The high cost of healing and teaching: a cross-sectional survey of burnout among academic physicians in Nigeria.

BACKGROUND: Globally, the medical and teaching professions are two major professions with the highest prevalence of burnout, and academic physicians bestride the two professions. This study investigated the prevalence and associated factors of burnout among academic physicians working in tertiary hospitals in Nigeria. METHODOLOGY: This was a self-administered online survey. Burnout was measured using the Maslach Burnout Inventory for Educators (MBI-ES) on Google Form and sent to 256 academic physicians in tertiary hospitals across Nigeria using the WhatsApp broadcast feature. MBI-ES was categorized into two categories (Burnout and No Burnout), and binary logistic regression was used to test the influence of 13 predictors on the three dimensions of MBI-ES as well as MBI in its entirety. FINDINGS: A total of 155 academic physicians responded, resulting in a response rate of 60.5%. There were 121 (80.7%) males and 29 (19.3%) females (five cases respondents omitted this detail). Eighty-seven respondents exhibited moderate to high burnout in at least one of the dimensions of the MBI, translating to a prevalence rate of 57.7% in our study. Five variables, number of peer reviewed articles published, hours of weekly teaching, enjoyment of academic writing, apathy to teaching and religion were all significantly associated with burnout. Moderate to high emotional exhaustion was reported by 30.8% (45 respondents), moderate to high depersonalization by 5.5% (8 respondents),, and low to moderate personal accomplishment by 43.5% (67 respondents).Eight variables: religion, geopolitical zone of practice, enjoyment of academic writing, apathy toward teaching, university ownership, number of published peer-reviewed articles, salary, and supplementary income were significantly associated with emotional exhaustion, while the number of weeks spent teaching in a year and teaching hours/week were significantly associated with depersonalization and personal accomplishment, respectively. Age (OR 1.302, CI 1.080-1.570), Teaching hours/week (OR 0.924, CI 0.854-0.999), Salary (OR 0.996, CI 0.993-1.0), and supplementary salary (OR 0.996, CI 0.993-0.999) were found to significantly predict emotional exhaustion. CONCLUSION: The study reveals a high prevalence of burnout (57.7%) among academic physicians in Nigeria, highlighting an urgent need for targeted interventions and policy changes. Given the significant role these professionals play in healthcare and medical education, immediate action is essential to address this issue. Future research should focus on evaluating the effectiveness of preventive measures and exploring the long-term impacts of burnout.

Assessment of burnout level among clinical dental students during the COVID-19 pandemic.

BACKGROUND: The Coronavirus Disease (COVID-19) outbreak has caused especially health workers to face mental and physical problems all over the world. The aim of this study is to evaluate burnout, stress perception and perceived social support levels of clinical (the fourth and fifth year) dental students during the COVID-19 pandemic. METHODS: The Sociodemographic Information Form (SIF), Maslach Burnout Inventory (MBI), Sense of Coherence-13 (SoC-13), Perceived Stress Scale-10 (PSS-10), and Multidimensional Scale of Perceived Social Support (MSPSS) were used for data. Questionnaires were answered directly or online by the participants. RESULTS: A total of 211 participants, 67.8% were female, 32.2% were male. Of these, 96.2% were aged 20-24 years, 84.4% were nuclear family, 11.8% were extended family, and 3.8% were blended family, and 91.5% were willingly for dentistry choice. Based on the results; the total burnout score indicated moderate burnout (41.99 ± 9.94), the SoC-13 scale indicated a strong sense of coherence (55.24 ± 7.21), the PSS-10 score (22.44 ± 3.44) indicated moderate perceived stress and the MSPSS score (65.92 ± 13.22) indicated high perceived social support. A positive correlation was found between perceived stress and burnout. Based on the personal accomplishment subscale; females, those living in extended family, and those who unwillingly choose dentistry among the clinical dental students had higher intense burnout (p < 0.05). CONCLUSIONS: The findings demonstrated that clinical dental students were affected by the emotional stress caused by the COVID-19 pandemic conditions. In the education of dentistry faculties, it would be appropriate to carry out comprehensive studies on adaptation to the changing living conditions with the COVID-19 pandemic and taking the necessary measures for the psychological distress caused by the difficulties experienced.

