[Prevalence of worker burnout and psychiatric illness in primary care physicians in a health care area in Madrid]. / Prevalencia de desgaste profesional y psicomorbilidad en médicos de atención primaria de un área sanitaria de Madrid.

AIM: To analyze worker burnout and the prevalence of psychiatric illness among primary care physicians, and to determine how burnout is related with sociodemographic and work-related factors. DESIGN: Cross-sectional, descriptive study. SETTING: Primary care centers in Area 8, Madrid (central Spain).Subjects. All 244 physicians (family medicine and pediatrics) who provided care at centers in Area 8 at the time of the study.Method. Anonymous, self-administered questionnaire that included the Maslach Burnout Inventory (worker burnout); GHQ-28 (possible mental illness); survey of sociodemographic and work-related factors, unhealthy behaviors, use of medications, and perceived quality of care and risk of medical errors in relation with work-related pressures; open question regarding causes of work-related stress. RESULTS: Response rate, 80.3%. Burnout was detected in 69.2% of the physicians (95% CI, 62.1%-75.4%) and was severe in 12.3%. The prevalence of possible psychiatric illness was 36.7%. Burnout was found to be related with possible psychiatric illness (P<.01); perception that work-related pressures frequently led to diminished quality of care and medical errors (P<.o1); permanent employment status (P<.05); more than 1700 patients on the patient list (P<.05); age between 37 and 46 years (P<.01) and patient load of 35 to 47 patients/day (P<.05). CONCLUSIONS: The prevalence of worker burnout and possible psychiatric illness was high, and the two variables were related. A large percentage of participants perceived that work-related pressures diminished the quality of care provided.

Prevalencia de desgaste profesional y psicomorbilidad en médicos de atención primaria de un área sanitaria de Madrid / Prevalence of worker burnout and psychiatric illness in primary care physicians in a health care area in Madrid

Objetivo. Analizar el desgaste profesional y la prevalencia de psicomorbilidad entre facultativos de atención primaria (AP) y determinar su relación con aspectos sociodemográficos y laborales. Diseño. Estudio transversal y descriptivo. Emplazamiento. Centros de AP del Área 8 de Madrid. Sujetos. Los 244 médicos y pediatras con labor asistencial en dicha área en el momento de realizarse el estudio. Método. Cuestionario anónimo autoadministrado que incluye: el Maslach Burnout Inventory (mide el desgaste profesional); el GHQ-28 (detección de una posible enfermedad mental); encuesta sobre datos sociodemográficos, laborales, conductas no saludables, consumo de medicamentos y percepción de calidad de la asistencia y riesgo de errores médicos en relación con la presión en el trabajo, y pregunta abierta sobre las causas de estrés laboral. Resultados. La tasa de respuesta fue del 80,3 por ciento. Está afectado por burnout el 69,2 por ciento (IC del 95 por ciento, 62,1-75,4 por ciento) de los facultativos, un 12,3 por ciento de ellos, de forma aguda. La prevalencia de posible psicomorbilidad es del 36,7 por ciento. Se encontró una asociación del desgaste profesional con los siguientes aspectos: una posible psicomorbilidad (p < 0,01); la percepción de que la presión en el trabajo produce con frecuencia una disminución de la calidad y la precipitación de errores médicos (p < 0,01); tener plaza en propiedad (p < 0,05), más de 1.700 pacientes en el cupo (p < 0,05), una edad de 37 y 46 años (p < 0,01) y una presión asistencial de 35-47 pacientes/día (p < 0,05).Conclusiones. Existe una elevada prevalencia de desgaste profesional y de posible psicomorbilidad, apareciendo ambas variables relacionadas. Se percibe en un elevado porcentaje que la presión del trabajo ha hecho disminuir la calidad de la asistencia prestada (AU)

En relación con el burn-out / In relation to the burn-out

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[Transmission routes of hepatitis C virus in carrier patients and study of family contacts]. / Vías de transmisión del virus de la hepatitis C en pacientes portadores y estudio de los contactos familiares.

A study was made of the routes of transmission of HCV in 106 carrier patients and the prevalence of antibodies to HCV antigen (HCV Ab) in 132 family contacts (mothers, sexual partners and children of carrier women) attended at a Primary Care Center in Madrid. The following data were obtained through a personal interview: age, gender and possible routes of contagion. Also, ALT and serologic status to HBV. Household contacts were interviewed and HCV Ab status obtained. Only in 21 patients (19.8%) was no risk factor found ("sporadic cases"). Eighty-one individuals (76.4%) and 13 (12.3%) had percutaneous transmission and sexual transmission risk factors, respectively. Out of 18 studied mothers, two (11.1%) had HCV Ab. The prevalence of HCV Ab in household contacts was 8.35%. These results suggest that the proportion of sporadic cases decreases significantly when a thorough investigation is carried out in carrier patients. The percutaneous route is responsible for most of HCV infections. The prevalence of HCV Ab among household contacts appears to be higher than among general population.