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PubMed2005

Burnout in academic chairs of otolaryngology: head and neck surgery.

BACKGROUND: Burnout can be characterized by a low degree of personal accomplishment and a high degree of emotional exhaustion and depersonalization using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). With increasing demands and constraints placed on academic department chairs, the risk of developing burnout may be increasing. The prevalence of burnout in chairs of academic departments of otolaryngology and the factors associated with it have not been previously described. OBJECTIVES/HYPOTHESIS: The purpose of this study was to determine the prevalence of burnout in otolaryngology chairs and to identify the factors that are associated with burnout development. Understanding these elements can lead to improved prevention, recognition, and treatment of professional burnout. STUDY DESIGN: A cross-sectional questionnaire-based study of 120 academic chairs of otolaryngology in the United States was performed. METHODS: A confidential questionnaire was mailed to U.S. otolaryngology chairs. The questionnaire consisted of six parts assessing the following elements: 1) demographic information, 2) professional stressors, 3) personal and professional life satisfaction, 4) a self efficacy survey, 5) a spousal support survey, and 6) the MBI-HSS. Statistical analyses were performed using Pearson correlation and analysis of variance, and burnout data were compared with previously reported data from other department chairs and physicians. RESULTS: Questionnaires were returned from 107 department chairs for a response rate of 89%. Chairs were on average 56 years of age, serving as chair for a mean of 11 years. Average work week was 68 hours and did not vary significantly with increasing duration as chair. Sixty-six percent of time was spent delivering patient care, 8% in research, and 26% performing administrative duties. MBI-HSS scores demonstrate 3% of chairs experiencing high burnout, 81% of chairs with moderate burnout, and 16% of chairs with low burnout. On average, chairs have low depersonalization scores, low-moderate emotional exhaustion scores, and low-moderate personal accomplishment scores. High emotional exhaustion or depersonalization was correlated with low self-efficacy, low spousal support, disputes with the dean, department budget deficits, working nights and weekends, Medicare audits, loss of key faculty, and being a malpractice defendant. High personal accomplishment was correlated with increased time spent performing administrative duties. When compared with other physician specialties, otolaryngology chairs demonstrate less sense of emotional exhaustion and depersonalization but also slightly less sense of personal accomplishment. Duration as chair, age, and hours worked per week were not associated with increased burnout. CONCLUSIONS: Most otolaryngology chairs experience moderate levels of burnout. The biggest risk factors for burnout include low self-efficacy, low spousal support, disputes with the medical school dean, department budget deficits, and nights/weekends worked. These findings may help department chairs identify and prevent burnout and may help in developing programs to minimize burnout in our field's academic leaders.

Academies and Institutes↗
PubMed2006

Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses.

AIMS: The aim of this study was to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK. METHODS: The research instruments used were the Maslach Burnout Inventory and the Manchester Clinical Supervision Scale. At the time of the survey 817 community mental health nurses were reported to work within Wales. Two hundred and sixty (32%) community mental heath nurses working in 11 NHS Trusts responded to the survey. RESULTS: One hundred and eighty-nine (73%) community mental heath nurses had experience of clinical supervision in their present posts and 105 (40%) in their previous posts. The findings from the Maslach Burnout Inventory indicated high levels of emotional exhaustion for 36%, high levels of depersonalization for 12% and low levels of personal accomplishment for 10% of the community mental heath nurses surveyed. Univariate analysis showed that those community mental heath nurses who were younger, male and who had not experienced six or more sessions of clinical supervision were more likely to report cold negative attitudes towards their clients as indicated by higher scores on the depersonalization subscale of the Maslach Burnout Inventory. One hundred and sixty-six community mental heath nurses had experienced six or more sessions of clinical supervision and had completed the Maslach Burnout Inventory. Higher scores on the Manchester Clinical Supervision Scale were also associated with lower levels of measured burnout, with significant negative correlations between the total Manchester Clinical Supervision Scale score and the emotional exhaustion subscale (r = -0.148, P = 0.050) and the depersonalization subscale (r = -0.220, P = 0.003) of the Maslach Burnout Inventory. These findings suggest that if clinical supervision is effective then community mental heath nurses are likely to report lower levels of emotional exhaustion and depersonalization. CONCLUSIONS: The findings from this study suggest that if clinical supervision is effective then community mental heath nurses report lower levels of burnout. Further research is required to determine the long-term benefits of implementing clinical supervision and to determine which other factors have an influence on levels of burnout for this group of nurses. Health service organizations have a responsibility for ensuring that all individual practitioners have access to effective clinical supervision and the Nursing and Midwifery Council could extend the registered nurses personal accountability to include - to seek clinical supervision as and when necessary.

