[Evolution of burnout and associated factors in primary care physicians]
- PMID: 22608369
- PMCID: PMC7025610
- DOI: 10.1016/j.aprim.2010.05.021
[Evolution of burnout and associated factors in primary care physicians]
Abstract
Purpose: To analyse the course of burnout and develop an explanatory model.
Design: Prospective cohort dynamics. SITE: All primary health care centres in Burgos.
Subjects: All physicians except medical emergencies, paediatrics and residents.
Main measurements: Anonymous self-report questionnaire: Maslach Burnout Inventory (MBI) and related variables. An analysis was performed using the Student-t, X(2) test and logistic regression.
Results: The response rate was 47.76% in 2007, which was lower than that of 2005. There were significant differences between 2005 and 2007, for increases in the percentage of physicians who smoked, postgraduate training, residency, and those who believe that coordination with nursing and specialist care and institutional communication is appropriate. There was an increase in the prevalence of burnout by almost one point compared with 2005, a decrease in maximum burnout and emotional exhaustion (EC), and an increase in depersonalisation (DP) and personal accomplishment (RP). The incidence density of burnout was 1/113. 5 primary care physicians per year. The existence of burnout is associated with the use of chronic medication and inadequate coordination between nursing and EC, and also with the high workload.
Conclusions: The increase in the prevalence found is consistent with the idea of burnout as a dynamic development and the theoretical model described. Stable and quality employment is one way to indirectly mitigate (by encouraging internal communication) professional burnout. In the multivariate analysis, the most critical variable in the onset of burnout is the inadequate coordination with nursing.
Objetivo: Analizar la evolución del burnout y elaborar un modelo explicativo.
Diseño: Estudio prospectivo de cohorte dinámica.
Emplazamiento: Todos los centros de AP de Burgos.
Sujetos: Todos los médicos de AP excepto urgencias, pediatría y residentes.
Mediciones principales: Cuestionario anónimo autoadministrado: Maslach Burnout Inventory (MBI) y variables relacionadas. Análisis mediante la t de Student, el test de la χ2 y regresión logística.
Resultados: Respuesta del 47,76% en 2007, inferior a la del 2005.
Existieron diferencias significativas entre 2005 y 2007, para los incrementos en el porcentaje de médicos fumadores, formación postgrado, especialidad vía MIR, y los que consideran que la coordinación con enfermería y atención especializada y comunicación institucional son adecuadas.
Aumenta la prevalencia de burnout casi un punto con respecto a 2005, disminuye el desgaste máximo; disminuyó el cansancio emocional (CE) y aumentó la realización personal (RP) y despersonalización (DP). Densidad de incidencia de burnout de 1/113,5 médicos de atención primaria por año.
La existencia de burnout se asocia a la utilización de medicación crónica e inadecuada coordinación con enfermería y CE además con elevada presión asistencial.
Conclusiones: El aumento de la prevalencia hallado es compatible con la idea del burnout como desarrollo dinámico y el modelo teórico descrito.
El empleo estable y de calidad es una vía para mitigar indirectamente (favoreciendo la comunicación interna) el desgaste profesional.
En el análisis multivariado la variable más determinante en la aparición de burnout es la inadecuada coordinación con enfermería.
Copyright © 2008 Elsevier España, S.L. All rights reserved.
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Comment in
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[Burnout and associated factors in primary care physicians].Aten Primaria. 2013 Feb;45(2):123-4. doi: 10.1016/j.aprim.2012.10.001. Epub 2012 Nov 20. Aten Primaria. 2013. PMID: 23182211 Free PMC article. Spanish. No abstract available.
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