Euro-Burn I: Assessment of burnout syndrome in health workers in a mediterranean country during the SARS-CoV-2 pandemic.

BACKGROUND: Burnout syndrome (BS) has a negative impact among health professionals. AIMS: Our research objective is to quantify the level of burnout in health workers of the Spanish National Health System during the COVID-19 pandemic using and comparing two independent measurement instruments. METHODS: Cross-sectional, descriptive and multicenter study conducted through an anonymous online survey among health workers of the National Health System, measuring the level of burnout using the Maslach Burnout Inventory (MBI) and the Copenhagen Burnout Inventory (CBI). RESULTS: A total of 448 questionnaires were analyzed, the mean age of the participants was 43.53 years (range: 20-64), 365 (81.5%) women. 161 (35.9%) participants presented BS measured with the MBI and 304 (67.9%) measured with the CBI. Regarding work contract, those who had greater job stability presented a higher degree of cynicism with respect to the eventual ones (p = .010), the eventual ones presenting higher mean scores in professional efficacy (p = .034). Urban workers had higher scores of exhaustion (p < .001) and cynicism (p < .001) than those living in rural areas. When comparing both tests, a high predictive value for exhaustion and cynicism was found to measure BS through the CBI (AUC = 0.92 and 0.84, respectively) and a low AUC with respect to the predictive value for efficacy (AUC = 0, 59). CONCLUSIONS: The results obtained show a high level of BS among the health workers who participated in our study. Both tests have an excellent correlation in the degree of exhaustion and cynicism, but not in efficacy. The BS measurement must be performed with at least two validated instruments to increase its reliability.

Monitoreo serológico y psicológico en personal de salud durante el comienzo de la pandemia COVID-19 / Serological and psychological monitoring of healthcare workers during the start of the COVID-19 pandemic

Introducción: el personal de salud (PdS) es esencial en la lucha contra el COVID-19. Al inicio de la pandemia, el riesgo de adquirir la enfermedad en este grupo era desconocido. Buscamos estimar incidencia y prevalencia de anticuerpos anti-SARS-CoV-2, y prevalencia de burnout en una cohorte de PdS durante la pandemia COVID-19, así como valorar la prevalencia de burnout y depresión en la cohorte. Materiales y métodos: cohorte prospectiva conformada por médicos que atendían pacientes COVID-19 desde marzo de 2020 hasta enero de 2021, en un hospital de alta complejidad de la ciudad de Buenos Aires. Se evaluó IgM e IgG anti-SARS-CoV-2 quincenalmente durante 3 meses, así como la presencia de síntomas compatibles y factores asociados a la exposición. Se remitió a participantes con alteraciones de la esfera psíquica a contacto con el equipo de salud mental del hospital. Resultados: se incluyeron 52 participantes; de ellos, 31 eran mujeres; mediana de edad 32 años (rango 25-58). La mediana de horas semanales de trabajo autoinformadas fue 48 (IIC [intervalo intercuartil] 40-69,5). Inicialmente todos fueron PCR SARS-CoV-2 negativos en hisopado nasal; 11 (21,50% IC 95%; 9,62-32,53%) tuvieron COVID-19 sintomático con anticuerpos positivos. Los factores con mayor asociación a riesgo de COVID-19 fueron anosmia/disgeusia OR 403,33 (IC 95%; 47,60-3417,02), fiebre OR 172,53 (IC 95%; 28,82-1032,65), mialgias OR 41,97 (IC 95%; 8,08-217,84), conviviente con COVID-19 OR 28,17 (IC 95%; 5,67-179,97). Cerca del 40% presentaba alteraciones en las escalas de medición de burnout o depresión. Discusión: la incidencia hallada coincide con las cifras informadas acerca de personal de salud en la etapa inicial de la pandemia en la Argentina. Otro aspecto similar fue una mayoría de infecciones de curso leve, sin ningún paciente hospitalizado. No obstante, se halló una elevada incidencia de alteraciones de la esfera psíquica, tanto al comienzo como al final del seguimiento. Conclusiones: la incidencia de positivización de anticuerpos anti-SARS-CoV-2 fue cercana al 20%. No evidenciamos infecciones presintomáticas o asintomáticas. En cambio, la prevalencia de burnout y depresión fue elevada. La salud mental es un componente del personal de salud que debe ser priorizado en situaciones futuras de impacto similar. (AU)

