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      Burnout y su relación con el estrés percibido y la satisfacción laboral en profesionales sanitarios de Atención Primaria de una Comunidad Autónoma Translated title: Burnout and its connection with perceived stress and job satisfaction in primary healthcare professionals in an Autonomous Community

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          Abstract

          RESUMEN Objetivo: Evaluar la prevalencia de burnout y sus componentes en profesionales sanitarios de Atención Primaria de Castilla-La Mancha, así como su relación con el estrés percibido y la satisfacción laboral. Diseño: Estudio descriptivo observacional transversal. Emplazamiento: Estudio multicéntrico realizado en equipos de Atención Primaria de seis Áreas Sanitarias de Castilla-La Mancha. Participantes: Todos los profesionales de medicina y enfermería de Atención Primaria de las Áreas Sanitarias participantes. Mediciones Principales: Incluidas las siguientes variables: características de participantes (sociodemográficas/laborales), características lugar de trabajo, estrés percibido (Perceived Stress Scale), burnout (Maslach Burnout Inventory) y satisfacción laboral (cuestionario Font-Roja). Resultados: La prevalencia de burnout fue del 20,7 % (IC 95 %: 16,6-24,7). Un 53,3 % presentó alterada al menos una subescala. El 38,9 % mostró alto grado de despersonalización, 28,2 % agotamiento emocional y 8,0 % baja realización personal. La puntuación de estrés percibido fue significativamente superior al aumentar el grado de burnout en las tres subescalas (p<0,001). Mediante regresión logística, las variables asociadas a burnout fueron: mayor puntuación escala estrés percibido (OR: 1,20; IC95 %: 1,12-1,28), menor puntuación en escala satisfacción (OR: 8,42; IC 95 %: 1,96-36,10), contar con mayor número de pacientes en cupo (OR: 1,01; IC 95 %: 1,00-1,02) y no ser tutor de residentes (OR: 2,88; IC 95 %: 1,06-8,25). Conclusiones: El burnout afecta a uno de cada cinco profesionales de Atención Primaria de nuestra Comunidad Autónoma, siendo la despersonalización la subescala más alterada. Los profesionales con burnout presentan puntuaciones superiores de estrés percibido e inferiores de satisfacción laboral. Otras variables relacionadas con el puesto de trabajo también se asocian con la presencia de burnout.

          Translated abstract

          ABSTRACT Objective: To evaluate the prevalence of burnout and its components in health care providers in primary care of Castilla-La Mancha, as well as its relation with perceived stress and job satisfaction. Design: Descriptive, observational cross-sectional study. Location: Multicenter study carried out by Primary Care Teams of six health areas of Castilla-La Mancha. Participants: Every health care professional (doctors and nurses) of the six health areas of Castilla-La Mancha. Main measurements: The variables included were: features of the participants (sociodemographic/occupational), work place features, perceived stress (Perceived-Stress-Scale), burnout (Maslach-Burnout-Inventory) and job satisfaction (Font-Roja test). Results: Prevalence of burnout: 20.7 % (CI 95 %: 16.6 - 24.7). About 53.3 % had at least one altered subscale. 38.9 % showed high level of depersonalization, 28.2 % emotional exhaustion and 8.0 % low personal fulfillment. Perceived stress score was significantly higher as the level of burnout increased in all three subscales (p<0.001). By using logistic regression, burnout associated variables were: Higher score in perceived stress scale (OR: 1.20; CI 95 %: 1.12-1.28), lower score in satisfaction scale (OR: 8.42; CI 95 %: 1.96-36.10), having more patients in their quota (OR: 1.01; CI 95 %:1.00-1.02) and no resident supervision (OR: 2.88; CI 95 %: 1.06-8.25). Conclusion: Burnout affects one in five primary care providers in our Autonomous Community, being depersonalization the most altered subscale. Professionals with burnout present higher perceived stress and lower job satisfaction. Other job-related variables are also associated with the presence of burnout.

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          Most cited references26

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          Association of resident fatigue and distress with perceived medical errors.

