The Effects of the COVID-19 Pandemic on Resident Education and Burnout.

Background: The COVID-19 pandemic has impacted the residency experience for physicians across all specialties. There have been studies examining resident perspectives on changes in curriculum and clinical experiences due to the pandemic; however, little research has been conducted on how residents in different specialties interpreted their educational experience and rates of burnout during the pandemic. Methods: We extended surveys to 281 residents across 15 separate residency programs between November 17, 2020, and December 20, 2020. The questions pertained to burnout and the effects of the pandemic on their careers. Differences between general and specialty medicine resident responses were analyzed using descriptive statistics and the Mann-Whitney U test. Results: The final analysis included 105 responses (40% response rate). We received 62 surveys (59%) from general medicine residents and 43 surveys (41%) from specialty medicine residents, with a higher response rate from junior level trainees in both groups. We found no significant differences between general and specialty residents on the level of burnout, impact on clinical experience, or future career due to COVID-19, though there was a significant difference between resident groups on the perceived impact of COVID-19 on learning. Conclusion: Specialty medicine residents reported a negative perception of the pandemic's impact on their learning during residency suggesting a greater impact on training than was perceived by the general medicine residents. Residents from general and specialty medicine programs reported similar levels of burnout and similar perceptions of the pandemic's impact on their clinical experience and future career prospects. Understanding the impacts of the COVID-19 pandemic on resident education and well-being should serve graduate medical education administrators well and prepare them for future interruptions in the traditional learning process.

Efecto de la "ley de residentes" sobre el bienestar laboral en cirugía: resultados de un estudio nacional de métodos mixtos en Colombia / Effect of the "residents' law" on occupational well-being in surgery: Results of a national mixed methods study in Colombia

Introducción. El efecto de las políticas para el mejoramiento del bienestar de los residentes, en términos de desgaste profesional y compromiso laboral, es controversial y su resultado tras la implementación de la "ley de residentes" (1917/2018) en Colombia es desconocido. Este estudio explora el efecto de esta ley en médicos residentes de cirugía colombianos. Métodos. Estudio de métodos mixtos secuencial explicativo. Inicialmente, se invitó a todos los residentes de cirugía del país a autodiligenciar los cuestionarios UWES-17 y MBI-HSS para evaluar el compromiso laboral (vigor, dedicación y absorción) y desgaste profesional (agotamiento emocional, despersonalización y baja realización personal) antes (2019) y después (2022) de la implementación de la ley. Se probaron diferentes hipótesis mediante modelos de ecuaciones estructurales. Los resultados fueron explorados con cirujanos mediante grupos focales. La información cualitativa fue analizada manualmente y por inteligencia artificial, y reportada en temas principales. Resultados. Participaron en el estudio 400 residentes. La tasa de desgaste profesional fue de 24,8 % antes y 15,8 % después (p=0,032). El análisis de ecuaciones estructurales confirmó que el agotamiento emocional sobre el desgaste profesional fue menor en 2022 (p=0,022). No se identificaron cambios significativos en el compromiso laboral. La principal explicación fue atribuida a los beneficios económicos de la ley. Conclusión. La tasa de desgaste profesional en médicos residentes de cirugía colombianos se redujo significativamente tras la implementación de la "ley de residentes". Estos hallazgos tienen implicaciones para la practica y el mejoramiento de la calidad de la educación.

Introduction. The effect of policies to improve residents' well-being, in terms of professional burnout and work commitment is controversial, and its result after the implementation of the "residents' law" (1917/2018) in Colombia is unknown. This study explores the effect of this law on Colombian surgical residents. Methods. Explanatory sequential mixed methods study. Initially, all surgical residents in the country were invited to self-complete the UWES-17 and MBI-HSS questionnaires to evaluate work commitment (vigor, dedication, and absorption) and professional burnout (emotional exhaustion, depersonalization, and low personal accomplishment) before (2019) and after (2022) the implementation of the law. Different hypotheses were tested using structural equation models. The results were explored with surgeons through focus groups. Qualitative information was analyzed manually and by artificial intelligence, and reported into main themes. Results. 400 residents participated in the study. Burnout rates were 24.8% before and 15.8% after (p=0.032). The structural equations analysis confirmed that emotional exhaustion over professional burnout was lower in 2022 (p=0.022). No significant changes in work commitment were identified. The main explanation was attributed to the economic benefits of the law. Conclusion. The burnout rate in Colombian surgical residents was significantly reduced after the implementation of the "residents' law". These findings have implications for practice and improving the quality of education