Introduction: healthcare personnel are essential in the response against COVID-19. At the beginning of the pandemic the risk of acquiring the disease in this group was unknown. We sought to estimate incidence and prevalence of anti SARS-CoV-2 antibodies, as well as burnout prevalence in a cohort of healthcare staff during the pandemic, as well as assessing the prevalence of burnout and depression in this group. Materials and methods: prospective cohort formed by physicians tending to COVID-19 patients from march 2020 to january 2021 in a high-complexity hospital in the city of Buenos Aires. We evaluated anti SARS-CoV-2 IgM and IgG each 15 days for 3 months as well as the presence of compatible symptoms and factors associated to exposition to the virus. Patients showing signs of burnout and/or depression were referred to proper care by the mental health team in the hospital. Results: we included 52 patients, 31 women, median age was 32 years (range 25 - 58). Median amount of self-reported hours worked each week was 48 (IQR 40 - 69.5). Initially all participants had a negative COVID-19 PCR nasopharyngeal swab; 11 (21.50% CI95% 9.62 - 32.53%) had symptomatic COVID-19 with positive antibodies. Factors showing stronger association with testing positive were anosmia/dysgeusia OR 403.33 (CI95% 47.60-3417.02), fever OR 172.53 (CI95% 28.82 - 1032.65), myalgia OR 41.97 (CI95% 8.08 - 217.84), cohabitation with confirmed COVID-19 case OR 28.17 (CI95% 5.67 - 179.97). Near 40% showed alterations in burnout or depression scales. Discussion: the incidence rate we found was like reported values in the initial stages of the pandemic in Argentina. Another similarity was that all cases were mild; no hospitalization was required for any participant. We found an elevated incidence of alterations in the psychic sphere, both at the beginning and end of the follow up period. Conclusions:the incidence of positive SARS-CoV-2 antibodies was around 20%. No pre or asymptomatic cases were identified. Burnout and depression incidence was high. Mental health is a component that should never be overlooked in similar situations to come. (AU)

A Rasch analysis of the Burnout Assessment Tool (BAT).

Burnout as a concept indicative of a work-related state of mental exhaustion is recognized around the globe. Numerous studies showed that burnout has negative consequences for both individuals and organizations but also for society at large, especially in welfare states where sickness absence and work incapacitation are covered by social funds. This underlines the importance of a valid and reliable tool that can be used to assess employee burnout levels. Although the Maslach Burnout Inventory is by far the most frequently used questionnaire for assessing burnout, it is associated with several shortcomings and has been criticized on theoretical as well as empirical grounds. Thus, there is a need for an alternative questionnaire with a strong conceptual basis and proper psychometric qualities. This challenge has been taken up by introducing the Burnout Assessment Tool (BAT), according to which burnout is conceived as a work-related state of exhaustion among employees, characterized by extreme tiredness, reduced ability to regulate cognitive and emotional processes, and mental distancing. Given that the BAT is a new measure of burnout, its psychometric properties need to be evaluated. This paper focuses on an evaluation of the internal construct validity of the BAT using Rasch analysis in two random samples (n = 800, each) drawn from larger representative samples of the working population of the Netherlands and Flanders (Belgium). The BAT has sound psychometric properties and fulfils the measurement criteria according to the Rasch model. The BAT score reflects the scoring structure indicated by the developers of the scale and the BAT's four subscales can be summarized into a single burnout score. The BAT score also works invariantly for women and men, younger and older respondents, and across both countries. Hence, the BAT can be used in organizations for screening and identifying employees who are at risk of burnout.