          Fatigue and distress have been separately shown to be associated with medical errors. The contribution of each factor when assessed simultaneously is unknown. To determine the association of fatigue and distress with self-perceived major medical errors among resident physicians using validated metrics. Prospective longitudinal cohort study of categorical and preliminary internal medicine residents at Mayo Clinic, Rochester, Minnesota. Data were provided by 380 of 430 eligible residents (88.3%). Participants began training from 2003 to 2008 and completed surveys quarterly through February 2009. Surveys included self-assessment of medical errors, linear analog self-assessment of overall quality of life (QOL) and fatigue, the Maslach Burnout Inventory, the PRIME-MD depression screening instrument, and the Epworth Sleepiness Scale. Frequency of self-perceived, self-defined major medical errors was recorded. Associations of fatigue, QOL, burnout, and symptoms of depression with a subsequently reported major medical error were determined using generalized estimating equations for repeated measures. The mean response rate to individual surveys was 67.5%. Of the 356 participants providing error data (93.7%), 139 (39%) reported making at least 1 major medical error during the study period. In univariate analyses, there was an association of subsequent self-reported error with the Epworth Sleepiness Scale score (odds ratio [OR], 1.10 per unit increase; 95% confidence interval [CI], 1.03-1.16; P = .002) and fatigue score (OR, 1.14 per unit increase; 95% CI, 1.08-1.21; P < .001). Subsequent error was also associated with burnout (ORs per 1-unit change: depersonalization OR, 1.09; 95% CI, 1.05-1.12; P < .001; emotional exhaustion OR, 1.06; 95% CI, 1.04-1.08; P < .001; lower personal accomplishment OR, 0.94; 95% CI, 0.92-0.97; P < .001), a positive depression screen (OR, 2.56; 95% CI, 1.76-3.72; P < .001), and overall QOL (OR, 0.84 per unit increase; 95% CI, 0.79-0.91; P < .001). Fatigue and distress variables remained statistically significant when modeled together with little change in the point estimates of effect. Sleepiness and distress, when modeled together, showed little change in point estimates of effect, but sleepiness no longer had a statistically significant association with errors when adjusted for burnout or depression. Among internal medicine residents, higher levels of fatigue and distress are independently associated with self-perceived medical errors.
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            Psychometric properties of a European Spanish version of the Perceived Stress Scale (PSS).

            This paper presents evidence from a heterogeneous sample of 440 Spanish adults, for the reliability and validity of a European Spanish version of the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The European Spanish version PSS (14-item) demonstrated adequate reliability (internal consistency, alpha = .81, and test-retest, r = .73), validity (concurrent), and sensitivity. Additional data indicate adequate reliability (alpha = .82, test-retest, r = .77), validity, and sensitivity of a 10-item short version of the PSS.
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              The well-being of physicians.

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                albacete
                Revista Clínica de Medicina de Familia
                Rev Clin Med Fam
                Sociedad Castellano-Manchega de Medicina de Familia y Comunitaria (Albacete, Castilla La Mancha, Spain )
                1699-695X
                2386-8201
                June 2018
                : 11
                : 2
                : 51-60
                Affiliations
                [5] Ciudad Real orgnameServicio de Salud de Castilla-La Mancha (SESCAM) orgdiv1G.A.I. de Ciudad Real España
                [1] Albacete orgnameServicio de Salud de Castilla-La Mancha (SESCAM) orgdiv1Gerencia de Atención Integrada (G.A.I.) de Albacete orgdiv2Centro de Salud de La Roda (Albacete) España
                [3] Ciudad Real orgnameServicio de Salud de Castilla-La Mancha (SESCAM) orgdiv1G.A.I de Manzanares orgdiv2Centro de Salud de La Solana (Ciudad Real) España
                [2] Albacete orgnameUniversidad de Castilla-La Mancha orgdiv1Facultad de Medicina de Albacete España
                [4] Toledo orgnameServicio de Salud de Castilla-La Mancha (SESCAM) orgdiv1Gerencia de Atención Primaria de Toledo orgdiv2Unidad Docente Multiprofesional de Atención Familiar y Comunitaria de Toledo España
                Article
                S1699-695X2018000200051
                e3227cb9-6760-4c06-84e0-a36b57d8ec46

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

                History
                : 15 May 2018
                : 01 May 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 10
                Product

                SciELO Spain


                Primary Health Care,Estrés laboral,Satisfacción en el Trabajo,Quality of Life,Burnout, Professional,Atención Primaria de Salud

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