Adult↗
PubMedDate not supplied

[Burnout syndrome among health staff].

OBJECTIVE: To determine the prevalence of burnout syndrome components among the medical and nursing staff of the second care level hospitals of the Instituto Mexicano del Seguro Social and Instituto de Seguridad Social al Servicio de los Trabajadores del Estado from Durango, Mexico. MATERIAL AND METHODS: A cross-sectional comparative study was carried out among 73 physicians and 100 nurses randomly selected from both hospitals. The prevalence of burnout syndrome components was established by the Maslash Burnout Inventory, which determines the presence of physical/emotional exhaustion, depersonalization, and labor performance. In addition, sociodemographic and labor information was collected. Prevalence was calculated with a reliability interval of 95% (CI 95%). RESULTS: 73 physicians and 100 nurses enrolled, corresponding to 22.8% and 14.5% of such personnel working in both institutions. Among the IMSS and ISSSTE workers respectively, the prevalence of depersonalization was 43.2% (34.4-52.9) and 14.5% (6.8-25.8), whereas the prevalence of physical/emotional exhaustion was 41.4% (32.7-51.1) and 19.4% (10.4-31.4). Pre-valence of labor performance was higher among the personnel of Instituto Mexicano del Seguro Social: 99.1% (95.1-100) versus 96.8% (88.8-100). Severe depersonalization (p = 0.004), but not emotional exhaustion (p = 0.09) nor labor performance (p = 0.06) was significantly higher among personnel working at the Instituto Mexicano del Seguro Social. CONCLUSIONS: Prevalence of depersonalization and physical/emotional exhaustion was higher among physicians and nurses of the Instituto Mexicano del Seguro Social; nonetheless, their labor performance was high. Our finding suggests that personnel working at the Instituto Mexicano del Seguro Social make a greater effort to maintain the high labor performance that medical care requires.

Adult↗
PubMed1991

The contexts of caring: conscience and consciousness.

In this paper, I have maintained a distinction between person and self in order to describe and analyze contexts of caring in nursing encounters. As the nursed person's perspectives are examined in light of the nurse's capacity to engage his or her own experience, four contextual categories emerge: comprehension, consideration, concern, and communion. Such concepts can help us describe and analyze many situations in clinical nursing and in nursing education. The following paragraphs describe several of the possibilities for future research. It is important to study in which contexts in nursing personhood and selfhood are enhanced and when they are diminished. Diminishment of personhood leads to depersonalization which describes a condition of loss of agency and helplessness in a world where others are in control. This can happen to the nursed person and to the nursing person. When nurses are placed in contexts where they experience lack of agency and authority in their practice settings (even when they attempt to engage others with concern and compassion), they can start to feel and become depersonalized. Diminishment of self leads to dehumanization, which describes a loss of contact with one's own experience. Rules and relationships are oppressive or inflexible and the participants experience meaninglessness. For example, how long can nurses be in daily situations of administering painful procedures to patients without experiencing dehumanization? The same question can be asked of nurses at all levels in hierarchies, and in all relationships, for example, nursing instructors with students, nurse administrators with staff nurses, faculty in academic institutions, and staff nurses with each other. Depersonalization and dehumanization eventually lead to one another. Another significant question to explore could be this: In which of the four contexts defined above does the nurse experience most satisfaction, most dissatisfaction, and the condition we call burnout? We live in a world, a society, and a profession where depersonalization and dehumanization are the plight of many. How can personhood and selfhood be enhanced or even restored in our hospitals, clinics, classrooms, and academic institutions? I propose that investigations of the contexts of caring can help us explore, discover, describe, and analyze these questions.

Conscience↗
PubMed2002

Job satisfaction among nurses: a predictor of burnout levels.