Síndrome de desgaste profesional en el personal de salud durante la pandemia de COVID-19 / Burnout Syndrome in Health Care Personnel During the COVID-19Pandemic

La Organización Mundial de la Salud (OMS) define el estrés laboral como una reacción que puede manifestarse ante exigencias y presiones laborales que ponen a prueba la capacidad que tiene cada persona para afrontar ciertas situaciones y que se agravan en el personal de salud que atiende pacientes con la COVID-19. Es decir, lo que resulta del desequilibrio entre las presiones y exigencias a las que se enfrenta el individuo, por una parte, y los conocimientos adquiridos por otra parte. El Síndrome de desgaste profesional, conocido también como síndrome de agotamiento emocional o psicológico, o por el anglicismo burnout, es un tipo de estrés laboral que engloba un estado de agotamiento físico, emocional y mental que conlleva a consecuencias individuales y sociales. El objetivo de esta revisión narrativa es identificar los factores de riesgo para el desarrollo del Síndrome de desgaste profesional en el personal de salud relacionado con la atención de pacientes con la COVID-19. Se realizó una búsqueda en la base de datos PubMed, se incluyeron artículos originales, estudios aleatorizados, revisiones sistemáticas y otros textos en español e inglés, publicados durante el periodo 2020-2023. Los principales factores de riesgo identificados en la literatura para el desarrollo de Síndrome de desgaste profesional fueron la juventud, sexo femenino, la soltería, la carga de trabajo y el nivel de satisfacción laboral de los profesionales.

The WHO defines occupational stress as a reaction that may occur when a person is faced with work-related demands and pressures that test the individual's ability to cope with certain situations, and it exacerbates in healthcare personnel who provide care to patients with COVID-19. That is, what results from the imbalance between the pressures and demands that the individual faces, on the one hand, and the knowledge acquired on the other hand. Burnout syndrome is a type of work-related stress that encompasses a state of physical, emotional and mental exhaustion that leads to individual and social consequences. The objective of this systematic review is to identify the risk factors for the development of Burnout Syndrome in health personnel related to the care of patients with COVID-19. A search was carried out in the PubMed database, including original articles, randomized studies, systematic reviews, and textbooks in Spanish and English, published during the period 2020-2023. The main risk factors for the development of Burnout Syndrome identified in the literature were youth, female sex, singleness, workload and the level of job satisfaction of the professionals

Análisis bibliométrico sobre estrategias para reducir el riesgo de Burnout entre enfermeras / Bibliometric Analysis about Strategies for Reducing the Risk of Burnout among Nurses

Introducción: El síndrome de Burnout gana atención de investigadores y profesionales, en particular en el área de la salud, por las consecuencias e implicaciones que puede generar en los profesionales afectados por la enfermedad, lo que puede comprometer la seguridad del paciente y la calidad del servicio ofrecido. Objetivo: Caracterizar la producción científica sobre estrategias e intervenciones para reducir el riesgo del síndrome de Burnout entre los profesionales de enfermería. Métodos: Análisis bibliométrico de las publicaciones hasta el 2021 en las bases de datos PubMed, Scopus y Web of Science. Los análisis se desarrollaron con el apoyo del bibliometrix R-package. El estudio recuperó 70 publicaciones. Conclusiones: El análisis de los trabajos más citados reveló estrategias psicoeducativas, psicosociales y de yoga para el autocuidado. Entre los temas de tendencia de investigación, el más destacado fue el término Mindfulness, lo que muestra un aumento en las investigaciones que aplicaron esta intervención para reducir el Burnout. El número de estudios producidos es incipiente. Sin embargo, con la inclusión del Burnout en la Clasificación Internacional de Enfermedades, se espera un aumento de las publicaciones y del interés de las organizaciones en implementar estrategias para promover la salud y el bienestar entre los profesionales(AU)

