The Inner Life of Physicians and Care of the Seriously Ill

Meier, Diane E.; Back, Anthony L.; Morrison, R. Sean

doi:10.1001/jama.286.23.3007

Cited by 578 publications

(448 citation statements)

References 94 publications

(148 reference statements)

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“…tajas para los pacientes, los profesionales y por supuesto las instituciones implicadas [47][48][49][50] .…”

Section: Discussionunclassified

Síndrome de Burnout en el personal de enfermería de un hospital de Madrid

Albaladejo¹,

Villanueva²,

Ortega³

et al. 2004

Rev. Esp. Salud Publica

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RESUMENFundamento: El término Burnout se refiere a una situación que es cada vez más frecuente entre los profesionales que prestan sus servicios a través de una relación directa y mantenida con las personas, entre los que se encuentran todos los profesionales sanitarios. El objetivo de nuestro estudio ha sido determinar la prevalencia del sín-drome de Burnout y de sus tres componentes (cansancio emocional, despersonalización y falta de realización personal) entre los profesionales del área de enfermería del Hospital Clínico Universitario San Carlos de Madrid y su relación con determinados factores sociodemográficos, laborales e institucionales. Métodos:Se realizó un estudio tranversal entre los profesionales adscritos al área de enfermería del mencionado hospital. Las variables implicadas se recogieron mediante un cuestionario de elaboración propia. En cuanto al síndrome de Burnout se midió mediante el Maslach Burnout Inventory, en su versión validada en español.Resultados: El personal de enfermería está más despersonalizado (p=0,004) y menos realizado (p=0,036) que el grupo de auxiliares/técnicos. Cuando se analizaron los resultados de las 4 escalas por servicios comprobamos que el agotamiento es superior en los trabajadores de oncología y urgencias (p=0,001), la despersonalización en urgencias (p=0,007), y el Burnout es de nuevo más alto en las áreas de oncología y urgencias (p=0,000). Los profesionales que respondí-an que su labor asistencial era poco reconocida obtenían las peores puntuaciones en el Burnout y sus tres dimensiones (p =0,000). A menor grado de satisfacción laboral más altas son las puntuaciones en las 4 escalas (p=0,000). Conclusiones:Podemos concluir que en nuestro estudio el perfil del sujeto afecto de Burnout se corresponde con el de un profesional con experiencia laboral que sin embargo manifiesta un escaso grado de reconocimiento a su labor asistencial y un alto nivel de insatisfacción con la gestión de su centro de trabajo.Palabras clave: Agotamiento profesional. Enfermeras. Demografía. Satisfacción en el trabajo. Hospitales. ABSTRACT Burnout Syndrome among Nursing Staff at a Hospital in MadridBackground: The term «burnout» is related to a situation arising increasingly more often among the professionals performing their duties by way of a long-term, direct, people-to-people relationship, which includes all healthcare professionals. This study is aimed at determining the prevalence of the Burnout syndrome and of the three components involved therein (emotional exhaustion, impersonalization and lack of personal fulfillment) among the nursing staff at the «Hospital Clínico Universitario San Carlos» in Madrid and the relationship thereof to certain socio-demographic, job-related and institutional factors. Methods:A cross-sectional study was conducted among the professionals assigned to the nursing staff at the above-mentioned hospital. The variables involved were gathered by means of a questionnaire prepared by those conducting this study. The Burnout syndrome was measured by means of the M...