Assessment of burnout in medical students using the Maslach Burnout Inventory-Student Survey: a cross-sectional data analysis.

BACKGROUND: Medical student burnout can cause emotional and physical exhaustion and detachment. The objectives of this study were to evaluate burnout using the Maslach Burnout Inventory-Student Survey (MBI-SS), identify factors that may predict burnout, and assess wellness initiatives effectiveness at reducing burnout. METHODS: The MBI-SS was administered to all medical students (Classes 2019 to 2022) at the University of Illinois College of Medicine (UICOM) from February to May 2019. Factor analysis and internal consistency of the MBI-SS were assessed. Mean MSBI-SS subscale scores for burnout were calculated for cynicism (CY), emotional exhaustion (EE), and academic efficacy (AE). Multiple regression analysis was used to identify student factors that may predict burnout. RESULTS: A total of 273 (21.6%) UICOM students completed the survey and 110 (40.3%) respondents reported self-perceived burnout. MBI-SS subscale scores were significantly higher for CY and EE, and significantly lower for AE in students who reported suffering from burnout versus students who did not report burnout. Mean ± SD subscale scores for CY, EE, and AE in burnout students were 14.44 ± 5.59, 23.23 ± 4.74, and 24.81 ± 5.35, respectively. In comparison, mean ± SD subscale scores for CY, EE, and AE in non-burnout students were 7.59 ± 5.16, 14.96 ± 5.71, and 28.74 ± 3.21, respectively. Regression analysis denoted significant associations between burnout and being out-of-phase in the curriculum, the effectiveness of wellness initiatives, and strength of motivation for medical school (SMMS) in both the two- and three-dimensional MBI-SS models. Gender was significantly associated with burnout in only the two-dimensional model. CONCLUSIONS: Self-reported burnout in medical students at UICOM was validated using the MBI-SS. Being out-of-phase in the curriculum, being female, rating wellness initiatives as less effective, and demonstrating lower motivation for continued medical school education may be used as predictors of medical student burnout. This investigation may act as a guide for measuring burnout in medical student populations and how the implementation of wellness initiatives may ameliorate burnout.

Work Addiction, Obsessive-Compulsive Personality Disorder, Burn-Out, and Global Burden of Disease: Implications from the ICD-11.

Occupational stress and high workload are being increasingly recognized as significant contributors to the diseases and disorders constituting major components of the global burden of disease. A more detailed definition of burn-out was recently included by the World Health Organization (WHO) in the eleventh revision of the International Classification of Diseases (ICD-11) which reflects a growing acknowledgment of the role of professional work in mental health. One of the symptoms of obsessive-compulsive personality disorder/anankastic personality disorder (OCPD/APD) is an undue preoccupation with productivity to the exclusion of pleasure and interpersonal relationships. This compulsive overworking is closely related to the concept of work addiction, and OCPD/APD was suggested to be its major risk factor. OCPD/APD is the most prevalent personality disorder and one that appears to produce the highest direct and indirect medical costs. At the same time, it is vastly understudied. In recent years, it has been repeatedly emphasized that it requires consistent conceptualization and clarification of its overlapping with similar conditions. Even though the limited existing studies suggest its strong relationship with burn-out and depression among employed individuals, there has been no systematic effort to investigate its role in the consequences of occupational stress and high workload. This paper identifies several substantial gaps in the current understanding of the relationships between work addiction, OCPD/APD, burn-out, and the global burden of disease within the context of the WHO's plan of developing evidence-based guidelines on mental wellbeing in the workplace.

Burnout syndrome should not be underestimated.

