Work-related mental and behaviour disorders in anesthesiologists / Transtornos mentais e do comportamento relacionados ao trabalho em médicos anestesiologistas

BACKGROUND: Anaesthesiology is a specialty whose specificity of the working process results in high levels of stress as an inevitable condition - a particularly worrying situation in the daily life of these professionals. OBJECTIVES: This study, based on data from national and international literature, aims to discuss the basis of the occurrence of mental and behavioural disorders or of psychopathological injuries (psychological distress) related to working activity in anesthesiologists. METHOD: A literature review was conducted, with papers selected from Medline and Lilacs databases, published between 2000 and 2012 in Portuguese, English and Spanish, and addressing the possible association between occupational hazards of the anaesthesiologist profession and mental health problems and psychic distress. Twenty-six publications were listed. RESULTS: Several aspects of the anesthesiologist's work are important points to better understand the relationship between mental health at work and working organization. Poor temporal structuring of work, conflictuous interpersonal relationships and poor control over the activity itself may be mentioned as illness enhancers. CONCLUSION: The working organization, when not appropriate, is an important occupational risk factor for the life and mental health of workers, mainly of professionals focused on the care of people. This paper focuses on anesthesiologists, who are constantly exposed to stressful and anxiogenic factors.

JUSTIFICATIVA: a anestesiologia é uma especialidade cuja especificidade do processo de trabalho torna elevados níveis de estresse uma condição inevitável, situação preocupante no cotidiano desses profissionais. OBJETIVOS: o presente estudo, fundamentado em dados da literatura nacional e internacional, tem o propósito de discutir as bases da ocorrência de transtornos mentais e de comportamento ou agravos psicopatológicos (sofrimento psíquico) relacionados à atividade laboral em médicos anestesiologistas. MÉTODO: fez-se uma revisão de literatura em que foram selecionados artigos científicos nas bases de dados Medline e Lilacs, publicados entre 2000 e 2012, em português, inglês e espanhol, que abordam a possível associação entre riscos ocupacionais da profissão de médico anestesiologista e problemas de saúde mental e sofrimento psíquico. Foram enumeradas 26 publicações. RESULTADOS: vários aspectos do trabalho do médico anestesiologista apresentam-se como pontos importantes para a compreensão das relações entre saúde mental no trabalho e organização do trabalho. Podem ser destacados como adoecedores a má estruturação temporal do trabalho, as relações interpessoais conflituosas e o mau controle sobre a própria atividade. CONCLUSÃO: a organização do trabalho, quando não adequada, é um importante fator de risco ocupacional para a vida e a saúde mental dos trabalhadores, principalmente, dos profissionais voltados para o cuidado de pessoas. O foco presente são os médicos anestesiologistas, constantemente expostos a fatores estressantes e ansiogênicos.

The government's research and development policies and institutions for health technology

Health Technology Research and Development (R&D) national grant system has been progressed by the unique governance of each countries. From this reason, it has historical context and path-dependency. South Korea, also have started their investment from Bio Technology Master Plan of Ministry of Science and Technology (1994) and Korea Health Technology R&D Project of Ministry of Health and Welfare (1995), currently investing around 1.1 trillion won (in the year 2012) into the Ministry of Education, Science and Technology (now, Ministry of Science, ICT and Future Planning), Ministry of Health and Welfare and Ministry of Knowledge Economy (now, Ministry of Trade, Industry and Energy). This paper focuses on the Health Technology R&D national grant system in the aspect of governance, mid-long term strategic plan, main program, planning-evaluation-management system. And last but not least, implications. First, there would be important to build the effective governance, performance based policy and administration mechanisms of national grant system for the Health Technology R&D. Second, main objective of Health Technology R&D, which is improving the quality of life for the public, could not meet their target practically. Third, R&D investment has been enlarged from treatment based to prevention and care focused and from technology-centered into demand-centered, which based on the unmet health needs. Last, most of Health Technology R&D project could not consider sustainable health system, which would be the most important value in healthcare.