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“…tajas para los pacientes, los profesionales y por supuesto las instituciones implicadas [47][48][49][50] .…”

Section: Discussionunclassified

Síndrome de Burnout en el personal de enfermería de un hospital de Madrid

Albaladejo¹,

Villanueva²,

Ortega³

et al. 2004

Rev. Esp. Salud Publica

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“…65,71 Therefore, physicians are likely to better address patients' emotional needs if they incorporate tools for reflective self-awareness into their practices. [72][73][74] Finally, stigma forms a powerful barrier to envisioning adapting to disability. Stigmatizing images of illness and disability depict broken and unfulfilling lives.…”

Section: Emotional and Social Influences On Affective Forecastingmentioning

confidence: 99%

Affective Forecasting: An Unrecognized Challenge in Making Serious Health Decisions

2008

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Patients facing medical decisions that will impact quality of life make assumptions about how they will adjust emotionally to living with health declines and disability. Despite abundant research on decision-making, we have no direct research on how accurately patients envision their future well-being and how this influences their decisions. Outside medicine, psychological research on "affective forecasting" consistently shows that people poorly predict their future ability to adapt to adversity. This finding is important for medicine, since many serious health decisions hinge on quality-of-life judgments. We describe three specific mechanisms for affective forecasting errors that may influence health decisions: focalism, in which people focus more on what will change than on what will stay the same; immune neglect, in which they fail to envision how their own coping skills will lessen their unhappiness; and failure to predict adaptation, in which people fail to envision shifts in what they value. We discuss emotional and social factors that interact with these cognitive biases. We describe how caregivers can recognize these biases in the clinical setting and suggest interventions to help patients recognize and address affective forecasting errors.

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“…Supportive colleagues, viewing oneself as a therapeutic agent, and a closer relationship with patients and families could all contribute to increased job satisfaction and decreased burnout. [10][11][12] Our conceptual model of the development of communication skills and their relationship to job satis-faction and burnout has features in common with models used by adult learning theorists such as Schon, Meizrow, and others to explain the processes of professional growth and development in adulthood. [13][14][15][16] These theorists suggest that a learner's ability to identify, conceptualize, and describe a complex task like communication allows the learner to experiment in an intentional way that supports continued skill development, resulting in increased satisfaction with work tasks.…”

Section: Conceptual Model: Communication Is Not "See One Do One Teamentioning

confidence: 99%

A Qualitative Study of Oncologists' Approaches to End-of-Life Care

Jackson

Mack

Matsuyama

et al. 2008

Journal of Palliative Medicine

125

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Purpose: To understand how oncologists provide care at the end of life, the emotions they experience in the provision of this care, and how caring for dying patients may impact job satisfaction and burnout.Participants and methods: A face-to-face survey and in-depth semistructured interview of 18 academic oncologists who were asked to describe the most recent inpatient death on the medical oncology service. Physicians were asked to describe the details of the patient death, their involvement with the care of the patient, the types and sequence of their emotional reactions, and their methods of coping. Grounded theory qualitative methods were utilized in the analysis of the transcripts.Results: Physicians, who viewed their physician role as encompassing both biomedical and psychosocial aspects of care, reported a clear method of communication about end-of-life (EOL) care, and an ability to positively influence patient and family coping with and acceptance of the dying process. These physicians described communication as a process, made recommendations to the patient using an individualized approach, and viewed the provision of effective EOL care as very satisfying. In contrast, participants who described primarily a biomedical role reported a more distant relationship with the patient, a sense of failure at not being able to alter the course of the disease, and an absence of collegial support. In their descriptions of communication encounters with patients and families, these physicians did not seem to feel they could impact patients' coping with and acceptance of death and made few recommendations about EOL treatment options.Conclusion: Physicians' who viewed EOL care as an important role described communicating with dying patients as a process and reported increased job satisfaction. Further research is necessary to determine if educational interventions to improve physician EOL communication skills could improve physician job satisfaction and decrease burnout. 893

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The Inner Life of Physicians and Care of the Seriously Ill

Cited by 578 publications

References 94 publications

Síndrome de Burnout en el personal de enfermería de un hospital de Madrid

Síndrome de Burnout en el personal de enfermería de un hospital de Madrid

Affective Forecasting: An Unrecognized Challenge in Making Serious Health Decisions

A Qualitative Study of Oncologists' Approaches to End-of-Life Care

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