OBJECTIVES: Burnout syndrome can be seen among health professionals at every stage of their careers. The incidence of burnout syndrome among health care professionals has increased in recent years and varies between countries and depending on different areas of specialization and work units. It is known that burnout syndrome significantly affects the work and social life of individuals. We aimed to investigate the effect of burnout syndrome on trauma and infection. METHODS: The study was conducted in the Alanya Alaaddin Keykubat University, Faculty of Medicine, Training and Research Hospital. All health professionals working at the hospital were included in the study. The Maslach Burnout Inventory was applied to the participants, who were asked about infective disease and trauma history over the past year. RESULTS: The total burnout rate was 77.8% among participants. We found that the rate of trauma and infective disease history was significantly high in employees who had burnout syndrome (p<0.05). CONCLUSION: Burnout syndrome is a common and important problem among health professionals that also has adverse effects on people's daily life, especially increasing the incidence of infection and trauma.

Burnout Syndrome in medical internship students and its prevention with Balint Group.

BACKGROUND: We intend to estimate the Burnout Syndrome prevalence and its associated factors among medical internship students at a public university in northeastern Brasil, besides investigating the Balint Group (BG) contribution in its prevention. METHODS: We conducted a cross-sectional study in February/2018 with Medical Internship Students at the University researched. We applied a structured questionnaire developed by the authors about socio-demographic data, educational process with BG participation, and current psycho-emotional experiences, in addition to the Maslach Burnout Inventory - Student Survey (MBI-SS), for Burnout Syndrome screening. We performed descriptive data analysis, logistic regression, and cluster analysis. RESULTS: A total of 184 students (98%) participated in the study, with a mean age of 25.9±3.9 years, of which 54.9% were men. The prevalence of Burnout Syndrome was 10.3% based on the three-dimensional criterion and 35.9% on two-dimensional criterion (Exhaustion and Cynicism); it was higher in those who thought about quitting the program (OR=2.14), were dissatisfied with the teaching strategies (OR=2.67) and their performance (OR=2.64) and made use of licit drugs (OR=2.37). The variables associated with Burnout Syndrome allowed individuals to be discriminated, classifying them into three subgroups. Burnout Syndrome prevalence decreased, and vulnerability factors were attenuated when there was a higher frequency of students participating in BG. CONCLUSIONS: The prevalence of two-dimensional Burnout Syndrome was high, with factors associated with the educational process. Participation in BG was associated with a lower Burnout rate prevalence. Longitudinal studies should be conducted.

Burnout Syndrome in medical internship students and its prevention with Balint Group

SUMMARY BACKGROUND: We intend to estimate the Burnout Syndrome prevalence and its associated factors among medical internship students at a public university in northeastern Brasil, besides investigating the Balint Group (BG) contribution in its prevention. METHODS: We conducted a cross-sectional study in February/2018 with Medical Internship Students at the University researched. We applied a structured questionnaire developed by the authors about socio-demographic data, educational process with BG participation, and current psycho-emotional experiences, in addition to the Maslach Burnout Inventory - Student Survey (MBI-SS), for Burnout Syndrome screening. We performed descriptive data analysis, logistic regression, and cluster analysis. RESULTS: A total of 184 students (98%) participated in the study, with a mean age of 25.9±3.9 years, of which 54.9% were men. The prevalence of Burnout Syndrome was 10.3% based on the three-dimensional criterion and 35.9% on two-dimensional criterion (Exhaustion and Cynicism); it was higher in those who thought about quitting the program (OR=2.14), were dissatisfied with the teaching strategies (OR=2.67) and their performance (OR=2.64) and made use of licit drugs (OR=2.37). The variables associated with Burnout Syndrome allowed individuals to be discriminated, classifying them into three subgroups. Burnout Syndrome prevalence decreased, and vulnerability factors were attenuated when there was a higher frequency of students participating in BG. CONCLUSIONS: The prevalence of two-dimensional Burnout Syndrome was high, with factors associated with the educational process. Participation in BG was associated with a lower Burnout rate prevalence. Longitudinal studies should be conducted.

