ABSTRACT
Abstract Introduction Burnout syndrome (BOS) comprises emotional exhaustion, depersonalization, and reduced personal accomplishment in those affected. Instruments such as the Maslach Burnout Inventory (MBI) can help to identify those affected. Physicians in training have been described as an at-risk group for this syndrome. Objective Describe the association between BOS and medical training by specialty in first-year residents. Method This is a cross-sectional analytical study of specialty residents at the Hospital Civil de Guadalajara. Sociodemographic data were obtained and the MBI was administered to identify BOS. Samples were compared, and a comparative analysis performed to identify factors associated with BOS. Results Eighty-eight residents were included, with 21.6% (n = 19) presenting BOS, 53.4% displaying emotional exhaustion (n = 47), 53.7% showing depersonalization (n = 47), and 39.8% reduced personal accomplishment (n = 35). Presenting BOS was not associated with sociodemographic characteristics or type of specialty. Work hours (ro = .229, p = .032), and a higher number of on-call hours/week (ro = .34, p = .001) were associated with higher BOS. Discussion and conclusion The prevalence of BOS was lower than expected. Over half scored for emotional exhaustion and depersonalization, which could be explained by a self-reporting bias. There was no association between the group/type of specialty and BOS. This study creates new knowledge that works as an institutional situational diagnosis, helps to determine the scope of the problem, and encourages to consider the contributing factors to its origin and maintenance.
Resumen Introducción El síndrome de burnout (SBO) comprende el agotamiento emocional, la despersonalización y la reducción de la realización personal en aquellos a quienes afecta. Instrumentos como el Maslach Burnout Inventory (MBI) pueden ayudar a identificar a los afectados. Los médicos en formación se han descrito como un grupo de riesgo para presentar este síndrome. Objetivo Describir la asociación entre el síndrome de burnout y la formación médica por especialidad en residentes de primer año. Método Se trata de un estudio analítico transversal de residentes de especialidad del Hospital Civil de Guadalajara. Se obtuvieron datos sociodemográficos y se administró el MBI para identificar SBO. Se compararon las muestras y se realizó un análisis comparativo para identificar los factores asociados con SBO. Resultados Se incluyeron 88 residentes, con 21.6% (n = 19) presentando SBO; 53.4% mostrando agotamiento emocional (n = 47); 53.7% (n = 47) mostrando despersonalización; y 39.8% (n = 35) reducción de realización personal. La presentación de SBO no se asoció a características sociodemográficas ni al tipo de especialidad. Las horas de trabajo (ro = .229, p = .032) y un mayor número de horas de guardia/semana (ro = .34, p = .001) se asociaron con una mayor BOS. Discusión y conclusión La prevalencia de SBO fue menor de lo esperado. Más de la mitad puntuó por agotamiento emocional y despersonalización, lo que podría explicarse por un sesgo en la autoevaluación. No hubo asociación entre el grupo/tipo de especialidad y SBO. Este estudio genera nuevos conocimientos que funcionan como un diagnóstico situacional institucional, ayuda a determinar el alcance del problema y alienta a considerar los factores que contribuyen a su origen y mantenimiento.
ABSTRACT
A falha coesiva na porcelana de revestimento de próteses com infraestruturas de policristais de zircônia tetragonal estabilizada por ítrio (PZT-I) tem causado elevadas taxas clínicas de fracassos. No presente estudo avaliou-se a confiabilidade e modos de fratura de próteses fixas implanto-suportadas confeccionadas em uma liga de paládio-prata (PdAg) e em PZT-I, submetidas à fadiga acelerada progressiva. Embebeu-se análogos de implantes em uma resina acrílica. Infraestruturas em PZT-I e PdAg (n = 21/grupo) foram fabricadas, revestidas com porcelana, cimentadas e submetidas a uma carga estática (n = 3/grupo) para obtenção dos valores de resistência à fratura. Em seguida, 18 espécimes de cada grupo foram distribuídos ao longo de 3 perfis de estresse progressivo e submetidos à fadiga em água com a carga aplicada na cúspide vestibular do pôntico. Encontrou-se no grupo PdAg um modo de fratura incluindo trincas flexurais na área do conector competindo com a falha coesiva da porcelana, enquanto que as próteses em PZT-I apresentaram falha coesiva na porcelana de revestimento. O cálculo da confiabilidade (Alta Pro, Relia Soft, intervalo de confiança de 90%, bilateral) revelou confiabilidade significativamente inferior para o grupo PZT-I na finalização de uma missão de 100.000 ciclos a 300 N quando comparada ao grupo PdAg. Concluiu-se que para uma missão de 100.000 ciclos a 300 N a confiabilidade é mais alta para a prótese metalocerâmica quando comparada à em PZT-I. Os modos de fratura diferiram entre os grupos.
Statement of problem: chipping within veneering porcelain has resulted in high clinical failure rates for implant-supported zirconia (Y-TZP) bridges. This study evaluated the reliability and failure modes of mouth-motion step-stress fatigued implant-supported Y-TZP versus Palladium-Silver alloy (PdAg) three-unit bridges. Methods: Implant-abutment replicas wereembedded in polymethylmethacrylate resin. Y-TZP and PdAg frameworks, of similar design (n = 21 each), were fabricated, veneered, cemented (n = 3 each), and Hertzian contact tested to obtain ultimate failure load. In each framework group eighteen specimens were distributed across 3 stepstress profiles and mouth-motion cyclically loaded according to the profile on the lingual slope of the buccal cusp of the pontic. Results: PdAg failures included competing flexural cracking at abutment and/or connector area and chipping, whereas Y-TZP presented predominantly cohesive failure within veneering porcelain. Including all failure modes, the reliability (2-sided at 90% confidence intervals) for a mission of 100,000 cycles at 300 N load was determined (Alta Pro, Reliasoft). Reliability remained unchanged for a mission of 100,000 for PdAg, but significantly decreased for Y-TZP. Conclusion: Higher reliability was found for PdAg for a mission of 100,000 cycles at 300N. Failure modes differed between materials.