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Doctoral Thesis
DOI
https://doi.org/10.11606/T.17.2020.tde-08012020-103116
Document
Author
Full name
Maria Luiza Costa
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Vicente, Walter Villela de Andrade (President)
Patti, Elci Antonia de Macedo Ribeiro
Robazzi, Maria Lucia do Carmo Cruz
Tucci Junior, Silvio
Title in Portuguese
Síndrome de Burnout em cirurgiões do Departamento de Cirurgia de um hospital universitário de alta complexidade
Keywords in Portuguese
Burnout em cirurgiões
Estresse ocupacional
Perfis latentes de Burnout
Síndrome de Burnout
Abstract in Portuguese
Introdução: A literatura referente à Síndrome de Burnout (SB) em cirurgiões é escassa. Objetivos: Avaliar a prevalência da SB em cirurgiões de hospital público universitário, terciário, de alta complexidade, identificar fatores de risco para o desenvolvimento da SB e comparar dois grupos de cirurgiões, contratados em regime de tempo parcial ou tempo integral. Participantes e Métodos: 77 cirurgiões do Departamento de Cirurgia, em atividade cirúrgica regular, responderam um Questionário geral, com 10 variáveis sócio demográficas, e o questionário MBI-HSS, inseridos no programa Research Electronic Data Capture (Redcap)) do computador pessoal da investigadora. Pela análise de perfis latentes (APL), os participantes foram enquadrados nos perfis Burnout, Sobrecarregado, Desengajamento, Ineficaz e Engajamento, conforme os niveis de burnout alto, médio e baixo, nas 3 dimensões, exaustão emocional (EE), despersonalização (DP) e realização pessoal (RP). Na determinação da prevalência, o grupo SB correspondeu aos cirurgiões enquadrados no perfil latente Burnout da APL. Um grupo, denominado Com burnout, foi constituído pelos cirurgiões dos perfis Burnout, Sobrecarregado, Desengajamento e Ineficaz, e foi utilizado como equivalente ao grupo SB, para a comparação com o grupo Sem SB. Este, por sua vez, constou dos cirurgiões enquadrados no perfil Engajamento. Os grupos tempo parcial e tempo integral também foram comparados. As análises estatísticas foram univariadas, e efetuadas pelo teste exato de Fisher. Foram consideradas significantes as diferenças com p<=0,05. Resultados: Dos 77 cirurgiões avaliados, 93% eram casados ou tinham união estável, 93% tinham filhos; 90% eram homens com idade >40, 85% fazem cirurgias de grande porte <= 2 x/sem, 74% eram Médicos Assistentes; 72% atuam em tempo parcial, 55% eram vinculados à Instituição há <=15, e 51% realizam <= 2 operações/semana ou fazem plantões presenciais. Apenas 5 (6%) dos 77 cirugiões enquadrou-se no perfil Burnout, ao passo que 32 (41,6%) deles não se enquadraram em nenhum dos 5 padrões da APL. Não houve diferenças significantes na comparação entre os grupos SB e Sem SB. No grupo tempo integral, os níveis de burnout foram significativamente maiores na dimensão EE, tanto nos cirurgiões mais jovens (p=0,033), como nos com menor tempo de vínculação trabalhista (p=0,005). No grupo tempo parcial, o subgrupo que opera <=2 d por semana apresentou maiores níveis de burnout na dimensão RP (p=0,021), enquanto o subgrupo solteiro(a)/separado(a) ou divorciado(a)/viúvo(a) teve 0% de nível baixo de burnout (p=0,010) nessa dimensão. O subgrupo plantonista teve maiores níveis de burnout na dimensão DP (p=0,016). Conclusões: A prevalência de SB foi 6%. Não foram identificados fatores de risco para SB. No entanto, operar menos dias por semana e atuar em tempo integral acentuam os níveis de burnout na dimensão RP. O regime contratual afeta significativamente os níveis de burnout em algumas dimensões da escala MBI-HSS.
Title in English
Burnout Syndrome in surgeons of the Department of Surgery of a high complexity university hospital
Keywords in English
Burnout in surgeons
Burnout syndrome
Latent Burnout profiles
Occupational stress
Abstract in English
Introduction: The literature on Burnout Syndrome (BS) in surgeons is scarce. Objectives: To evaluate the prevalence of BS in high complexity university public tertiary hospital surgeons, identify risk factors for BS development, and compare two groups of surgeons according to the contractual working regime (part time vs. full time job). Participants and Methods: 77 surgeons in regular surgical activity at the Department of Surgery were investigated. They responded a General questionnaire, with 10 socio demographic variables, and the MBI-HSS questionnaire, directly on the Research Electronic Data Capture (REDcap) program loaded into the investigators personal computer. By latent profile analysis (LPA), they were profiled as Burnout, Overextended, Disengaged, Ineffective or Engaged, according to the 3 dimensions ((emotional exhaustion (EE), depersonalization (DP) and personal accomplishement (PA)) high, medium or low burnout levels. BS prevalence was calculated as the percentage of surgeons LPA profiled as Burnout. In order to look for risk factors, a univariate analysis was carried out. For this purpose, a With burnout group, was formed by Burnout, Overextended, Disengaged and Ineffective profiled surgeons, while the Engagement profiled surgeons were used as proxy for the Without burnout group. The part-time and full-time groups were also compared by univariate analysis. Fisher's exact test was used, and the differences with p<=0.05 were considered significant. Results: Of the 77 surgeons evaluated, 93% were married or had stable union, 93% had children; 90% were men aged >40, 85% performed major surgeries <=2x/wk, 74% were Assistant Physicians; 72% were hired part-time, 55% worked in the Institution for <=15y, 51% performed <= 2 operations/week, and 51% take call shifts. The Burnout latent profile prevalence was 6%. However, 32 (41,6%) surgeons could not be classed in any of the 5 LPA patterns. There were no significant differences between the With BS and Without BS groups. In the fulltime group, EE burnout levels were significantly higher, both in the younger (p=0.033) and in the part time surgeons (p=0.005). In this group, higher PA burnout levels (p=0.021) were found in the <=2 operative days/week subgroup, whereas in the single/separated or divorced/widow(er) subgroup, none had low PA Burnout levels (p=0.010). In the call taking group, DP burnout levels were significantly higher (p=0.016). Conclusions: BS prevalence was 6%. No risk factors for BS were identified. However, less operative days/week and full time job both accentuate PA burnout levels. The contractual working regime significantly affects burnout levels in the MBIHSS scale dimensions.
 
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Publishing Date
2020-04-28
 
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