Introduction: Burnout syndrome gains attention from researchers and professionals, particularly in the health area, due to the consequences and implications that it can lead to in professionals affected by the disease, which can compromise patient safety and the quality of offered care. Objective: To characterize the scientific production about strategies and interventions for reducing the risk of Burnout syndrome among nursing professionals. Methods: A bibliometric analysis was performed of publications until 2021 in the PubMed, Scopus and Web of Science databases. The analyzes were developed with the support of the bibliometrix R-package. The study recovered 70 publications. Conclusions: The analysis of the most cited works revealed psychoeducational, psychosocial and yoga strategies for self-care. Among the research trend topics, the most prominent was the term mindfulness, a fact showing an increase in research that applied this intervention to reduce burnout. The number of studies produced is incipient. However, with the inclusion of burnout within the International Classification of Diseases, an increase is expected in the number of publications, as well as in the interest of organizations in implementing strategies to promote health and well-being among professionals(AU)

Asociación entre comportamientos ofensivos y riesgo de burnout y depresión en trabajadores de la salud / Association between offensive behaviors and burnout and depression risks in health workers / Associação entre comportamentos ofensivos e risco de burnout e de depressão em trabalhadores de saúde

Objetivo: evaluar la incidencia de conductas ofensivas en el trabajo, las características y la asociación con el sexo, el estrés, el burnout y la depresión en trabajadores de la salud. Método: estudio transversal, descriptivo, cuantitativo, realizado con 125 trabajadores del Sistema Único de Salud brasileño. Los datos fueron recolectados entre junio de 2021 y abril de 2022, por medio de tres cuestionarios autoadministrados que evalúan características personales y ocupacionales; comportamientos ofensivos, estrés y burnout y síntomas de depresión. Se aplicó estadística descriptiva, prueba de asociación chi-cuadrado y análisis de regresión logística Resultados: el 44% de la muestra declararon 83 conductas y las amenazas de violencia fueron las más frecuentes (26%). Técnicos/auxiliares de enfermería, enfermeros y médicos fueron los profesionales más expuestos. El principal agresor fue el paciente; excepto en el caso del bullying, que fue perpetrado por los compañeros de trabajo (48%). Hubo asociación entre conductas ofensivas y burnout (OR: 4,73; IC 95%: 1,29-17,3; p=0,02) y entre conductas ofensivas y síntomas de depresión (OR: 1,05; IC 95%: 1,01-1,10; p=0,02). Conclusión: la práctica de conductas ofensivas en el trabajo en salud es frecuente y característica; el burnout y los síntomas de depresión aumentaron, respectivamente, 4,73 y 1,05 veces las posibilidades de que el trabajador sufriera esas conductas ofensivas en el ambiente de trabajo.

Objective: to evaluate the occurrence of offensive behaviors at work, their characteristics and association with sex, stress, burnout and depression in health workers. Method: a cross-sectional, descriptive and quantitative study carried out with 125 workers from the Brazilian Unified Health System. The data were collected from June 2021 to April 2022 through three self-applied questionnaires that assess personal and occupational characteristics; offensive behaviors, stress and burnout; and depressive symptoms. Descriptive statistics, the chi-square association test and logistic regression analysis were applied. Results: 44% of the sample reported 83 behaviors, with threats of violence as the most frequent ones (26%). Nursing technicians/assistants, nurses and physicians were the most exposed professionals. The main aggressors were the patients, except for bullying, which was perpetrated by co-workers (48%). There was an association between offensive behaviors and burnout (OR: 4.73; 95% CI: 1.29-17.3; p=0.02) and between offensive behaviors and depression symptoms (OR: 1.05; 95% CI: 1.01-1.10; p=0.02). Conclusion: the occurrence of offensive behaviors in health work is frequent and characteristic and burnout and depressive symptoms respectively increased 4.73 and 1.05 times the chances of workers suffering these offensive behaviors in the work environment.