OBJECTIVE: This study assessed the impact of differential levels of job satisfaction on burnout among nurses, hypothesizing that higher levels of job satisfaction predict lower levels of burnout. BACKGROUND: Social environmental factors of the workplace arising from organizational restructuring cost containment strategies, diminishing resources, and increasing responsibilities, cause highly stressed, burned out nurses to leave the profession. METHODS: This study used the Maslach Burnout Inventory (MBI) to measure emotional exhaustion, depersonalization, and personal accomplishment. The job satisfaction scale of Katzell et al was used to measure overall job satisfaction. Statistical tests for significance used were Confirmatory Factor Analysis, Structural Equation Modeling, the chi statistic, Root Mean Square Error of Approximation, Goodness of Fit Index, and Comparative Fit Index. RESULTS: The findings show that job satisfaction has a significant direct negative effect on emotional exhaustion, whereas emotional exhaustion has a direct positive effect on depersonalization. A significant indirect effect was seen of job satisfaction on depersonalization via exhaustion. The path coefficient shows that job satisfaction has both direct and indirect effects on burnout, confirming job satisfaction as a significant predictor of burnout. IMPLICATIONS: Collaborative efforts between nurses, administrators, and educators to research and test practical models to improve job satisfaction may work as an antidote to burnout.

Adult↗
PubMed2004

Burnout in residency: a statewide study.

OBJECTIVE: To determine the prevalence of burnout in residents in obstetrics and gynecology through the use of a validated tool. METHODS: The Maslach Burnout Inventory Human Services questionnaire is a previously validated tool that measures burnout. Obstetrics and gynecology residents from Texas were invited to participate in this study in 2002. The Maslach Burnout Inventory Human Services questionnaire and a demographic survey were distributed to each resident. Responses were anonymous and returned by mail. Contingency coefficient and chi2 tests were used for analysis; values of P < 0.05 were significant. RESULTS: Residents (n = 368) from 17 programs in Texas were surveyed. Responses were received from 14 programs (82.4%), with 136 surveys (37%) returned. Overall, 38.2% reported high emotional exhaustion, 47.1% reported high depersonalization, and 19.1% reported reduced personal accomplishment. The number of residents experiencing true burnout (high emotional exhaustion, high depersonalization, and low personal accomplishment) was 17.6% (n = 24). CONCLUSIONS: High levels of emotional exhaustion and depersonalization occur in some residents. Burnout in residents included in this study was approximately 18%.

Burnout, Professional↗
PubMed2002

Personality factors associated with dissociation: temperament, defenses, and cognitive schemata.

OBJECTIVE: The purpose of this study was to investigate temperamental, psychodynamic, and cognitive factors associated with dissociation. METHOD: Fifty-three subjects with DSM-IV-defined depersonalization disorder and 22 healthy comparison subjects were administered the Dissociative Experiences Scale, the Tridimensional Personality Questionnaire, the Defense Style Questionnaire, and the Schema Questionnaire. RESULTS: Subjects with depersonalization disorder demonstrated significantly greater harm-avoidant temperament, immature defenses, and over-connection and disconnection cognitive schemata than comparison subjects. Within the group of subjects with depersonalization disorder, dissociation scores significantly correlated with the same variables. CONCLUSIONS: Particular personality factors may render individuals more vulnerable to dissociative symptoms. Risk factors associated with dissociative disorders merit further study.

Adult↗
PubMed2003

Interpersonal conflict, social support, and burnout among home care workers in Japan.

To examine associations between interpersonal relationships in work settings and burnout, a cross-sectional survey was conducted on home care workers in Sapporo, Japan, by using the Maslach Burnout Inventory (MBI) and scales of interpersonal conflict and social support developed by the authors. Questionnaires were distributed among 303 subjects and returned by 243 subjects (80%). Complete answers were obtained from 106 subjects and were used for analysis. In multiple regression analyses, conflict with clients and their families significantly related to emotional exhaustion and depersonalization of the MBI (p<.05). Supervisory conflict significantly related to emotional exhaustion (p<.05), whereas coworker conflict significantly associated with depersonalization (p<.01). It is suggested that conflicts with clients' families, as well as clients, are important indicators for emotional exhaustion and depersonalization of home care workers.

Adult↗
PubMed2004

Engagement and burnout: analysing their association patterns.

This study explored the negative patterns of association between Emotional Exhaustion and Depersonalization with the dimensions of Engagement, while it was hypothesized a positive link with Personal Accomplishment. The sample was composed by 112 Spanish human services professionals who work with mentally retarded people. The analysis showed moderate negative correlations among scores on Emotional Exhaustion and on all three Engagement scales (-.55 for Vigor; -.41 for Dedication; -.24 for Absorption), positive correlations among scores on Personal Accomplishment and Engagement dimensions (Vigor .57; Dedication .54; Absorption .50), and only significant correlations between scores on Depersonalization and Vigor (-.39) and on Dedication (-.22). The data obtained using the Maslach Burnout Inventory-Human Services Survey did not support the hypothesis of stronger negative correlations between the measures, Emotional Exhaustion-Vigor and Depersonalization-Dedication, hypothesized in the conceptual model developed by Schaufeli, Salanova, González-Romá, and Bakker.

