Relación entre la inteligencia emocional y el burnout en los médicos de Atención Primaria / Relationship between emotional intelligence and burnout syndrome in Primary Healthcare doctors

OBJETIVO: Evaluar la relación de la inteligencia emocional (IE) con el síndrome de burnout (BO) en los médicos de Atención Primaria. MATERIAL Y MÉTODOS: Estudio descriptivo transversal. EMPLAZAMIENTO: todos los centros de salud y consultorios del Principado de Asturias. PARTICIPANTES: médicos de Atención Primaria que estén en activo. Intervención: en abril de 2018 se envió un cuestionario anónimo autoadministrado con variables sociodemográficas, laborales y las escalas validadas TMMS-24 (IE) y MBI (BO). VARIABLES: la variable dependiente fue el BO. Como variables independientes se tomaron las 3 dimensiones de la IE, la edad, el sexo, el estado civil, el número de hijos, el tipo de formación, el tipo de contrato, el tiempo trabajado, las horas de guardia, los pacientes al día, el cupo, el ámbito rural o urbano, el área sanitaria, la relación con enfermería/hospital y la docencia. Análisis estadístico: inferencia bayesiana. RESULTADOS: Se enviaron 647 encuestas, participando 374 sujetos (tasa de respuesta del 57,8%). La distribución posterior de la prevalencia de BO fue del 64,5% [índice de credibilidad 95%: 59,7 a 69,2]. Encontramos asociación del BO con las 3 dimensiones de la IE; tener más habilidades emocionales disminuye el riesgo de presentar BO. Mostraron, además, incrementar la odds de prevalencia de BO la edad, el tipo de contrato, el ámbito urbano y la media de pacientes/día. Mostraron disminuir la odds de prevalencia tener hijos y ser tutor. CONCLUSIONES: Cabe destacar el elevado BO de los médicos de Atención Primaria, más de uno de cada 2 médicos están quemados. Por tanto, según resultados obtenidos, proponemos profundizar en la adquisición de habilidades relacionadas con la IE y mejorar las condiciones laborales en Atención Primaria

AIM: The purpose of this study is to analyse the relationship between emotional intelligence (EI) and burnout syndrome (BOS) in doctors in Primary Health Care. MATERIAL AND METHODS: Cross-sectional descriptive study. SETTING: All healthcare centres and clinics in Asturias. PARTICIPANTS: Doctors of Primary Health Care who are active. INTERVENTION: In April 2018, an anonymous self-administered questionnaire was sent to all concerned. It included sociodemographic data, employment data, and TMMS-24 (EI) and MBI (BOS) validated scales. VARIABLES: BOS as a dependent variable. Three dimensions of EI, age, sex, marital status, number of children, form of training, contract type, time worked, on-call hours, number of patients per day, quota, rural or urban setting, healthcare area, relationship with nursing/hospital, and teaching as independent variables. Statistical analysis: Bayesian inference. RESULTS: A total of 647 questionnaires were sent, and 374 subjects took part in the study (response rate: 57.8%). The subsequent distribution of BOS prevalence was 64.5% [95% credibility index: 59.7-69.2]. BOS was associated with 3 dimensions of the EI, and to have higher social skills decreased the risk of presenting with BOS. Age, contract type, urban setting, and number of patients per day tended to increase the odds of prevalence of BOS. Having children or being a guardian tended to decrease the odds of prevalence. CONCLUSIONS: The high level of BOS in Primary Health Care doctors should be pointed out, with more than one out of 2 doctors having burnout. Therefore, we suggest looking into how emotional skills are achieved, and also how to improve working conditions in Primary Health Care

[Relationship between emotional intelligence and burnout syndrome in Primary Healthcare doctors]. / Relación entre la inteligencia emocional y el burnout en los médicos de Atención Primaria.