Objetivo: avaliar a ocorrência de comportamentos ofensivos no trabalho, suas características e associação com o sexo, estresse, burnout e depressão em trabalhadores de saúde. Método: estudo transversal, descritivo, de natureza quantitativa, realizado com 125 trabalhadores do Sistema Único de Saúde brasileiro. Os dados foram coletados no período de junho de 2021 a abril de 2022, por meio de três questionários autoaplicáveis que avaliam as características pessoais e ocupacionais; comportamentos ofensivos, estresse e burnout e sintomas depressivos. Estatística descritiva, teste de associação Qui-Quadrado e análise de regressão logística foram aplicados. Resultados: 44% da amostra referiram 83 comportamentos, sendo as ameaças de violência mais frequentes (26%). Técnicos/auxiliares de enfermagem, enfermeiros e médicos foram os profissionais mais expostos. O principal agressor foi o paciente, exceto quanto ao bullying, perpetrado por colegas de trabalho (48%). Houve associação entre comportamentos ofensivos e burnout (OR: 4,73; IC 95%: 1,29-17,3; p=0,02) e entre comportamentos ofensivos e sintomas de depressão (OR: 1,05; IC 95%: 1,01-1,10; p=0,02). Conclusão: a ocorrência de comportamentos ofensivos no trabalho em saúde é frequente e característica; o burnout e os sintomas depressivos aumentaram, respectivamente, 4,73 e 1,05 vezes as chances de o trabalhador sofrer estes comportamentos ofensivos no ambiente de trabalho.

Burnout among Brazilian Dentists during the COVID-19 Pandemic: A Cross-sectional Study.

Background: This article identifies the factors associated with burnout among dentists in the state of Bahia, Brazil, during the COVID-19 pandemic. Methods: A cross-sectional study, conducted between November 2020 and February 2021, of 251 dentists, selected by snowball sampling. Sociodemographic, occupational, and epidemiological information was collected in an electronic form. Burnout was evaluated through the Maslach Burnout Inventory; anxiety through the Beck Anxiety Inventory; and quality of life through the WHOQol-BREF questionnaire. Multiple linear regression was used to identify factors associated with variations in levels of the three burnout dimensions. Results: The mean levels of the burnout dimensions were: Emotional Exhaustion: 28.9 ± 8.9 (SD); Depersonalization = 8.2 ± 6.3; and Personal Accomplishment: 28.0 ± 6.2. The proportion of professionals with high Emotional Exhaustion (≥ 30 cut-off score), high Depersonalization (≥ 12 cut-off score), and low Personal Accomplishment (≤ 33 cut-off score) were 43.4%, 26.3% and 81.3%, respectively. Burnout components were associated with high anxiety; lower levels of the physical, psychological, social relations, and environmental dimensions of quality of life; less time working as a dentist; increased alcohol consumption during the pandemic, feeling safe when using personal protective equipment, and support from work fellows. Conclusion: The dentists investigated showed moderate levels of Emotional Exhaustion and Depersonalization, and very low levels of Personal Accomplishment. The prevention and mitigation of burnout syndrome among dentists during a pandemic should consider several factors, such as quality of life, amount of time in the profession, use of personal protective equipment, support from fellow dentists, and alcohol consumption.

Effects of internet-based, psychosocial, and early medical interventions on professional burnout in health care workers: Systematic literature review and meta-analysis.

Background: The prevalence of professional burnout increased among healthcare workers during the coronavirus 2019 (COVID-19) pandemic, with negative effects on their mental health. Consequently, research interest in methods to decrease the prevalence of burnout and reduce the effects of burnout on healthcare workers has increased. Objective: This study was designed to evaluate the effects of Internet-based, psychosocial, and early medical interventions on professional burnout among healthcare workers. Methodology: This systematic review and meta-analysis involved 8004 articles identified from four databases: Cochrane, Web of Science, PubMed/Medline, and clinical trials. Results: Four articles were included in the systematic review, of which two could be meta-analyzed. The pooled effect of the group of interventions compared to control conditions was not statistically significant. Discussion: Evaluating therapeutic effectiveness requires more clinical trials that allow its evaluation. Although we did not find improvements in the three intervention categories, the methodological heterogeneity in each intervention and the need for a standardized intervention guide for managing and decreasing professional burnout, subject to the evaluation of its impact, are highlighted.

