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      Psychosocial factors and prevalence of burnout syndrome among nursing workers in intensive care units Translated title: Fatores psicossociais e prevalência da síndrome de burnout entre trabalhadores de enfermagem intensivistas

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          Abstract

          Objective

          To evaluate the prevalence of burnout syndrome among nursing workers in intensive care units and establish associations with psychosocial factors.

          Methods

          This descriptive study evaluated 130 professionals, including nurses, nursing technicians, and nursing assistants, who performed their activities in intensive care and coronary care units in 2 large hospitals in the city of Rio de Janeiro, Brazil. Data were collected in 2011 using a self-reported questionnaire. The Maslach Burnout Inventory was used to evaluate the burnout syndrome dimensions, and the Self Reporting Questionnaire was used to evaluate common mental disorders.

          Results

          The prevalence of burnout syndrome was 55.3% (n = 72). In the quadrants of the demand-control model, low-strain workers exhibited a prevalence of 64.5% of suspected cases of burnout, whereas high-strain workers exhibited a prevalence of 72.5% of suspected cases (p = 0.006). The prevalence of suspected cases of common mental disorders was 27.7%; of these, 80.6% were associated with burnout syndrome (< 0.0001). The multivariate analysis adjusted for gender, age, educational level, weekly work duration, income, and thoughts about work during free time indicated that the categories associated with intermediate stress levels - active work (OR = 0.26; 95%CI = 0.09 - 0.69) and passive work (OR = 0.22; 95%CI = 0.07 - 0.63) - were protective factors for burnout syndrome.

          Conclusion

          Psychosocial factors were associated with the development of burnout syndrome in this group. These results underscore the need for the development of further studies aimed at intervention and the prevention of the syndrome.

          Translated abstract

          Objetivo

          Descrever a prevalência da síndrome de burnout entre trabalhadores de enfermagem de unidades de terapia intensiva, fazendo associação a aspectos psicossociais.

          Métodos

          Estudo descritivo seccional realizado com 130 profissionais, enfermeiros, técnicos e auxiliares de enfermagem, que desempenhavam suas atividades em unidades de terapia intensiva e coronariana de dois hospitais de grande porte na cidade do Rio de Janeiro (RJ). Os dados foram coletados em 2011, por meio de questionário auto aplicado. Foi utilizado o Maslach Burnout Inventory , para a aferição das dimensões de burnout, e o Self Report Questionnaire, para avaliação de transtornos mentais comuns.

          Resultados

          A prevalência de síndrome de burnout foi de 55,3% (n = 72). Quanto aos quadrantes do modelo demanda- controle, a baixa exigência apresentou 64,5% de casos prevalentes suspeitos e a alta exigência, 72,5% de casos (p = 0,006). Foi constatada a prevalência de 27,7% de casos suspeitos para transtornos mentais comuns; destes, 80,6% estavam associados à síndrome de burnout (< 0,0001). Após análise multivariada com modelo ajustado para sexo, idade, escolaridade, carga horária semanal, renda e pensamento no trabalho durante as folgas, foi constatado caráter protetor para síndrome de burnout nas dimensões intermediárias de estresse: trabalho ativo (OR = 0,26; IC95% = 0,09 - 0,69) e trabalho passivo (OR = 0,22; IC95% = 0,07 - 0,63).

          Conclusão

          Contatou-se que os fatores psicossociais estavam envolvidos no surgimento de burnout no grupo estudado. Os resultados despertaram a necessidade de estudos para intervenção e posterior prevenção da síndrome.

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          Most cited references119

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          Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries.

          1624 patients who were attending primary health facilities in 4 developing countries were examined to determine how many were suffering from mental disorder. Using stringent criteria to establish the presence of psychiatric morbidity, 225 cases were found, indicating an overall frequency of 13.9%. The great majority of cases were suffering from neurotic illnesses and for most the presenting complaint was of a physical symptom, such as headache, abdominal pain, cough or weakness. The health workers following their normal procedure correctly detected one third of the psychiatric cases.
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            A validity study of a psychiatric screening questionnaire (SRQ-20) in primary care in the city of Sao Paulo.

            A validity study of the Self-Report Questionnaire (20 item version, Harding et al, 1980) against the criterion of a standardised psychiatric interview (Goldberg et al, 1970) was carried out at three primary care clinics in Sao Paulo; 875 patients filled in the SRQ-20 questionnaires and a subsample of 260 was interviewed by the psychiatrist. The SRQ-20 was shown to be a feasible screening instrument for psycho-emotional disturbance in these settings. Sensitivity was 83% and specificity 80%, and the questionnaire was a good indicator of morbidity. A correlation was found between questionnaire total scores and independent clinical judgment (r = +0.70). A sex difference in the validity coefficients is described.
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              Changes in job strain in relation to changes in physiological state. A longitudinal study.

              A sample of 73 men and women aged 22-63 years and working in six different occupations (air traffic controllers, waiters, physicians, symphony orchestra musicians, baggage handlers, and airplane mechanics) participated in a longitudinal study four times during a year. The spontaneous variations in job strain (determined as the self-reported ratio between psychological demands and decision latitude) were substantial. The average difference between the occasion with the highest level of strain and the occasion with the lowest level was 25% of the total mean. Systolic blood pressure during workhours, as well as self-reported sleep disturbance, increased when demands increased in relation to decision latitude. Among men with a depressive tendency (according to a diary) morning plasma prolactin levels increased markedly with increasing job strain. Among subjects with a positive family history of hypertension the increase in systolic blood pressure at work was particularly pronounced, and among the men in this group a lower than expected level of morning cortisol was found measured during the period with the highest level of strain.
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                Author and article information

                Journal
                Rev Bras Ter Intensiva
                Rev Bras Ter Intensiva
                Revista Brasileira de Terapia Intensiva
                Associação Brasileira de Medicina intensiva
                0103-507X
                1982-4335
                Apr-Jun 2015
                Apr-Jun 2015
                : 27
                : 2
                : 125-133
                Affiliations
                [1 ]Department of Maternal and Child Psychiatry, Universidade Federal Fluminense - Niterói (RJ), Brazil.
                [2 ]Secretaria Municipal de Saúde do Rio de Janeiro - Rio de Janeiro (RJ), Brazil.
                [3 ]Secretaria Municipal de Saúde de Bananal - Bananal (SP), Brazil.
                [4 ]Emergency Unit, Hospital Estadual Carlos Chagas - Rio de Janeiro (RJ), Brazil.
                [5 ]Gastroenterology Unit, Hospital Naval Marcílio Dias, Marinha do Brasil - São Gonçalo (RJ), Brazil.
                [6 ]Center for Studies on Worker Health and Human Ecology, Fundação Oswaldo Cruz - Manguinhos (RJ), Brazil.
                Author notes
                Corresponding author: Jorge Luiz Lima da Silva, Departamento Materno Infantil e Psiquiatria da Universidade Federal Fluminense, Rua Dr. Celestino, 74, 5º andar - Centro, Zip code: 24130-470 - Niterói (RJ), Brazil, E-mail: jorgeluizlima@ 123456gmail.com
                Article
                10.5935/0103-507X.20150023
                4489780
                26340152
                72bb0747-6ab8-49c9-a44e-c4a964c19cba

                This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License which permits unrestricted noncommercial use, distribution, and reproduction in any medium provided the original work is properly cited.

                History
                : 07 October 2014
                : 12 April 2015
                Categories
                Original Article

                stress,burnout, professional,nursing, team,occupational health,intensive care units

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