AIM: The purpose of this study is to analyse the relationship between emotional intelligence (EI) and burnout syndrome (BOS) in doctors in Primary Health Care. MATERIAL AND METHODS: Cross-sectional descriptive study. SETTING: All healthcare centres and clinics in Asturias. PARTICIPANTS: Doctors of Primary Health Care who are active. INTERVENTION: In April 2018, an anonymous self-administered questionnaire was sent to all concerned. It included sociodemographic data, employment data, and TMMS-24 (EI) and MBI (BOS) validated scales. VARIABLES: BOS as a dependent variable. Three dimensions of EI, age, sex, marital status, number of children, form of training, contract type, time worked, on-call hours, number of patients per day, quota, rural or urban setting, healthcare area, relationship with nursing/hospital, and teaching as independent variables. STATISTICAL ANALYSIS: Bayesian inference. RESULTS: A total of 647 questionnaires were sent, and 374 subjects took part in the study (response rate: 57.8%). The subsequent distribution of BOS prevalence was 64.5% [95% credibility index: 59.7-69.2]. BOS was associated with 3 dimensions of the EI, and to have higher social skills decreased the risk of presenting with BOS. Age, contract type, urban setting, and number of patients per day tended to increase the odds of prevalence of BOS. Having children or being a guardian tended to decrease the odds of prevalence. CONCLUSIONS: The high level of BOS in Primary Health Care doctors should be pointed out, with more than one out of 2 doctors having burnout. Therefore, we suggest looking into how emotional skills are achieved, and also how to improve working conditions in Primary Health Care.

Modulation of Immunity and Inflammation by the Mineralocorticoid Receptor and Aldosterone.

The mineralocorticoid receptor (MR) is a ligand dependent transcription factor. MR has been traditionally associated with the control of water and electrolyte homeostasis in order to keep blood pressure through aldosterone activation. However, there is growing evidence indicating that MR expression is not restricted to vascular and renal tissues, as it can be also expressed by cells of the immune system, where it responds to stimulation or antagonism, controlling immune cell function. On the other hand, aldosterone also has been associated with proinflammatory immune effects, such as the release of proinflammatory cytokines, generating oxidative stress and inducing fibrosis. The inflammatory participation of MR and aldosterone in the cardiovascular disease suggests an association with alterations in the immune system. Hypertensive patients show higher levels of proinflammatory mediators that can be modulated by MR antagonism. Although these proinflammatory properties have been observed in other autoimmune and chronic inflammatory diseases, the cellular and molecular mechanisms that mediate these effects remain unknown. Here we review and discuss the scientific work aimed at determining the immunological role of MR and aldosterone in humans, as well as animal models.

Variations in magnesium and zinc in hypertensive patients receiving different treatments.

We studied the influence of captopril, atenolol, and verapamil on serum and intraerythrocyte concentrations of magnesium and zinc in 30 normotensive control subjects (12 men and 18 women, aged 30 to 65 years, mean +/- SD 45.76 +/- 12.15 years) and 30 patients with untreated mild or moderate essential hypertension (14 men and 16 women, aged 30 to 65 years, mean +/- SD 49.50 +/- 13.58 years). Ten each of the hypertensive patients were treated with captopril, atenolol, or verapamil. Physical examination and biochemical analyses (serum Mg and Zn) were done in all participants at baseline, and in patients after 3 and 6 months of treatment. The results were compared according to a nested design with Neumann-Keuls test. We found no significant differences between controls and patients in serum and intraerythrocyte concentrations of Zn at the start of the study, although there was a significant decrease in serum Zn in patients after 3 (P < .01) and 6 months (P < .001) of treatment, regardless of the drug used. This decrease was thought to be attributable to the zincuric effect of captopril or to dietary measures, or both. Intraerythrocyte Zn was not significantly affected by antihypertensive treatment. Serum and intraerythrocyte concentrations of Mg were significantly lower (P < .001) in hypertensive than in normotensive subjects, and serum Mg in patients treated with verapamil was significantly lower (P < .05) than after treatment with captopril or atenolol. Serum Mg concentration was related directly with serum concentrations of high density lipoprotein cholesterol (r = 0.4043, P < .05). We conclude that supplementation with Mg may benefit patients with hypertension.