Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil.
Health-Related Quality of Life Research Group (GPQual), Learning and Research Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil.
BMC Cancer. 2018 Oct 26;18(1):1044. doi: 10.1186/s12885-018-4964-7.
Doctors who work at cancer hospitals are at high risk of developing emotional distress. This study evaluated the prevalence of burnout, anxiety, and depression in a sample of oncologists of various specialties and sought to identify how much of this distress is explained by specific pre-established characteristics.
This cross-sectional study used online surveys. Burnout was measured using the Maslach Burnout Inventory (MBI), and anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). The variables associated with p-values < 0.10 in the univariate analyses were included in blocks of hierarchical binary logistic regression models to identify the predictors of burnout, depression, and anxiety.
Of the 227 physicians (response rate = 70.5%), 132 (58.1%) were identified as having burnout (high emotional exhaustion [EE] and depersonalization [DP]); furthermore, 28 (12.3%) had depression (HADS-D ≥ 11), and 44 (19.4%) had anxiety (HADS-A ≥ 11). The block of perceptions related to the workplace explained 22.4%, 7.7%, and 10.6% of the variances of burnout, depression, and anxiety, respectively. On the other hand, the outside-of-work characteristics block explained only 3.1%, 13.4%, and 3.4% of the variances of burnout, depression, and anxiety, respectively.
Work-related stressors are associated with burnout, but few are associated with anxiety and depression. Outside-of-work characteristics explained little of the distress reported by physicians. Strategies focused on perceptions of professional recognition and lower workloads that stimulate positive relationships between doctors and other health professionals are desirable in oncological context.
在癌症医院工作的医生面临着情绪困扰的高风险。本研究评估了各种专业肿瘤学家样本中的倦怠、焦虑和抑郁的患病率，并试图确定有多少这种困扰可以用特定的既定特征来解释。
这项横断面研究使用在线调查。使用 Maslach 倦怠量表（MBI）测量倦怠，使用医院焦虑和抑郁量表（HADS）测量焦虑和抑郁。在单因素分析中 p 值<0.10 的变量被纳入分层二项逻辑回归模型块中，以确定倦怠、抑郁和焦虑的预测因素。
在 227 名医生（应答率为 70.5%）中，有 132 名（58.1%）被确定为存在倦怠（高情绪衰竭[EE]和去人性化[DP]）；此外，有 28 名（12.3%）患有抑郁（HADS-D≥11），有 44 名（19.4%）患有焦虑（HADS-A≥11）。与工作场所相关的看法块分别解释了倦怠、抑郁和焦虑方差的 22.4%、7.7%和 10.6%。另一方面，工作之外的特征块仅解释了倦怠、抑郁和焦虑方差的 3.1%、13.4%和 3.4%。
与工作相关的压力源与倦怠有关，但与焦虑和抑郁的关系较少。工作之外的特征仅能解释医生报告的困扰的一小部分。在肿瘤学背景下，关注职业认可的认知和降低工作量的策略，以刺激医生与其他卫生专业人员之间的积极关系，是可取的。
