[Burnout syndrome in different intensive care units]. / Síndrome de burnout en distintas Unidades de Cuidados Intensivos.

OBJECTIVES: To determine the prevalence of the professional burnout syndrome in health care personnel of different Intensive Care Units (ICUs). To know the association between burnout, its dimensions and sociodemographic-laboral variables. To compare the dimensions of burnout, characteristics of the personnel and of the patients of the different ICUs. MATERIAL AND METHODS: Analytic, comparative, cross-sectional study performed in the ICU of a tertiary hospital in November 2006 performed in a sample of 289 professionals. The Maslach Burnout Inventory questionnaire and sociodemographic-laboral variables were provided. The following were evaluated in the ICUs: Therapeutic Intervention Scoring System (TISS), Nine Equivalents of Nursing Manpower Use Score (NEMS), mortality, stay, isolations and travel of third parties. The chi2 test, Fischer test, Kruskall-Wallis test and multivariate logistic regression analysis were used. RESULTS: A total of 73% of the workers answered. Ages ranged from 37 +/- 9 and 81% were women. The prevalence of burnout was 14%, this affecting 16% of the nurses, 14% of residents, 13% physicians and 10% auxiliary workers. Burnout was associated to low professional satisfactions, relationship with regular colleagues, low work recognition and time worked and experience in the ICU to high emotional tiredness, with a p < 0.05. In a polyvalent ICU, higher values of the following were obtained: TISS 42 +/- 11, NEMS 35 +/- 10, mortality 18%, stay 5 +/- 9, isolation 21%, burnout syndrome 17%, elevated emotional tiredness 49%, elevated depersonalization 63% and low professional performance 44%. CONCLUSIONS: The prevalence of the burnout syndrome in our sample was 14%, those being affected most being the nursing professionals. We detected elevated levels of depersonalization and middle levels of emotional tiredness and professional performance. The variables related with professional burnout syndrome were low professional satisfaction, relationship with regular colleagues, low work recognition, and elevated emotional tiredness in the more expert personnel. The ICU with the greatest prevalence of burnout during the month studied attended patients with greater TISS, NEMS, mortality, stay and isolations.

Síndrome de burnout en distintas Unidades de Cuidados Intensivos / Burnout syndrome in different Intensive Care Units

Objetivos. Determinar la prevalencia del síndrome de desgaste profesional (burnout) enel personal sanitario de distintas Unidades de Cuidados Intensivos (UCI).Conocer la asociaciónentre el burnout, sus dimensiones y variables sociodemográficas-laborales. Comparardimensiones del burnout, características del personal y de los pacientes de distintas UCI.Material y métodos. Estudio analítico comparativo transversal, realizado en UCI de un hospitalterciario, en noviembre de 2006. La muestra fue 289 profesionales. Se entregó el cuestionarioMaslach Burnout Inventory y variables sociodemográficas-laborales. Se valoró en UCI:Therapeutic Intervention Scoring System (TISS), Nine Equivalents of Nursing Manpower UseScore (NEMS), mortalidad, estancia, aislamientos y desplazamientos terciarios. Se empleó laprueba de la χ2, Fischer, Kruskall-Wallis y análisis multivariable de regresión logística.Resultados. Contestaron el 73% de los trabajadores, edad 37 ± 9 y un 81% eran mujeres.Prevalencia de burnout 14%, afectados el 16% de enfermeros, 14% de residentes, 13% demédicos y 10% de auxiliares. El burnout se asoció a satisfacción profesional baja, relacióncon compañeros regular, reconocimiento laboral bajo, y tiempo trabajado y experienciaen UCI a un cansancio emocional elevado, con una p < 0,05. En la UCI Polivalente se obtuvieronvalores más elevados de: TISS 42 ± 11, NEMS 35 ± 10, mortalidad 18%, estancia5 ± 9, aislamientos 21%, síndrome burnout 17%, cansancio emocional elevado 49%, despersonalizaciónelevada 63% y realización profesional baja 44%.Conclusiones. La prevalencia del síndrome de burnout en nuestra muestra fue del 14%,siendo los profesionales de enfermería los más afectados. Detectamos niveles elevadosde despersonalización y niveles medios de cansancio emocional y de realización profesional.Las variables relacionadas con el (..) (AU)