RESUMO OBJETIVO: Estimar a prevalência de Síndrome de Burnout (SB) e fatores associados entre os internos de medicina de uma universidade pública no Nordeste do Brasil, além de investigar a contribuição do Grupo Balint (GB) na sua prevenção. MÉTODOS: Estudo transversal em fevereiro/2018 com os internos de medicina da universidade pesquisada. Aplicou-se um questionário estruturado elaborado pelos autores sobre características sociodemográficas, processo educacional com participação do GB e vivências psicoemocionais atuais, além do Maslach Burnout Inventory - Student Survey (MBI-SS) para triagem de SB. Realizaram-se análise descritiva, regressão logística e análise de agrupamentos. RESULTADOS: Participaram 184 estudantes (98%), com idade média de 25,9±3,9 anos, sendo 54,9% do sexo masculino. A prevalência de SB foi 10,3% pelo critério tridimensional e 35,9% pelo bidimensional (Exaustão e Descrença), sendo maior naqueles que pensaram em abandonar o curso (OR=2,14), estavam insatisfeitos com as estratégias de ensino (OR=2,67) e com seu desempenho acadêmico (OR=2,64) e faziam uso de drogas lícitas (OR=2,37). As variáveis associadas à SB permitiram discriminar os indivíduos classificando-os em três subgrupos. A prevalência de SB diminuiu e fatores de vulnerabilidade foram atenuados quando houve maior frequência de estudantes participantes do GB. CONCLUSÕES: A prevalência de SB pelo critério bidimensional foi alta, com fatores associados ao processo educacional. A participação no GB foi associada à menor prevalência de SB. Estudos longitudinais devem ser realizados.

Every doctor needs a wife: An old adage worth reexamining.

Half of medical school graduates are women, but female doctors experience significant professional tensions. Low numbers of women in leadership roles, high burnout and attrition, and continued harassment suggest a culture that undermines the contributions of women. This manuscript explores research from sociology, business and medicine through a personal lens. Understanding the way gender influences the complex state of women in medicine suggests changes are needed in the architecture of the modern medical workforce. Individuals, mentors and organizations can make changes that would improve the way that the working environment cultivates a diverse workforce to reach its full potential.

Assessment of burnout in medical undergraduate students in Riyadh, Saudi Arabia.

BACKGROUND: To assess the prevalence of burnout symptoms among preclinical and clinical medical students studying at AlFaisal University in Riyadh, Saudi Arabia. METHODS: A cross-sectional study was conducted using Maslach Burnout Inventory questionnaire on 276 medical students from Alfaisal University, Riyadh, Saudi Arabia. The study was approved by Alfaisal University research ethics committee. Chi-square test was used to identify statistically significant differences, and binary logistic regression was used to identify predictors of burnout. RESULTS: 276 entered into final data analysis with a mean age 20.62 ± 1.58, of whom 54% were males, and 46% were females. The overall burnout prevalence was 13.4%, of which PA was the most prevalent domain of burnout with 64.9%. Female gender was a significant predictor of EE and DP [OR = 4.34; 95% Cl 1.86-10.13; P-value 0.001] and [OR = 2.01; 95% Cl 1.07-3.79; P-value 0.030] respectively as per multivariate analysis for demographic characteristics. Regarding the total level of burnout, females (75.7%) had significantly higher levels of burnout compared to males (41.4%); (P-value < 0.001). CONCLUSION: Burnout is prevalent among medical student. Gender was found to exhibits effect on the burnout. Mutual proactive strategies and reactive coping mechanisms between the students and the universities are encouraged to prevent and reduce burnout among medical students.

Caregivers of patients receiving long-term treatment with a tyrosine kinase inhibitor (TKI) for gastrointestinal stromal tumour (GIST): a cross-sectional assessment of their distress and burden.