Adult↗
PubMed2000

Predictors of the development of phobic avoidance.

BACKGROUND: Panic disorder and agoraphobia are closely linked. There are indications that uncontrolled panic attacks often lead to the rapid development of phobic avoidance, but our ability to predict which individuals with panic will develop avoidance has been limited. The purpose of this study was to identify independent predictors of the development of phobic avoidance and the time course of that development. METHOD: We conducted a secondary analysis of survey data from the community-based Panic Attack Care-Seeking Threshold Study. The presence of panic attacks was confirmed in 97 randomly selected adults from randomly selected households screened using the Structured Clinical Interview of DSM-III-R (SCID). The presence of limited and extensive phobic avoidance was measured using the SCID, while rapidity of development (lag time) was measured as the difference between onset of panic and onset of avoidance. Predictors considered included panic characteristics, psychiatric comorbidity, cognitive appraisal, family characteristics, illness attitudes, symptom perceptions, and coping style. RESULTS: Thirty-six subjects (37%) had at least mild phobic avoidance, with 81% (N = 29) of those developing the avoidance less than 1 year after the onset of panic attacks. The development of phobic avoidance was associated with the presence of panic disorder (beta = 1.36), the number of comorbid psychiatric disorders (beta = 0.69), and the number of family members and/or friends available to discuss health concerns (beta = 0.87). Further progression to agoraphobia was predicted by the presence of depersonalization during panic attacks (beta = 0.50). Rapid onset of avoidance (panic avoidance lag time < 1 year) was predicted by the perception that depersonalization is a life-threatening symptom (beta = 1.56). CONCLUSION: The development of phobic avoidance is closely linked to panic attacks and often develops soon after panic onset. Full-blown panic disorder and psychiatric comorbidity are important in this development. Depersonalization is also key to the development of avoidance and the rapidity of the development.

Adult↗
PubMedDate not supplied

[Prevalence of burnout among anesthesiologists at Hospital Universitario Virgen Macarena de Sevilla].

Burnout, characterized by emotional exhaustion, depersonalization, and lowered sense of professional accomplishment, is a consequence of chronic stress. Few studies have been published on burnout in anesthesiology even though this specialty is considered particularly stressful. We surveyed members of the department of anesthesiology and postoperative care in our hospital, using an anonymous questionnaire including items on social and personal characteristics and the Spanish language version of the Maslach Burnout Inventory. Forty-valid questionnaires were returned, for a response rate of 69.4%. Mean (SD) scores were 19.5 (9.5) points for emotional exhaustion, 7.4 (5.5) for depersonalization, and 32.5 (9.1) for professional accomplishment. We detected high levels of emotional exhaustion in 19.5% of the anesthesiologists and of depersonalization in 31.7%. Scores reflecting low levels of sense of personal accomplishment were recorded for 41.4%. Scores for concern on at least 1 subscale were noted for 58.3% of the anesthesiologists, on 2 subscales for 21.8%, and on 3 subscales for 12.1%. No significant differences were detected in relation to gender, age, stage in professional life, or employment status. Burnout levels in our department are similar to those reported for anesthesiologists in other countries and detectably lower than those of other specialties in Spain.

Adult↗
PubMed2004

Effect of the 80-hour workweek on resident burnout.

HYPOTHESIS: With the introduction of the newly mandated restrictions on resident work hours, we expected improvement in subjective feelings of personal accomplishment and lessened emotional exhaustion and depersonalization. DESIGN: Residents and faculty members completed an anonymous online Maslach Burnout Inventory Human Services Survey (3rd ed; Consulting Psychologist Press Inc, Palo Alto, Calif) and work-hour registry before and after implementation of new restrictions. SETTING: Urban, university-based department of surgery. PARTICIPANTS: All house staff (n = 37) and faculty (n = 27). INTERVENTION: Introduction of new Institutional Standards for Resident Duty Hours 2003. Main Outcome Measure Resident work hours and levels of emotional exhaustion, perceived degree of depersonalization, and personal accomplishment. RESULTS: Resident work hours per week decreased from 100.7 to 82.6 (P < .05) with introduction of the new schedule. Home call and formal educational activity time within working hours (eg, clinical conferences) significantly (P < .05) decreased from 11.5 and 4.8 hours to 4.6 and 2.5 hours per week, respectively. Operating room hours, clinic time, and duration of rounds did not show a significant change. Changes in parameters of resident and faculty emotional exhaustion, depersonalization, and personal accomplishment did not show statistical significance (P > .05). CONCLUSIONS: Despite successful reductions in resident work hours, measures of burnout were not significantly affected. However, important clinical activities such as time spent in the operating room, clinic, and making rounds were maintained. Formal in-hospital education time was reduced.

