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      Esgotamento entre profissionais da Atenção Primária à Saúde Translated title: Burnout Syndrome in Primary Health Care Professionals

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          Abstract

          O esgotamento profissional (EP) caracteriza-se por exaustão emocional, despersonalização, e baixa realização profissional, podendo ocorrer entre profissionais da saúde. Este artigo avalia o EP entre trabalhadores da Atenção Primária à Saúde (APS) em três municípios de pequeno porte da Zona da Mata Mineira. O estudo analisa a associação por regressão logística entre EP, aspectos socioeconômicos, demográficos e aspectos do trabalho. Um total de 149 profissionais foi selecionado, destes, 107 responderam a todos os questionários. Para mensurar o EP, foi utilizado o Maslach Burnout Inventory(MBI) e, para a caracterização dos profissionais, foi utilizado outro questionário segundo três diferentes questões: aspectos individuais, sociodemográficos e área de cobertura da equipe. Foram classificados 101 profissionais com indicação positiva para EP. As variáveis presentes no modelo de regressão logística backward stepwise, associadas positivamente com indicativo de esgotamento profissional foram: possuir idade inferior à mediana da população (> 29,5 anos) e fazer uso de medicamentos "calmantes, tranquilizantes e remédios para dormir". Os resultados contribuem para identificar fatores associados com o esgotamento profissional e apontam, neste sentido, para a necessidade de investigações mais detalhadas.

          Translated abstract

          Burnout is characterized by emotional exhaustion, depersonalization and low occupational performance, which may occur among health professionals. This article evaluates burnout among workers in Primary Health Care (PHC) in three small towns in the Zona da Mata Mineira. The study analyzes associations by logistic regression between burnout, socioeconomic, and demographic aspects of work. A total of 149 professionals were selected, 107 of these responded to all questionnaires. To measure burnout, the Maslach Burnout Inventory (MBI) was used and to characterize the professional, a questionnaire assessing three different issues - namely individual and sociodemographic aspects and team area coverage - was used. 101 professionals were classified with positive indication for burnout. The variables present in the backward stepwise logistic regression model positively associated with indicative of burnout were: being younger than the population average (> 29.5 years) and use of drugs, including sedatives, tranquilizers and sleeping pills. The results contribute to the identification of factors associated with burnout and therefore highlight the need for more detailed investigation.

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          Working conditions in primary care: physician reactions and care quality.

          Adverse primary care work conditions could lead to a reduction in the primary care workforce and lower-quality patient care. To assess the relationship among adverse primary care work conditions, adverse physician reactions (stress, burnout, and intent to leave), and patient care. Cross-sectional analysis. 119 ambulatory clinics in New York, New York, and in the upper Midwest. 422 family practitioners and general internists and 1795 of their adult patients with diabetes, hypertension, or heart failure. Physician perception of clinic workflow (time pressure and pace), work control, and organizational culture (assessed survey); physician satisfaction, stress, burnout, and intent to leave practice (assessed by survey); and health care quality and errors (assessed by chart audits). More than one half of the physicians (53.1%) reported time pressure during office visits, 48.1% said their work pace was chaotic, 78.4% noted low control over their work, and 26.5% reported burnout. Adverse workflow (time pressure and chaotic environments), low work control, and unfavorable organizational culture were strongly associated with low physician satisfaction, high stress, burnout, and intent to leave. Some work conditions were associated with lower quality and more errors, but findings were inconsistent across work conditions and diagnoses. No association was found between adverse physician reactions, such as stress and burnout, and care quality or errors. The analyses were cross-sectional, the measures were self-reported, and the sample contained an average of 4 patients per physician. Adverse work conditions are associated with adverse physician reactions, but no consistent associations were found between adverse work conditions and the quality of patient care, and no associations were seen between adverse physician reactions and the quality of patient care.
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            Cancer care workers in Ontario: prevalence of burnout, job stress and job satisfaction.

            Cancer Care Ontario's Systemic Therapy Task Force recently reviewed the medical oncology system in the province. There has been growing concern about anecdotal reports of burnout, high levels of stress and staff leaving or decreasing their work hours. However, no research has systematically determined whether there is evidence to support or refute these reports. To this end, a confidential survey was undertaken. A questionnaire was mailed to all 1016 personnel of the major providers of medical oncology services in Ontario. The questionnaire consisted of the Maslach Burnout Inventory, the 12-item General Health Questionnaire, a questionnaire to determine job satisfaction and stress, and questions to obtain demographic characteristics and to measure the staff's consideration of alternative work situations. The overall response rate was 70.9% (681 of 961 eligible subjects): by group it was 63.3% (131/207) for physicians, 80.9% (314/388) for allied health professionals and 64.5% (236/366) for support staff. The prevalence of emotional exhaustion were significantly higher among the physicians (53.3%) than among the allied health professionals (37.1%) and the support staff (30.5%) (p < or = 0.003); the same was true for feelings of depersonalization (22.1% v. 4.3% and 5.5% respectively) (p < or = 0.003). Feelings of low personal accomplishment were significantly higher among physicians (48.4%) and allied health professionals (54.0%) than among support staff (31.4%) (p < or = 0.002). About one-third of the respondents in each group reported that they have considered leaving for a job outside the cancer care system. Significantly more physicians (42.6%) than allied health professionals (7.6%) or support staff (4.5%) stated that they have considered leaving for a job outside the province. The findings support the concern that medical oncology personnel are experiencing burnout and high levels of stress and that large numbers are considering leaving or decreasing their work hours. This is an important finding for the cancer care system, where highly trained and experienced health care workers are already in short supply.
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              Métodos de pesquisa de survey

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro )
                1413-8123
                December 2014
                : 19
                : 12
                : 4739-4750
                Affiliations
                [1 ] Universidade Federal de Juiz de Fora Brazil
                Article
                S1413-81232014001204739
                10.1590/1413-812320141912.03202013
                c07fec51-3399-42e1-9d90-077259e3d824

                http://creativecommons.org/licenses/by/4.0/

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                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielosp.org/scielo.php?script=sci_serial&pid=1413-8123&lng=en
                Categories
                Health Policy & Services

                Public health
                Occupational burnout,Health personnel,Primary health care,Esgotamento profissional,Pes soal de saúde,Atenção Primária à Saúde

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