Síndrome de Burnout em professores durante a pandemia de COVID-19 / Burnout syndrome in teachers during the COVID-19 pandemic

Avaliar o acometimento da síndrome de Burnout e estratégias de coping relacionadas ao trabalho de professores em tempos de COVID-19. Trata- se de um estudo transversal, realizado com 114 professores de todos os níveis de ensino, residentes na capital Teresina, Piauí. A coleta foi realizada por meio de um formulário com informações sociodemográficas e profissionais, no período que compreendeu os meses de maio a julho de 2022, por meio da técnica survey. Os dados foram processados no software IBM® SPSS®, versão 26.0. A análise inferencial foi realizada por meio do teste de correlação de Pearson; a comparação das médias foi realizada por meio do teste ANOVA One-Way, com pós-teste de Tukey quando significativa. Foi verificada uma associação estatisticamente significativa entre o sexo dos professores e a estratégia de enfrentamento do tipo controle (p=0,001), de modo que professores do sexo masculino utilizaram a estratégia controle para enfrentamento dos estressores.

Evaluate the involvement of Burnout Syndrome and coping strategies related to the work of teachers in times of COVID-19. This is a cross-sectional study, carried out with 114 teachers of all levels of education, living in the capital Teresina, Piauí. The collection was carried out using a form with sociodemographic and professional information, in the period from May to July 2022, using the survey technique. Data were processed using IBM® SPSS® software, version 26.0. The inferential analysis was performed using the Pearson Correlation Test, the comparison of means was performed using the ANOVA One-Way Test, with Tukey's post-test when significant. A statistically significant association was verified between the teachers' gender and the control-type coping strategy (p=0.001), so that male teachers used the control strategy to cope with stressors.

Athletic Trainers' Psychosocial Experiences During the COVID-19 Pandemic: A Qualitative Research Study.

CONTEXT: Despite the many challenges posed by the COVID-19 pandemic, athletic programs have sought ways to persevere and deliver sport programming. This process has strained the psychosocial health of all sport stakeholders but especially those entrusted with promoting the health of participants and enforcing safety protocols. Athletic trainers (ATs) have been a major influence in striving to achieve these goals by expanding their typical roles to lead in promoting the safe delivery of sport programs. OBJECTIVE: To examine the psychosocial lived experiences of ATs as they practiced during the COVID-19 pandemic. DESIGN: Qualitative study. SETTING: National Collegiate Athletic Association Divisions I, II, and III. PATIENTS OR OTHER PARTICIPANTS: A total of 27 ATs practicing at the collegiate level (Divisions I, II, and III) who were actively involved in planning and implementing return-to-sport protocols during the COVID-19 pandemic. DATA COLLECTION AND ANALYSIS: Semi-structured interviews were conducted via Zoom. Inductive conventional content analysis identified emerging themes that characterized participants' narratives. Three members of the research team were involved in the analysis process and used field notes, continuous member checking, peer review, and multiple-researcher triangulation to establish data credibility and confirmability. RESULTS: Three higher-order themes related to ATs' psychosocial lived experiences emerged: (1) internalized experience, (2) interpersonal interactions, and (3) AT identity. Several subthemes were also identified to further organize elements that characterized or differentiated participants' lived experiences. CONCLUSIONS: Athletic trainers encountered significant challenges in maintaining their psychosocial health during the pandemic as they strived to assist others in this regard. Providing effective psychological and social support resources and strategies for ATs may not only allow them to better support themselves but may also enhance their ability to deliver professional services and promote psychosocial health among their athletes and other stakeholders in their respective sport systems in the future.

Tensiones éticas, causas y consecuencias del síndrome de burnout en el personal de salud en tiempos de la Covid-19: una revisión y análisis desde la bioética

