RESUMEN
Introducción: los residentes de especialidad médica están expuestos a un alto nivel de burnout lo cual impacta negativamente en el profesionalismo. Esto ha promovido que los programas de residencias instalen curricularmente actividades de bienestar y autocuidado. Este estudio busca identificar la presencia de actividades de autocuidado/bienestar en residencias de psiquiatría de Chile y conocer la opinión docente respecto del tema. Materiales y métodos: se realizó un estudio descriptivo transversal invitando vía correo electrónico a 80 docentes de 3 departamentos de psiquiatría a contestar un cuestionario sobre el tema de bienestar/autocuidado de sus residentes en sus programas de formación. Se realizó un análisis cuantitativo de los datos. Resultados: un 69,4% de los encuestados señaló que su residencia no cuenta con contenidos curriculares formales o un programa de autocuidado/bienestar para sus residentes. Las actividades existentes para las residentes relacionadas al autocuidado/bienestar y mencionadas por los docentes son: supervisión, resolución de conflictos, habilidades de comunicación y apoyo o trabajo grupal guiado. Las principales barreras son la limitación de tiempo, la falta de conocimiento y el financiamiento. Discusión: el bienestar de los residentes ha ganado relevancia en los últimos años. El Consejo de Acreditación de Educación Médica para Graduados (ACGME) lo promueve activamente. En Chile, según los programas encuestados, hay poca presencia sistemática de actividades estandarizadas o programas dirigidos al autocuidado y bienestar de este grupo. Parece necesario incluir este aspecto considerando el impacto del burnout en el personal de salud especialmente en un contexto de pandemia o crisis sanitaria.
Introduction: medical speciality residents are exposed to high burnout, which harms professionalism. This mental health situation has led to creating programs promoting well-being and self-care, which have not been installed transversally in medical education. The present study seeks to identify self-care/well-being activities in psychiatry residences in Chile and the teaching interest in implementing them. Methods: 80 professors from 3 Departments of Psychiatry were invited via email to answer a questionnaire on aspects of well-being. A quantitative analysis was performed. Results: 69.4% of those surveyed said their residence does not have formal content or a self-care/well-being program for its residents. The self-care/well-being activities most included in the residents surveyed were su-pervision, conflict resolution and communication skills, and support or guided group work. The main barriers are limited time and lack of knowledge. Discussion: The well-being of residents has gained relevance in recent years, so much so that the Accreditation Council for Graduate Medical Education (ACGME) actively promotes it. In Chile, the situation seems to be different; there is a systematic lack of standardized activities aimed at self-care and the resident's well-being. Including mental health advocating programs is an essential challenge considering the context of pandemic and the relevance of preventing burnout in health personnel.
RESUMEN
Abstract Introduction Mental health in training physicians is a growing issue. The aim of this study was to investigate emotional distress in psychiatry residents. Method This web-based survey evaluated 115 (62%) psychiatry residents in training in the Brazilian State of Rio Grande do Sul. The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Adult, the Patient Health Questionnaire-2, the Alcohol Use Disorders Identification Test-concise, and the Maslach Burnout Inventory were all administered. Linear regression models were estimated with burnout dimensions as dependent variables. Result Positive screening rates were 53% for anxiety, 35.7% for somatization, 16.5% for depression, and 7% for suicidal ideation. Half of the male residents were at risk of alcohol abuse and dependence. Regarding burnout, 60% met criteria for emotional exhaustion, 54.8% for depersonalization, and 33% for low personal accomplishment. The most consistent risk factors were the nature of the relationships with preceptors, relations to the institutions themselves, age, and the quality of relationships with family. Conclusion Besides disconcerting rates of psychiatric symptoms, the study revealed that characteristics of the workplace (i.e., the nature of relationships with preceptors and relations to the institution) can be regarded as potential targets for development of interventions aimed at improving mental health during training periods.
RESUMEN
El presente estudio se basa en la Encuesta de Calidad de Vida de la Organización Mundial de la Salud (WHOQOL-BREF), que se utilizó para analizar la calidad de vida y los factores que contribuyen a su calidad de vida en Psiquiatras Infanto-Juveniles y Neuropediatras, además de residentes de ambas especialidades en Chile. Se realizaron entrevistas electrónicas a 79 profesionales, asociados a la Sociedad de Psiquiatría y Neurología de la Infancia y de la Adolescencia. Los resultados mostraron que las puntuaciones medias en cada dominio del WHOQOL-BREF de los profesionales son las siguientes: la capacidad física (CF) es de 15,11 +/- 2.55, el bienestar psicológico (BP) fue de 15,22 +/- 2.08, relaciones sociales (RS) fue 14,63 +/- 2.75 y el medio ambiente (MA) 15,04 +/- 2.39. Estas puntuaciones medias fueron inferiores a las de la población general. Por último, se realizaron regresiones múltiples por pasos para examinar las características del Psiquiatra Infanto-Juvenil, Neurólogo Infantil y residentes de la especialidad. El estudio encontró que los siguientes tres factores: la percepción subjetiva del estado de salud, los hogares, los ingresos y el estrés de apoyo familiar insuficiente, fueron significativamente correlacionados con los cuatro dominios de regresión múltiple análisis. Los resultados destacan que los cuidadores de los niños y adolescentes con discapacidad intelectual parecen mostrar una menor WHOQOL-BREF puntuación media que la población general, probablemente por una combinación de estrés, la salud y los factores de ingreso de los hogares. Estas conclusiones deben tenerse en cuenta en la formulación de políticas para proporcionar medidas de mayor apoyo e intervenciones más específicas para los psiquiatras infanto-juveniles y Neuropediatras.
The present study is based on World Health Organization´s quality of life (WHOQOL-BREF) scale to examine quality of life of child and adolescent psychiatrists and child neurologists in Chile, and the factors contributing to their quality of life. Structured interviews were conducted with 79 practitioners. Self-evaluation of their quality of life revealed that 72 percent considered it good or very good, while 58 percent were pleased of very pleased with regards to health satisfaction. The mean scores obtained in each domain of WHOQOL-BREF were: physical capacity (PC) 15.11 +- 2.55, psychological well-being (PW) 15.22 +-2.08, social relationship (SR) 14.63 +- 2.75 and environment (EN) 15.04 +- 2.39. Finally, multiple stepwise regressions were conducted to examine the characteristics of the practitioners which more likely explained the WHOQOL-BREF mean scores. The study found that marital status was significantly correlated to psychological well-being and environment; religion was significantly correlated to the environment; and the number of work places with physical capacity and quality of life score. The results highlights that child and adolescent psychiatrists and child neurologists display a higher WHOQOL-BREF mean score than the general population however, in certain domains the scores are lower, probably due to a combination of stress and health factors. These finding must be taken into account in policy making to provide better and more specific supports and interventions for the child and adolescent psychiatrists and child neurologists.