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      Síndrome de Burnout en el personal de enfermería de un hospital de Madrid Translated title: Burnout Syndrome among Nursing Staff at a Hospital in Madrid

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          Abstract

          Fundamento: El término Burnout se refiere a una situación que es cada vez más frecuente entre los profesionales que prestan sus servicios a través de una relación directa y mantenida con las personas, entre los que se encuentran todos los profesionales sanitarios. El objetivo de nuestro estudio ha sido determinar la prevalencia del síndrome de Burnout y de sus tres componentes (cansancio emocional, despersonalización y falta de realización personal) entre los profesionales del área de enfermería del Hospital Clínico Universitario San Carlos de Madrid y su relación con determinados factores sociodemográficos, laborales e institucionales. Métodos: Se realizó un estudio tranversal entre los profesionales adscritos al área de enfermería del mencionado hospital. Las variables implicadas se recogieron mediante un cuestionario de elaboración propia. En cuanto al síndrome de Burnout se midió mediante el Maslach Burnout Inventory, en su versión validada en español. Resultados: El personal de enfermería está más despersonalizado (p=0,004) y menos realizado (p=0,036) que el grupo de auxiliares/técnicos. Cuando se analizaron los resultados de las 4 escalas por servicios comprobamos que el agotamiento es superior en los trabajadores de oncología y urgencias (p=0,001), la despersonalización en urgencias (p=0,007), y el Burnout es de nuevo más alto en las áreas de oncología y urgencias (p=0,000). Los profesionales que respondían que su labor asistencial era poco reconocida obtenían las peores puntuaciones en el Burnout y sus tres dimensiones (p =0,000). A menor grado de satisfacción laboral más altas son las puntuaciones en las 4 escalas (p=0,000). Conclusiones: Podemos concluir que en nuestro estudio el perfil del sujeto afecto de Burnout se corresponde con el de un profesional con experiencia laboral que sin embargo manifiesta un escaso grado de reconocimiento a su labor asistencial y un alto nivel de insatisfacción con la gestión de su centro de trabajo.

          Translated abstract

          Background: The term «burnout» is related to a situation arising increasingly more often among the professionals performing their duties by way of a long-term, direct, people-to-people relationship, which includes all healthcare professionals. This study is aimed at determining the prevalence of the Burnout syndrome and of the three components involved therein (emotional exhaustion, impersonalization and lack of personal fulfillment) among the nursing staff at the «Hospital Clínico Universitario San Carlos» in Madrid and the relationship thereof to certain socio-demographic, job-related and institutional factors. Methods: A cross-sectional study was conducted among the professionals assigned to the nursing staff at the above-mentioned hospital. The variables involved were gathered by means of a questionnaire prepared by those conducting this study. The Burnout syndrome was measured by means of the Maslach Burnout Inventory, in the validated Spanish version thereof. Results: The nursing staff is more impersonalized (p=0.004) and less fulfilled (p=0.036) than the nursing assistant/technician group. When the results of the four scales by units were analyzed, burnout was found to be greater among the nursing staff assigned to oncology and emergency care units (p=0.001), the impersonalization in the emergency rooms (p=0,007), and Burnout is once again greater in the oncology and emergency units (p=0.000). Those professionals who answered that there was little recognition of their nursing care scored worst regarding Burnout and the three aspects thereof (p =0.000). The lower the degree of on-the-job satisfaction, the higher the scores on the four scales (p=0.000). Conclusions: The conclusion which may be drawn from this study is that the profile of a person affected by Burnout is that of a professional with on-the-job experience who nevertheless considers very little recognition to be given to their caregiving and a high degree of dissatisfaction with the way in which their workplaces are managed.

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          Chronic burnout, somatic arousal and elevated salivary cortisol levels.

