Esteva M, Larraz C, Jiménez F
Gerencia Atención Primaria de Mallorca, Servei de Salut de les Illes Balears (Ibsalut), Palma.
Rev Clin Esp. 2006 Feb;206(2):77-83. doi: 10.1157/13085357.
To asses "burnout" and psychiatric morbidity among family physicians and its relationship with stress and satisfaction at work.
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.
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.
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.
评估家庭医生的“职业倦怠”和精神疾病发病率及其与工作压力和满意度的关系。
邀请马略卡初级卫生保健区的346名家庭医生和84名儿科医生填写问卷。使用28项一般健康问卷评估精神疾病发病率。用马氏职业倦怠量表评估“职业倦怠”的三个成分(情感耗竭、去个性化和低个人成就感)。分别用丰特罗亚量表和塔巴尔卡量表评估工作满意度和工作压力。
266名家庭医生和儿科医生回答了问卷(61.86%)。估计精神疾病发病率为25.7%。在一般健康问卷结果与人口统计学和工作变量之间未发现显著差异。53%的人有较高的情感耗竭,47.1%的人有较高的去个性化,33.3%的医生有低个人成就感。在职业倦怠维度的分布与人口统计学和工作特征之间未发现显著差异。工作满意度似乎能保护医生免受精神困扰和职业倦怠。工作压力与较高的情感耗竭和去个性化有关,但与精神疾病发病率无关。
工作满意度较高的家庭医生心理健康可能得到保护,而工作压力大的医生心理健康可能受到威胁。这些事实不应被视为个人问题,而应被视为所有卫生组织的普遍问题。