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      Veinte años después: prevalencia y evolución del burnout en Pediatría, de 1998-1999 a 2018-2019 Translated title: Twenty years after: prevalence and evolution of burnout in pediatrics, from 1998-1999 to 2018-2019

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          Abstract

          Resumen Introducción: el burnout es un síndrome de estrés crónico, descrito como un proceso de cansancio emocional, despersonalización y falta de realización personal. Tiene elevado impacto tanto a nivel personal como en calidad y seguridad asistencial, y su prevalencia es elevada. El presente estudio pretende determinar la prevalencia de este síndrome en pediatras de Lleida, analizar su relación con diversas variables y comparar los resultados actuales con los del estudio previo en 1998. Método: estudio descriptivo transversal observacional, que valora información sociodemográfica y cuestionario de burnout de Maslach. Se comparan los datos con los del estudio de 1998, en el que se recogieron los mismos datos. Resultados: han participado 42 pediatras (64%), 66% de mujeres, edad media de 42,1 años. Un 36% presentaban puntuaciones sugestivas de síndrome burnout en cansancio emocional. No había diferencias respecto a las horas trabajadas, el género, el estado civil ni el lugar de trabajo. Los pediatras con más desgaste profesional presentaban mayor decepción y depresión en relación con el trabajo, así como también mayor presencia de enfermedad física o psíquica. Por otro lado, aquellos que concebían el trabajo como una vocación y disfrutaban de reconocimiento institucional tenían valores más altos de realización personal. Se comparan los datos con los del estudio de 1998. Conclusiones: la prevalencia de desgaste profesional elevado es del 36%. Se confirma la cifra de aproximadamente un tercio de los pediatras con niveles significativos de burnout, que está presente de forma estructural y que requiere de estrategias de abordaje, no solo individual sino también del equipo y de las organizaciones.

          Translated abstract

          Abstract Introduction: burnout is a chronic stress syndrome, described as a process of emotional exhaustion, depersonalization, and reduced personal accomplishment. It has a high impact both on a personal level and on healthcare quality and safety, and its prevalence is high. The present study aimed to determine the prevalence of this syndrome in paediatricians in Lleida, analyse its association with different variables and compare current results with the results of a previous study conducted in 1998. Method: we conducted a descriptive, cross-sectional observational study analysing sociodemographic data and Maslach burn-out questionnaire scores. We compared these data to the results of the 1998 study, in which the same information was collected. Results: a total of 42 paediatricians (64%) participated in the survey, 66% were female, and the mean age was 42.1 years. Thirty-six percent had scores suggestive of burnout syndrome with emotional exhaustion. There were no differences associated with the number of hours worked, sex, marital status, or the work setting. The paediatricians with the highest level of burnout were more likely to express disappointment and depression in relation to work and or have physical and/or mental illness. On the other hand, respondents who perceived their work as a calling and felt recognised by their organizations had higher scores in the dimension of personal accomplishment. We compared the data of this sample to the data of the 1998 study. Conclusions: We found a high level of burnout in 36% of respondents. The data confirmed that approximately one third of paediatricians have significant levels of burnout, which is a structural problem and therefore must be addressed with strategies not only at the individual level, but also at the level of the team and the institution.

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          Most cited references40

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          Understanding the burnout experience: recent research and its implications for psychiatry.

          The experience of burnout has been the focus of much research during the past few decades. Measures have been developed, as have various theoretical models, and research studies from many countries have contributed to a better understanding of the causes and consequences of this occupationally-specific dysphoria. The majority of this work has focused on human service occupations, and particularly health care. Research on the burnout experience for psychiatrists mirrors much of the broader literature, in terms of both sources and outcomes of burnout. But it has also identified some of the unique stressors that mental health professionals face when they are dealing with especially difficult or violent clients. Current issues of particular relevance for psychiatry include the links between burnout and mental illness, the attempts to redefine burnout as simply exhaustion, and the relative dearth of evaluative research on potential interventions to treat and/or prevent burnout. Given that the treatment goal for burnout is usually to enable people to return to their job, and to be successful in their work, psychiatry could make an important contribution by identifying the treatment strategies that would be most effective in achieving that goal.
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            Physician burnout: contributors, consequences and solutions