          Burnout syndrome, comprised of the symptoms of emotional exhaustion, physical fatigue, and cognitive weariness, is believed to be a result of ineffective coping with enduring stress. This study of 111 nonshift blue-collar workers free of cardiovascular disease (CVD) examined whether chronic burnout is associated with a state of somatic and physiological hyperarousal. Results showed that 37 workers exhibited symptoms of chronic burnout, with symptoms lasting at least 6 months. These workers, compared to those with no burnout symptoms (n = 52) or nonchronic burnout symptoms (n = 22), had higher levels of tension at work, postwork irritability, more sleep disturbances and complaints of waking up exhausted, and higher cortisol levels during the work day. These results suggest that chronic burnout is associated with heightened somatic arousal and elevated salivary cortisol levels. This may be part of the mechanism underlying the emerging association between burnout and risk of CVD.
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            Aspectos epidemiológicos del síndrome de Burnout en personal sanitario

            FUNDAMENTOS: El Síndrome Burnout se invoca como probable responsable de la desmotivación que sufren los profesionales sanitarios actualmente. Esto sugiere la posibilidad de que este síndrome esté implicado en las elevadas tasas de absentismo laboral que presentan estos profesionales. El estudio pretende aportar una serie de caracterizaciones de las variables epidemiológicas universales que permitan una aproximación al perfil de riesgo en esta profesión. MÉTODO: Estudiamos una muestra de 294 profesionales de atención primaria y atención especializada aleatoriamente. a los que se les aplicó el instrumento de medida del Síndrome de Burnout (Maslach Burnout Inventory) de forma autoadministrada. Se hizo estadística descriptiva con comparación de medias para variables sociodemográficas (P< 0,05) con Epiinfo V.60 y SPSS PC.W. RESULTADOS: Obtuvimos 87,76% de respuestas frente al 12,23% de pérdidas. Esta muestra nos permite una confianza del 95% y un error del 5%. Obtuvimos diferencias significativas en función del sexo, edad, estado civil, antigüedad en la profesión en el centro de trabajo, número de trabajadores en el centro, lugar de trabajo, número de enfermos a cargo, horas de trabajo semanales, tiempo de interacción con los pacientes. La media de presencia del síndrome de Burnout fue 47,16 + 7.93, siendo las mayores proporciones las consignadas para las dimensiones cansancio emocional y falta de realización. CONCLUSIONES: El perfil epidemiológico de riesgo obtenido sería: mujer de más de 44 años sin pareja estable, con más de 19 años de antigüedad en la profesión y más de 11 en el centro, profesional de atención especializada, con más de 21 pacientes diarios a su cargo, a los que dedica más del 70% de la jornada laboral y a ésta entre 36 y 40 horas semanales.
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              Impact of structural and psychological empowerment on job strain in nursing work settings: expanding Kanter's model.

              In this study, we tested an expanded model of Kanter's structural empowerment, which specified the relationships among structural and psychological empowerment, job strain, and work satisfaction. Strategies proposed in Kanter's empowerment theory have the potential to reduce job strain and improve employee work satisfaction and performance in current restructured healthcare settings. The addition to the model of psychological empowerment as an outcome of structural empowerment provides an understanding of the intervening mechanisms between structural work conditions and important organizational outcomes. A predictive, nonexperimental design was used to test the model in a random sample of 404 Canadian staff nurses. The Conditions of Work Effectiveness Questionnaire, the Psychological Empowerment Questionnaire, the Job Content Questionnaire, and the Global Satisfaction Scale were used to measure the major study variables. Structural equation modelling analyses revealed a good fit of the hypothesized model to the data based on various fit indices (chi 2 = 1140, df = 545, chi 2/df ratio = 2.09, CFI = 0.986, RMSEA = 0.050). The amount of variance accounted for in the model was 58%. Staff nurses felt that structural empowerment in their workplace resulted in higher levels of psychological empowerment. These heightened feelings of psychological empowerment in turn strongly influenced job strain and work satisfaction. However, job strain did not have a direct effect on work satisfaction. These results provide initial support for an expanded model of organizational empowerment and offer a broader understanding of the empowerment process.
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                Author and article information

                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad, Consumo y Bienestar social (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                August 2004
                : 78
                : 4
                : 505-516
                Affiliations
                [01] Madrid orgnameUniversidad Complutense de Madrid orgdiv1Facultad de Medicina orgdiv2Departamento de Medicina Preventiva y Salud Pública e Historia de la Ciencia
                Article
                S1135-57272004000400008 S1135-5727(04)07800400008
                10.1590/S1135-57272004000400008
                15384264
                af8006d7-77de-4cf6-95c3-7562986fd71f

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 50, Pages: 12
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                SciELO Public Health

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                Demografía,Demography,Job satisfaction,Agotamiento profesional,Satisfacción en el trabajo,Enfermeras,Hospitales,Burnout,professional,Nurses

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