BACKGROUND: TKIs are a long-term treatment for GIST, and may have an impact on caregivers. MATERIAL AND METHODS: For this cross-sectional study, patients and caregivers were both included when patients had been treated with TKIs for at least six months. Caregivers completed questionnaires including demographics, distress (Hospital Anxiety and Depression scale), burden (Self-Perceived Pressure from Informal Care) general health (RAND-36), comorbidity (Self-administered Comorbidity Questionnaire), social support (Social Support List - Discrepancies) and marital satisfaction (Maudsley Marital Questionnaire). Patients completed similar questionnaires, without 'burden'. We conducted analyses to explore differences between caregivers with low/moderate versus high levels of burden and low versus high levels of distress. RESULTS: Sixty-one out of seventy-one eligible couples (84%) were included in the analysis. The median age of the caregivers was 60 years; 66% were female and 78% were the patients' spouse. The median age of the patients was 66 years; 43% were female. Caregivers experienced high levels of burden and distress in 10% and 23%, respectively. Caregivers with high levels of burden perceived significantly lower mental health, less vitality, lower general health and high levels of distress. Significantly higher levels of burden were found in non-spouses, caregivers of patients with more treatment-related side-effects, caregivers who spent more hours caring, and those caring for more than one person. For distress, caregivers with high levels of distress perceived significantly more burden, lower social functioning, more role physical and emotional problems, lower mental health, less vitality and lower general health. Furthermore, high levels of distress were found in caregivers of more dependent patients and those caring for more than one person. CONCLUSIONS: Caregivers of the patients with GIST treated with TKI are managing well. There is a small, vulnerable group of caregivers with high levels of burden and/or distress, show more health-related problems, both physical and mental, and require adequate support.

[Psychological distress and caregiving burden among spouses of women with breast cancer]. / Niveau de détresse psychologique et de fardeau perçu chez les conjoints de femmes atteintes d'un cancer du sein.

Breast cancer is a chronic disease that affects both patients and their caregivers. Spouses, in particular, will generally assume the role of primary caregiver and experience significant physical, social, economic and emotional stress. In the face of cancer, being the spouse of a patient is synonymous with unmet psychosocial needs and a new role assignment, that of a primary caregiver. In addition, cancer confronts spouses with fear of partner loss. This leads to a set of adverse consequences such as depression, anxiety, uncertainty, stress, etc. Several studies have shown that breast cancer reduces the quality of life of patients' spouses and increases their emotional distress, their psychosocial needs, and their responsibilities within the family. Spouses may live a complex powerful emotional experience, which is equal to or greater than that experienced by patients during the diagnosis and treatment process. These multiple solicitations contribute to the heavy symptom burden. Therefore, in the context of breast cancer, identifying vulnerable spouses and providing them with appropriate support would help ensure better adherence to the care of their wives at different stages of the disease.

Factors associated with spousal burden in Parkinson's disease.

Parkinson's disease is characterized by motor and non-motor symptoms, which can lead to progressive disability that, in turn, can lead to a burden on caregivers. Thus, the objective of this study was to determine correlations between intensity of disease burden and characteristics of patients and their spouses. The study included 38couples (patients and spouses) living at home with no severe comorbidities. The following patients' characteristics were measured: disease severity (MDS-UPDRS); cognitive status (MoCA); non-motor signs (NMSS); quality of life (PDQ-8); anxiety and depression (HADS); and levodopa equivalent dose. The Zarit Burden Interview, quality of life questionnaire (EQ-5D-VAS) and HADS were administered to spouses. The average caregiver burden score was 14.4±12.7, and correlated (in descending order) with severity of non-motor signs (R2=0.46, P<0.0001), anxiety and depression in caregivers and patients (R2=0.35, P<0.0001 and R2=0.26, P<0.0001, respectively), motor severity (R2=0.3, P<0.0001), patients' quality of life (R2=0.27, P=0.0125), levodopa equivalent dose (R2=0.13, P=0.0261) and duration of illness (R2=0.12, P=0.0307). The severity of non-motor signs, patients' and caregivers' mood, and motor disease severity are the main determinants of caregiver burden, making them important targets in the management of Parkinson's disease.