global prevalence of common mental disorders was 21%. The group of combined exposure has shown higher magnitude (high demand and low social support), reaching 28% when compared to the 17% in the situation of no exposure (low demand and high social support). CONCLUSIONS The results strengthen the hypothesis of interaction between the factors investigated, directing to the synergy of the effects.

RESUMO OBJETIVO Analisar a interação entre aspectos psicossociais do trabalho e a ocorrência de transtornos mentais comuns entre trabalhadores da saúde. MÉTODOS Estudo transversal conduzido em amostra representativa de trabalhadores da atenção básica de cinco municípios da Bahia em 2012. As variáveis desfecho foram os transtornos mentais comuns avaliados pelo SRQ-20, as de exposição foram a alta exigência (alta demanda psicológica e baixo controle sobre o próprio trabalho) e o baixo apoio social no trabalho. A interação foi verificada pelo afastamento da aditividade dos efeitos para fatores estudados a partir do cálculo do excesso de risco devido à interação, proporção de casos atribuída à interação e índice de sinergia. RESULTADOS A prevalência global de transtornos mentais comuns foi de 21%. Apresentou maior magnitude no grupo de exposição combinada (alta exigência e baixo apoio social), chegando a 28% quando comparada a 17% na situação de nenhuma exposição (baixa exigência e alto apoio social). CONCLUSÕES Os resultados fortalecem a hipótese de interação entre os fatores investigados, com direção para a sinergia dos efeitos.

National Survey of US academic anesthesiology chairs on clinician wellness.

STUDY OBJECTIVE: The prevalence of anesthesiology department wellness programs is unknown. A database of wellness programs is needed as a resource for departments attempting to respond to the Accreditation Council for Graduate Medical Education Anesthesiology Milestones Project. The purpose of this study was to survey academic anesthesiology chairs on wellness issues, characterize initiatives, and establish wellness contacts for a Wellness Initiative Database (WID). DESIGN: An Internet-based survey instrument was distributed to academic anesthesiology department chairs in the United States. SETTING: On-line. PATIENTS: None. INTERVENTIONS: None. MEASUREMENTS: Analysis for continuous variables used standard means, modes, and averages for individual responses; 95% confidence intervals for proportions were calculated by Wilson's method. MAIN RESULTS: Seventy-five (56.4%) responses (of a potential 133 programs) were obtained. Forty-one (of 71 responders; 57.8%) expressed interest in participating in a WID, and 33 (44%) provided contact information. Most (74.7%) had recently referred staff for counseling or wellness resources, yet many (79.5% and 67.1%, respectively) had never surveyed their department's interest in wellness resources. Thirty-four percent had a wellness resources repository. Of 22 wellness topics, 8 garnered >60% strong interest from respondents: Addiction Counseling, Sleep Hygiene, Peer Support Program, Stress Management, Conflict Management, Burnout Counseling, Time Management, and Dealing with Adverse Events Training. There was a statistically significant difference in interest between those willing to participate or not in the WID across most topics but no significant difference based on need for recent staff referral. CONCLUSIONS: The majority of chairs needed to recently refer a department member to wellness resources or counseling. Most were interested in participating in a WID, whereas a minority had gauged staff interest in wellness topics or had a wellness resource repository. Highest interest was in topics most related to function as an anesthesiologist. Those willing to participate in the database had statistically significant differences in interest across most wellness topics.

Therapy of the burnout syndrome.

BACKGROUND: The prevalence, diagnostics and therapy of the burnout syndrome are increasingly discussed in the public. The unclear definition and diagnostics of the burnout syndrome are scientifically criticized. There are several therapies with unclear evidence for the treatment of burnout in existence. OBJECTIVES: The health technology assessment (HTA) report deals with the question of usage and efficacy of different burnout therapies. METHODS: For the years 2006 to 2011, a systematic literature research was done in 31 electronic databases (e.g. EMBASE, MEDLINE, PsycINFO). Important inclusion criteria are burnout, therapeutic intervention and treatment outcome. RESULTS: 17 studies meet the inclusion criteria and are regarded for the HTA report. The studies are very heterogeneous (sample size, type of intervention, measuring method, level of evidence). Due to their study design (e.g. four reviews, eight randomized controlled trials) the studies have a comparable high evidence: three times 1A, five times 1B, one time 2A, two times 2B and six times 4. 13 of the 17 studies are dealing with the efficacy of psychotherapy and psychosocial interventions for the reduction of burnout (partly in combination with other techniques). Cognitive behaviour therapy leads to the improvement of emotional exhaustion in the majority of the studies. The evidence is inconsistent for the efficacy of stress management and music therapy. Two studies regarding the efficacy of Qigong therapy do not deliver a distinct result. One study proves the efficacy of roots of Rhodiola rosea (evidence level 1B). Physical therapy is only in one study separately examined and does not show a better result than standard therapy. DISCUSSION: Despite the number of studies with high evidence the results for the efficacy of burnout therapies are preliminary and do have only limited reach. The authors of the studies complain about the low number of skilled studies for the therapy of burnout. Furthermore, they point to the insufficient evaluation of the therapy studies and the need for further research. Some authors report the effects of considerable natural recovering. Numerous limitations affect the quality of the results. Intervention contents and duration, study design and study size are very diverse and do not permit direct comparison. Most of the samples are small by size with low statistical power, long-term follow-ups are missing. Comorbidities and parallel utilized therapies are insufficient documented or controlled. Most of the studies use the Maslach Burnout Inventory (MBI) as diagnostic or outcome-tool, but with different cut-off-points. It should be noticed that the validity of the MBI as diagnostic tool is not proved. Ethical, juridical and social determining factors are not covered or discussed in the studies. CONCLUSION: The efficacy of therapies for the treatment of the burnout syndrome is insufficient investigated. Only for cognitive behavioural therapy (CBT) exists an adequate number of studies which prove its efficacy. Big long-term experimental studies are missing which compare the efficacy of the single therapies and evaluate their evidence. The natural recovering without any therapy needs further research. Additionally, it has to be examined to what extent therapies and their possible effects are thwarted by the conditions of the working place and the working conditions.