Burnout, Professional↗
PubMed1996

Burnout in the internist--intensivist.

OBJECTIVES: Caring for acutely ill patients imposes significant demands on physicians. The environment and stresses of the ICU may lead to the burnout syndrome. The purpose of this study was to evaluate the prevalence of burnout among internal medicine intensivists and the contributing factors present in ICU practice. DESIGN: Mailed survey utilizing the Maslach Burnout Inventory (MBI). Increasing burnout has been shown to be associated with low levels on personal achievement and high scores on depersonalization and emotional exhaustion. SUBJECTS: Random sample of members of the Internal Medicine Section of the Society of Critical Care Medicine. MEASUREMENTS AND MAIN RESULTS: 248 people responded: 220 (88.7%) males and 28 females. Mean age of all respondents was 41.6 +/- 6.7 years. The majority (58.1%) worked in large hospitals (> 400 beds); 55.6% devoted more than 50% of their time to critical care. The emotional exhaustion subscale of the MBI averaged 22.2 +/- 9.5, with a third of respondents scoring in the high range. The depersonalization score averaged 7.1 +/- 5.1%, with 20.4% of respondents scoring in the high range. Similarly personal achievement subscores were poor, with a mean value of 30.9 +/- 6.4%, with 59% scoring in the low range. High levels of emotional exhaustion were associated with anticipating leaving critical care before retirement. CONCLUSIONS: Burnout as measured by the MBI appears to be common in internal medicine intensivists. High levels of emotional exhaustion and depersonalization are related not only to patient care issues but also to a poor support system.

Adult↗
PubMed2000

Coping strategies and burnout among veteran child protection workers.

OBJECTIVES: First, to learn how veteran (2 years or more) child protective service (CPS) investigations workers cope with job stress; and secondly, to examine the relationship between coping strategies and levels of emotional exhaustion, depersonalization, and sense of reduced personal accomplishment (burnout syndrome). METHOD: Cross-sectional, self-report methodology was used to measure coping strategies and the burnout syndrome. The voluntary subjects were 151 front-line CPS workers with at least 2 years experience in a southeastern Department of Social Services. They attended one of nine stress management workshops provided in various locations around the state. Quantitative analyses were run on the data. RESULTS: These workers perceived themselves to use Engaged (active) coping strategies more than Disengaged (avoidant) strategies. Sixty-two percent of participants scored in the high range on Emotional Exhaustion, the aspect some researchers consider to be the heart of Burnout. Those who used Engaged coping were less likely to feel depersonalized and more likely to feel a sense of personal accomplishment. Those who used Disengaged coping were more likely to feel emotionally exhausted, depersonalized, and to have a sense of reduced personal accomplishment. CONCLUSION: Neither the use of active nor avoidant coping strategies saved these workers from Emotional Exhaustion. The problem-focused strategies they are taught and use most do not help deal with the emotional content and context of their work, suggesting the use of emotion-focused coping to prevent and remediate burnout.

Adaptation, Psychological↗
PubMedDate not supplied

[Burnout syndrome in health workers and relationship with personal and environmental factors].

OBJECTIVES: High rates of professional burnout syndrome have been found among health service professionals. Our objective was to study the prevalence of burnout syndrome in hospital health workers and to determine its relationship with personal and environmental factors. METHODS: A total of 2290 health workers from five hospitals in the province of Girona (Spain) were invited to participate. Interviewees were given a specifically designed questionnaire, a questionnaire on organizational climate, and the Spanish version of the Maslach Burnout Inventory, which includes three scales: emotional exhaustion, depersonalization, and reduced personal accomplishment. RESULTS: Responses were received from 1095 health workers (a response rate of 47.8%). A high level of emotional exhaustion was found in 41.6% of staff members, especially among doctors and nurses; a high level of depersonalization was found in 23%, mainly among doctors, and reduced personal accomplishment was found in 27.9%, mainly among technicians and doctors. Multiple logistic regression revealed that a high level of emotional exhaustion was associated with frequent consumption of tranquilizers or antidepressants, whereas optimism and job satisfaction showed an inverse association. The variables that were inversely associated with a high level of depersonalization were the number of years in the profession, optimism, evaluation of work as being useful and the perception of being valued by others. Reduced personal accomplishment was also inversely associated with optimism, satisfaction with the usefulness of one's work, and satisfaction with teamwork. CONCLUSIONS: In view of the results obtained, to reduce professional burnout in hospitals, optimism and a sense of self-worth among individuals should be encouraged and the organizational environment should be improved.