Objectives. To determine the prevalence of the professional burnout syndrome inhealth care personnel of different Intensive Care Units (ICUs). To know the associationbetween burnout, its dimensions and sociodemographic-laboral variables. To comparethe dimensions of burnout, characteristics of the personnel and of the patients of thedifferent ICUs.Material and methods. Analytic, comparative, cross-sectional study performed in the ICUof a tertiary hospital in November 2006 performed in a sample of 289 professionals. TheMaslach Burnout Inventory questionnaire and sociodemographic-laboral variables wereprovided. The following were evaluated in the ICUs: Therapeutic Intervention ScoringSystem (TISS), Nine Equivalents of Nursing Manpower Use Score (NEMS), mortality, stay,isolations and travel of third parties. The χ2 test, Fischer test, Kruskall-Wallis test andmultivariate logistic regression analysis were used.Results. A total of 73% of the workers answered. Ages ranged from 37 ± 9 and 81% werewomen. The prevalence of burnout was 14%, this affecting 16% of the nurses, 14% ofresidents, 13% physicians and 10% auxiliary workers. Burnout was associated to lowprofessional satisfactions, relationship with regular colleagues, low work recognition andtime worked and experience in the ICU to high emotional tiredness, with a p < 0.05. In apolyvalent ICU, higher values of the following were obtained: TISS 42 ± 11, NEMS 35 ± 10,mortality 18%, stay 5 ± 9, isolation 21%, burnout syndrome 17%, elevated emotionaltiredness 49%, elevated depersonalization 63% and low professional performance 44%.Conclusions. The prevalence of the burnout syndrome in our sample was 14%, those beingaffected most being the nursing professionals. We detected elevated levels ofdepersonalization and middle levels of emotional tiredness and professional performance. (..) (AU)

Acceso y cesión de la información genética contenida en la historia clínica (2. parte) / The access and use possibilities of the genetic information content in medical records

Una de las cuestiones más delicadas relacionadas con el tratamientode los datos genéticos en el sector sanitario, es la relativaa las posibilidades de acceso y uso de esta información,objeto de interés para terceros ajenos al ámbito sanitario. Elobjetivo del estudio, es delimitar los requisitos, condiciones ysujetos que pueden tener acceso a la información contenida enla historia clínica. Para ello, se ha analizado críticamente la normativainternacional y nacional que regula el tratamiento deestos datos, delimitando los conceptos legales, los principiosfundamentales que rigen su protección y los derechos del afectadoen relación con el tratamiento de este tipo de información.Se ha detectado la ausencia en el Ordenamiento jurídico españolde una norma específica que regule el tratamiento de losdatos genéticos y de una mención particular dentro de las normasque regulan los derechos del paciente en materia de documentaciónclínica, al reconducir la protección de la informacióngenética a la categoría genérica de datos relativos a la salud y alas normas reguladoras de los mismos. Esto se traduce en unainsuficiente protección para esta información de carácter personal,cuya divulgación puede colocar al individuo en una situaciónde vulnerabilidad frente a intereses de terceros. Por ello, ha deapelarse a una aplicación estricta de los principios y derechosque rigen en materia de protección de datos, pues los derechosfundamentales constituyen un pilar básico a tener en cuenta enel tratamiento de los datos genéticos

One of the most delicated questions in relation with thegenetic data processing in the health sector, is the relative tothe access and use possibilities of this information, an interestpoint for third persons outside the health area. Theobjective of this investigation is to delimit the requisites, conditionsand individuals who can access to the informationcontent in the case-history. For that, it has been criticallyanalyzed the international and national guidelines whichregulate the data treatment, delimiting the legal concepts,the fundamental principles that rules its protection and therights of the affected in relation with the treatment for thiskind of information. It has detected the absence of a specificnorm in the Spanish Legislation which rules the genetic datatreatment and a particular mention inside the norms thatrules the patient´s rights in the matter of clinic documents,to renew the protection of the genetic information to thegeneric category of data relative to the health and the rulednorms of selfsame. That means, no enough protection forthis personal information, for which circulation can cause avulnerable situation to the individual in relation with third persons.For that, it is necessary a severe application of theprinciples and rights that rules in matter of data protection,because the fundamental rights are one of the main pointsto take in account in the genetic data treatment