Stress em servidores públicos do instituto nacional de seguro social / Stress in public officials of the national institute of social security

O objetivo deste estudo foi investigar o nível de stress e as fontes estressoras dos servidores públicos que atendem segurados no Instituto Nacional de Seguro Social de Campo Grande, no estado de Mato Grosso do Sul, Brasil. A amostra (n=42) constitui-se com predominância do sexo feminino (73,8 por cento) e com média de idade de 46 anos. Para a coleta de dados foram utilizados três instrumentos: Inventário de Sintomas de Stress para Adultos de Lipp, Escala de Reajustamento Social e Inventário de Crenças Irracionais. Os resultados obtidos no primeiro instrumento revelaram que 61,9 por cento dos funcionários encontravam-se estressados, com 85,0 destes na fase de resistência. Os estressores externos mais frequentes referiam-se a família, mudanças no ambiente, perda de suporte social, trabalho, finanças e dificuldades pessoais. Os dados foram interpretados a favor da hipótese de que tanto as crenças irracionais quanto os estressores externos são potentes fontes de stress.

The objective of this study was to investigate the level of stress and the triggers of stress in public officials who deal with people receiving assistance from the Instituto Nacional de Seguro Social in Campo Grande (MS) in the state of Mato Grosso do Sul. The sample (n=42) was predominantly made up of women (73.8 percent), with an average age of 46. For the collection of data, three tools were used: Lipp's Inventory of Stress Symptoms for adults, the Social Adjustment Scale and the Inventory of Irrational Beliefs. The results of the Lipp's Inventory of Stress Symptoms showed that 61.9 percent of the workers were stressed, of which 85 percent were in the resistance phase. The most frequent external stress triggers related to the family, changes in environment, loss of public support, work, finances and personal difficulties. The data were interpreted in favor of the hypothesis that both irrational beliefs and external triggers are significant sources of stress.

Superposição de atribuições e autonomia técnica entre enfermeiras da Estratégia Saúde da Família / Superposición de atribuciones y autonomía técnica entre enfermeras de la Estrategia Salud de la Familia / Overlapping of duties and technical autonomy among nurses of the Family Health Strategy

OBJETIVO: Compreender como enfermeiras da Estratégia Saúde da Família vivem a superposição de atribuições e construção da autonomia técnica. PROCEDIMENTOS METODOLÓGICOS: Pesquisa qualitativa realizada com 22 enfermeiras em Recife, PE, entre agosto de 2005 e novembro de 2006. A partir de avaliação da gerência (acesso geográfico, conflitos na equipe, entre equipe e distrito, entre equipe e comunidade e violência pública na área), em cada um dos seis distritos sanitários foram selecionadas quatro equipes. Foram realizadas entrevistas semi-estruturadas...

OBJECTIVE: To understand how Estratégia Saúde da Família (Family Health Strategy) nurses experience the overlapping of duties and building of technical autonomy. METHODOLOGICAL PROCEDURES: This was a qualitative study performed with 22 nurses, in the city of Recife, Northeastern Brazil, between August 2005 and November 2006. Based on management evaluation (geographic access; conflicts in the team, between team and district and between team and community; and public violence in the area), four teams were selected in each of the six health districts. Semi-structured interviews were conducted...