Adult↗
PubMed2005

Individuality and social influence in groups: inductive and deductive routes to group identity.

A distinction between forms of social identity formation in small interactive groups is investigated. In groups in which a common identity is available or given, norms for individual behavior may be deduced from group properties (deductive identity). In groups in which interpersonal relations are central, a group identity may also be induced from individual group members' contributions, making individuality and individual distinctiveness a defining feature of the group (inductive identity). Two studies examined the prediction that depersonalization produced by anonymity has opposite effects for groups in which social identity has been induced or deduced. Results confirmed the prediction that depersonalization increases social influence in groups whose identity was more deductive. In contrast, depersonalization decreases social influence in inductive identity groups. Implications for the role of social identity in small groups are discussed. ((c) 2005 APA, all rights reserved).

Adult↗
PubMed2004

Decreasing GME training stress to foster residents' professionalism.

The author evaluates current concerns over medical professionalism in residency training. The recent professionalism requirements for residents promulgated by the Accreditation Council for Graduate Medical Education (ACGME) are discussed in relation to the atmosphere of current training. The author first reviews a recent study showing that unprofessional behavior may significantly correlate with burnout, as evaluated by the Maslach Burnout Inventory. Among the elements of that inventory, depersonalization is shown to significantly correspond to unprofessional actions and behavior. Several surveys and studies evaluating residency treatment and stress are reviewed and three sources of training stress are identified: (1) abusive treatment of residents, (2) financial pressures, and (3) pessimism and uncertainty in the medical field. The extent and effects of these stressors are discussed and evaluated in relation to depersonalization, depression, and unprofessional behavior. Each of these pressures is found to correlate with negative effects on residents, such as depersonalization, decreased satisfaction, depression, and burnout. In turn, such effects are found to potentially cause unprofessional behavior among residents. In light of these findings, the author suggests several modifications to the current graduate medical training environment to mitigate such stressors, promote professionalism, and increase morale. Prevention of abusive treatment of residents, alleviation of financial pressure, increased educational opportunities, and role modeling are suggested as beneficial interventions that may foster professionalism and prevent inappropriate behavior. The author indicates that such environmental changes would likely foster professionalism in young physicians more effectively than would ethics seminars or in-class training. Accordingly, the author suggests environmental changes to decrease residency stress as the most effective means of promoting the new ACGME requirements and the ideals of professionalism.

Attitude of Health Personnel↗
PubMed2006

[Mental health in family doctors: effects of satisfaction and stress at work].

OBJECTIVES: To asses "burnout" and psychiatric morbidity among family physicians and its relationship with stress and satisfaction at work. METHODS: The 346 family doctors and 84 pediatricians in the Primary Health Care district of Majorca were invited to fill-out a questionnaire. Psychiatric morbidity was evaluated using the 28-item General Health Questionnaire. The three components of "burnout" (emotional exhaustion, depersonalization and low personal accomplishment) were assessed with the Maslach Burnout inventory. Satisfaction and stress at work were assessed with the Font Roja and Tabarca scales, respectively. FINDINGS: 266 family doctors and pediatricians answered the questionnaire (61.86%). Estimated prevalence of psychiatric morbidity was 25.7%. No significant differences were found between those with GHQ results and demographic and job variables. Fifty three per cent had high emotional exhaustion, 47.1% high depersonalization and low personal accomplishment were found in 33.3% of the doctors. Non significant differences were identified in the distribution of burnout dimensions and demographic and job characteristics. Satisfaction at work seems to protect doctors from mental distress and burnout. Job stress is related to higher emotional exhaustion and depersonalization but not with psychiatric morbidity. CONCLUSIONS: Family practitioner's mental health is likely to be protected in those who are more satisfied at work and threatened in those doctors with high job stress. These facts have to be assumed not so much as an individual problem but rather as a general problem of all health organizations.

Adult↗