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      Estresores percibidos asociados a la presencia de burnout en médicos residentes Translated title: Perceived stressors associated with the presence of burnout in resident physicians

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          Resumen

          Introducción:

          la investigación científica ha reportado diversos estresores que podrían estar relacionados con el desarrollo del burnout en médicos residentes.

          Objetivo:

          identificar los estresores percibidos asociados con burnout en residentes de diversas especialidades médicas en el noroeste de México.

          Material y métodos:

          se realizó un estudio analítico, observacional, explicativo y transversal. El muestreo fue no probabilístico. Participaron médicos residentes de dos hospitales del sur de Sonora. Se utilizó la Escala de desgaste ocupacional (EDO) y la Lista de chequeo de estresores con intensidad.

          Resultados:

          se incluyeron 189 médicos residentes. El 87% presentó altos niveles de burnout. Específicamente los estresores sobrecarga laboral e insatisfacción laboral tuvieron mayor poder predictivo del agotamiento y la insatisfacción de logro en los médicos residentes. Por dimensiones, los problemas físicos fueron predictores de la dimensión de dolor en el estado de desgaste ocupacional. Asimismo, el ejercicio profesional y los problemas físicos predijeron el agotamiento en el estado de desgaste ocupacional. Y los problemas físicos fueron predictores para la presencia de depresión.

          Conclusiones:

          los datos obtenidos confirman la necesidad de atender la salud física y mental de los médicos residentes, así como promover ambientes laborales óptimos que tengan un impacto positivo en el bienestar de sus integrantes.

          Abstract

          Background:

          Scientific research has reported various stressors that could be related to the development of burnout in resident physicians.

          Objective:

          To identify the perceived stressors associated with burnout in residents of various medical specialties in Mexico’s northwest.

          Material and methods:

          A cross-sectional, explanatory, observational, and analytical study was carried out. The sampling was non-probabilistic. Resident physicians from two hospitals in southern Sonora participated. The Occupational Burnout Scale (OED) and the Stressors Check List with intensity were used.

          Results:

          189 resident physicians were included. 87% presented high levels of burnout. Specifically, the work overload and job dissatisfaction stressors were the ones with the greatest predictive power of burnout and dissatisfaction with achievement in resident physicians. By dimensions, physical problems were predictors of the pain dimension in the occupational burnout state. Professional exercise and physical problems predicted burnout in occupational burnout state. And physical problems were predictors for the presence of depression.

          Conclusions:

          The data obtained confirm the need to attend physical and mental health of resident doctors, and promote optimal work environments that have a positive impact on the well-being of their members.

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          Most cited references25

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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 satisfaction with work-life balance among US physicians relative to the general US population.

            Despite extensive data about physician burnout, to our knowledge, no national study has evaluated rates of burnout among US physicians, explored differences by specialty, or compared physicians with US workers in other fields. We conducted a national study of burnout in a large sample of US physicians from all specialty disciplines using the American Medical Association Physician Masterfile and surveyed a probability-based sample of the general US population for comparison. Burnout was measured using validated instruments. Satisfaction with work-life balance was explored. Of 27 276 physicians who received an invitation to participate, 7288 (26.7%) completed surveys. When assessed using the Maslach Burnout Inventory, 45.8% of physicians reported at least 1 symptom of burnout. Substantial differences in burnout were observed by specialty, with the highest rates among physicians at the front line of care access (family medicine, general internal medicine, and emergency medicine). Compared with a probability-based sample of 3442 working US adults, physicians were more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with work-life balance (40.2% vs 23.2%) (P < .001 for both). Highest level of education completed also related to burnout in a pooled multivariate analysis adjusted for age, sex, relationship status, and hours worked per week. Compared with high school graduates, individuals with an MD or DO degree were at increased risk for burnout (odds ratio [OR], 1.36; P < .001), whereas individuals with a bachelor's degree (OR, 0.80; P = .048), master's degree (OR, 0.71; P = .01), or professional or doctoral degree other than an MD or DO degree (OR, 0.64; P = .04) were at lower risk for burnout. Burnout is more common among physicians than among other US workers. Physicians in specialties at the front line of care access seem to be at greatest risk.
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              Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study.