OBJETIVO: Comprender como enfermeras de la Estrategia Salud de la Familia viven la sobreposición de atribuciones y construcción de la autonomía técnica. PROCEDIMIENTOS METODOLÓGICOS: Investigación cualitativa realizada con 22 enfermeras en Recife, en noreste de Brasil, entre agosto de 2005 y noviembre de 2006. A partir de evaluación de la gerencia (acceso geográfico, conflictos en el equipo, entre equipo y distrito, entre equipo y comunidad y violencia pública en el área), en cada uno de los seis distritos sanitarios fueron seleccionados cuatro equipos. Fueron realizadas entrevistas semi-estructuradas...

Síndrome de Burnout entre os trabalhadores da Estratégia de Saúde da Família / Síndrome de Burnout entre los trabajadores de la Estrategia de Salud de la Familia / Syndrome of Burnout among the workers of the Strategy of Health of the Family

Trata-se de um estudo descritivo, desenvolvido junto a dezesseis equipes de Estratégia de Saúde da Família de Santa Maria (RS), que objetivou identificar os trabalhadores com a Síndrome de Burnout e as variáveis associadas a este distúrbio. A amostra foi composta por 86 trabalhadores, representando 86,3 por cento dos profissionais (médico, enfermeiro, técnico de enfermagem, odontólogo e auxiliar de consultório dentário) e 30,2 por cento dos agentes comunitários de saúde, os quais responderam ao Maslach Inventory Burnout. A idade média do grupo foi de 36,94±9,3 anos, com predominância do sexo feminino (84,9 por cento). A maioria possui companheiro (68,2 por cento), tem filhos (69,4 por cento), trabalha, em média, 3,38±1,9 anos na equipe e não realiza atividades físicas (62,8 por cento). Identificaram-se seis trabalhadores (6,9 por cento) com a Síndrome de Burnout, a qual teve associação estatística significativa (p= 0,034) com a variável idade jovem. Os mais jovens obtiveram escores superiores nas subescalas de desgaste emocional e despersonalização do Inventário de Burnout.

This descriptive study was developed with sixteen Family Health Strategy teams from Santa Maria (Rio Grande do Sul), with the objective to identify works with the Burnout syndrome and the variables associated with this disorder. The sample consisted of 86 workers, representing 86.3 percent of professionals (physicians, nurses, nursing technicians, dentists and dental office assistants) and 30.2 percent of community health agents, who answered the Maslach Burnout Inventory. The average age of the group was 36.94±9.3 years, with a predominance of females (84.9 percent). Most participants had a partner (68.2 percent), children (69.4 percent), have worked in the team for, in average, 3.38±1.9 years and do not exercise regularly (62.8 percent). Six workers (6.9 percent) presented the Burnout Syndrome, which has a statistically significant association (p= 0.034) with the young age variable. Younger subjects obtained higher scores on the subscales for emotional distress and depersonalitation on the Burnout Inventory.

Se trata de un estudio descriptivo, desarrollado junto a dieciséis equipos de Estrategia de la Salud de la Familia de Santa María (RS, Brasil) que tuvo como objetivo identificar a los trabajadores con el Síndrome de Burnout y las variables asociadas a este disturbio. La muestra se compuso de 86 trabajadores, que representaban el 86,3 por ciento de los profesionales (médicos, enfermeros, técnicos en enfermería, odontólogos y auxiliares de consultorio odontológico) y 30,2 por ciento de los agentes comunitarios de salud, los cuales respondieron al Maslach Inventory Burnout. La edad promedio del grupo fue de 36,94±9,3 años, con predominancia de sexo femenino (84,9 por ciento). La mayoría vive en pareja (68,2 por ciento), tiene hijos (69,4 por ciento), ha trabajado en el equipo durante un promedio de 3,38±1,9 años y no realiza actividades físicas (62,8 por ciento). Se identificaron seis trabajadores (6,9 por ciento) con Síndrome de Burnout, los cuales tuvieron una asociación estadísticamente significativa con la parte más baja de la faja etaria estudiada. Los más jóvenes obtuvieron puntajes superiores en las subescalas de desgaste emocional y despersonalización del Inventario de Burnout.

Clima laboral en una escuela de medicina. Estudio de seguimiento / Work environment assessment at a medical school

Background: The work environment of an organization has to do with a set of permanent qualities that are experienced by its members. Aim: To assess the work environment perception of faculty members of a Medical School in two different periods (2005 and 2007). Material and methods: A standardized survey was applied to faculty members and Department chairs of the academic units of our Medical School. The survey used the Likert scale from 1 to 5 and included 59 items, distributed in 8 factors. Additionally, there were two groups of statements, indicating the priorities for the School and for the academic departments. Results: In the study performed in year 2005, the survey was answered by a total of 399 faculty members (68 percent) and in year 2007, it was answered by 408 members (68 percent). The global climate perceptions were 66 percent and 68 percent in 2005 and 2007, respectively (ns). Among the dimensions evaluated, communications (p =0,62) and physical conditions (p =0,008) improved in the two years period. Conclusions: The applied instrument was stable and useful to knowing the requirements of the faculty members and for improving the organizational climate.