            Physician burnout, a work-related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment, is prevalent internationally. Rates of burnout symptoms that have been associated with adverse effects on patients, the healthcare workforce, costs and physician health exceed 50% in studies of both physicians-in-training and practicing physicians. This problem represents a public health crisis with negative impacts on individual physicians, patients and healthcare organizations and systems. Drivers of this epidemic are largely rooted within healthcare organizations and systems and include excessive workloads, inefficient work processes, clerical burdens, work-home conflicts, lack of input or control for physicians with respect to issues affecting their work lives, organizational support structures and leadership culture. Individual physician-level factors also play a role, with higher rates of burnout commonly reported in female and younger physicians. Effective solutions align with these drivers. For example, organizational efforts such as locally developed practice modifications and increased support for clinical work have demonstrated benefits in reducing burnout. Individually focused solutions such as mindfulness-based stress reduction and small-group programmes to promote community, connectedness and meaning have also been shown to be effective. Regardless of the specific approach taken, the problem of physician burnout is best addressed when viewed as a shared responsibility of both healthcare systems and individual physicians. Although our understanding of physician burnout has advanced considerably in recent years, many gaps in our knowledge remain. Longitudinal studies of burnout's effects and the impact of interventions on both burnout and its effects are needed, as are studies of effective solutions implemented in combination. For medicine to fulfil its mission for patients and for public health, all stakeholders in healthcare delivery must work together to develop and implement effective remedies for physician burnout.
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              Burnout and self-reported patient care in an internal medicine residency program.

              Burnout is a syndrome of depersonalization, emotional exhaustion, and a sense of low personal accomplishment. Little is known about burnout in residents or its relationship to patient care. To determine the prevalence of burnout in medical residents and explore its relationship to self-reported patient care practices. Cross-sectional study using an anonymous, mailed survey. University-based residency program in Seattle, Washington. 115 internal medicine residents. Burnout was measured by using the Maslach Burnout Inventory and was defined as scores in the high range for medical professionals on the depersonalization or emotional exhaustion subscales. Five questions developed for this study assessed self-reported patient care practices that suggested suboptimal care (for example, "I did not fully discuss treatment options or answer a patient's questions" or "I made...errors that were not due to a lack of knowledge or inexperience"). Depression and at-risk alcohol use were assessed by using validated screening questionnaires. Of 115 (76%) responding residents, 87 (76%) met the criteria for burnout. Compared with non-burned-out residents, burned-out residents were significantly more likely to self-report providing at least one type of suboptimal patient care at least monthly (53% vs. 21%; P = 0.004). In multivariate analyses, burnout--but not sex, depression, or at-risk alcohol use--was strongly associated with self-report of one or more suboptimal patient care practices at least monthly (odds ratio, 8.3 [95% CI, 2.6 to 26.5]). When each domain of burnout was evaluated separately, only a high score for depersonalization was associated with self-reported suboptimal patient care practices (in a dose-response relationship). Burnout was common among resident physicians and was associated with self-reported suboptimal patient care practices.
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                Author and article information

                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                September 2021
                : 23
                : 91
                : 253-260
                Affiliations
                [4] Lleida orgnameHospital Sant Joan de Déu Terres de Lleida España
                [3] Lleida orgnameInstituto Catalán de la Salud España
                [2] Barcelona orgnameUniversidad Ramon Llull orgdiv1Instituto Borja de Bioètica España
                [1] Lleida orgnameUniversidad de Lleida orgdiv1Facultad de Medicina España
                [5] Lleida orgnameHospital Universitario Santa María-Gestión de Servicios Sanitarios España
                Article
                S1139-76322021000300004 S1139-7632(21)02309100004
                98e80805-0b0d-4019-8e70-c2403db7b394

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 40, Pages: 8
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                SciELO Spain

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                Emotional distress,Profesionalismo médico,Malestar emocional,Estrés laboral,Burnout,Professional burnout,Occupational stress,Medical professionalism

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