              Medical errors are associated with feelings of distress in physicians, but little is known about the magnitude and direction of these associations. To assess the frequency of self-perceived medical errors among resident physicians and to determine the association of self-perceived medical errors with resident quality of life, burnout, depression, and empathy using validated metrics. Prospective longitudinal cohort study of categorical and preliminary internal medicine residents at Mayo Clinic Rochester. Data were provided by 184 (84%) of 219 eligible residents. Participants began training in the 2003-2004, 2004-2005, and 2005-2006 academic years and completed surveys quarterly through May 2006. Surveys included self-assessment of medical errors and linear analog scale assessment of quality of life every 3 months, and the Maslach Burnout Inventory (depersonalization, emotional exhaustion, and personal accomplishment), Interpersonal Reactivity Index, and a validated depression screening tool every 6 months. Frequency of self-perceived medical errors was recorded. Associations of an error with quality of life, burnout, empathy, and symptoms of depression were determined using generalized estimating equations for repeated measures. Thirty-four percent of participants reported making at least 1 major medical error during the study period. Making a medical error in the previous 3 months was reported by a mean of 14.7% of participants at each quarter. Self-perceived medical errors were associated with a subsequent decrease in quality of life (P = .02) and worsened measures in all domains of burnout (P = .002 for each). Self-perceived errors were associated with an odds ratio of screening positive for depression at the subsequent time point of 3.29 (95% confidence interval, 1.90-5.64). In addition, increased burnout in all domains and reduced empathy were associated with increased odds of self-perceived error in the following 3 months (P=.001, P<.001, and P=.02 for depersonalization, emotional exhaustion, and lower personal accomplishment, respectively; P=.02 and P=.01 for emotive and cognitive empathy, respectively). Self-perceived medical errors are common among internal medicine residents and are associated with substantial subsequent personal distress. Personal distress and decreased empathy are also associated with increased odds of future self-perceived errors, suggesting that perceived errors and distress may be related in a reciprocal cycle.
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                Author and article information

                Contributors
                Journal
                Rev Med Inst Mex Seguro Soc
                Rev Med Inst Mex Seguro Soc
                Rev Med Inst Mex Seguro Soc
                Revista Médica del Instituto Mexicano del Seguro Social
                Instituto Mexicano del Seguro Social (Ciudad de México, México )
                0443-5117
                2448-5667
                Jan-Feb 2022
                Jan-Feb 2022
                : 60
                : 1
                : 12-18
                Affiliations
                [1] originalInstituto Tecnológico de Sonora, Departamento de Psicología. Ciudad Obregón, Sonora, México orgnameInstituto Tecnológico de Sonora México
                [2] originalInstituto Tecnológico de Sonora, Departamento de Psicología. Ciudad Obregón, Sonora, México orgnameInstituto Tecnológico de Sonora México
                [3] originalInstituto Politécnico Nacional, Escuela Superior de Medicina. Ciudad de México, México orgnameInstituto Politécnico Nacional México
                [4] originalInstituto Tecnológico de Sonora, Departamento de Psicología. Ciudad Obregón, Sonora, México orgnameInstituto Tecnológico de Sonora México
                [5] originalUniversidad Nacional Autónoma de México, Facultad de Psicología, Psicología de la Salud y Medicina Conductual. Ciudad de México, México orgnameUniversidad Nacional Autónoma de México México
                Author notes
                [*]
                Author information
                https://orcid.org/0000-0002-2786-5069
                https://orcid.org/0000-0003-3003-4415
                https://orcid.org/0000-0002-4943-4374
                https://orcid.org/0000-0003-1101-6844
                https://orcid.org/0000-0001-8378-8670
                Article
                457770302006
                10395985
                35266656
                bebc5241-73ad-455a-b41b-cba9199895f3
                © 2022 Revista Medica del Instituto Mexicano del Seguro Social.

                Esta obra está bajo una Licencia Creative Commons Atribución-NoComercial-SinDerivar 4.0 Internacional.

                History
                : 04 June 2021
                : 05 August 2021
                Page count
                Figures: 4, Tables: 0, Equations: 0, References: 25
                Categories
                Aportación Original

                agotamiento psicológico,salud mental,médicos,burnout,psychological,mental health,physicians

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