esta es una revisión bibliométrica sobre el síndrome de burnout que afectó a profesionales de la salud en tiempos de la Covid-19, los conflictos éticos que lo preceden y suceden, y las estrategias para combatirlo. Metodología/ enfoque: se hizo una revisión bibliométrica en la que se identificaron, de manera sistemática, artículos de revisión, estudios transversales, metaanálisis y estudios cualitativos de todo el mundo. Una vez aplicados los filtros de selección, se analizaron los resultados con el método deliberativo de Diego Gracia. Resultados: se identificaron cuatro subtemas principales, incidencia del burnout durante la pandemia de la Covid-19, estresores éticos que favorecen al síndrome de burnout, consecuencias de este síndrome y estrategias para prevenirlo y combatirlo. Cada subtema se describe desde los ámbitos individuales, institucionales y sociales. Discusión/conclusiones: se argumenta con la teoría de Diego Gracia y se presenta una jerarquización de principios éticos implicados en el burnout, existen factores que favorecen la aparición de esta enfermedad profesional con un profundo calado bioético, en el que subyacen problemas de reconocimiento moral y económico, equidad, seguridad laboral, deber de cuidar, buena práctica médica y el bienestar del paciente, la familia y la sociedad en general. De igual, forma, las consecuencias del síndrome tienen repercusiones en los ámbitos sociales, institucionales e individuales, por lo que las intervenciones para su prevención y atención deben de igual forma tener un enfoque pluralista y diverso desde lo macro, meso y micro. En este sentido, es necesario fortalecer las estrategias de investigación y educación, para comprender, explicar y abordar el fenómeno de una forma integral.

this is a bibliometric review of the burnout syndrome that affected health professionals during Covid-19, the ethical conflicts that precede and follow it, and the strategies to combat it. Methodology/approach: a bibliometric review was carried out in which review articles, cross-sectional studies, meta-analyses, and qualitative studies from all over the world were systematically identified. Once the selection filters were applied, the results were analyzed using Diego Gracia's deliberative method. Results: four main subthemes were identified: incidence of burnout during the Covid-19 pandemic, ethical stressors that favor burnout syndrome, consequences of this syndrome, and strategies to prevent and combat it. Each subtopic is described from the individual, institutional, and societal levels. Discussion/conclusions: it is argued with Diego Gracia's theory, and a hierarchy of ethical principles involved in burnout is presented; some factors favor the appearance of this professional disease with a deep bioethical significance, in which problems of moral and economic recognition, equity, job security, the duty of care, good medical practice and the welfare of the patient, the family and society in general underlie. Similarly, the consequences of the syndrome have repercussions in the social, institutional, and individual spheres, so interventions for its prevention and care must also have a pluralistic and diverse approach from the macro, meso, and micro levels. In this sense, it is necessary to strengthen research and education strategies to understand, explain, and comprehensively address the phenomenon.

esta é uma revisão bibliométrica sobre a síndrome de burnout que afetou profissionais da saúde em tempos da covid-19, os conflitos éticos que a precedem e sucedem, e as estratégias para combatê-la. Metodologia/abordagem: é feita uma revisão bibliométrica na qual foram identificados, de maneira sistemática, artigos de revisão, estudos transversais, metanálise e estudos qualitativos de todo o mundo. Uma vez aplicados os filtros de seleção, foram analisados os resultados com o método deliberativo de Diego Gracia. Resultados: foram identificados quatro subtemas principais: incidência do burnout durante a pandemia da covid-19, estressores éticos que favorecem a síndrome de burnout, consequências dessa síndrome e estratégias para preveni-lo e combatê-lo. Cada subtema é descrito a partir dos âmbitos individuais, institucionais e sociais. Discussão/conclusões: é argumentada com a teoria de Diego Gracia e é apresentada uma hierarquização de princípios éticos implicados no burnout; existem fatores que favorecem o surgimento dessa doença profissional com um profundo silêncio bioético, no qual subjazem problemas de reconhecimento moral e econômico, equidade, segurança profissional, dever de cuidar, boa prática médica e bem-estar do paciente, da família e da sociedade em geral. Além disso, as consequências da síndrome têm repercussões nos âmbitos sociais, institucionais e individuais, razão pela qual as intervenções para sua prevenção e atenção devem de igual forma ter uma abordagem pluralista e diverso a partir do macro, meso e micro. Nesse sentido, é necessário fortalecer as estratégias de pesquisa e educação, para compreender, explicar e abordar o fenômeno de uma forma integral.

Prevalence of symptoms of burnout syndrome in primary health care professionals.

Introduction: Burnout syndrome results from a response to chronic work stress and is responsible for causing symptoms related to three dimensions: emotional exhaustion, reflecting work overload; depersonalization, characterized by professional detachment and cynicism; and reduced professional accomplishment, related to low productivity at work. Burnout is often associated with jobs that require professionals to have direct contact with users, such as health professionals. Primary Health Care is the assistance level that greatest contact with the community and requires teamwork, thus exposing workers to potential psychosocial stressors. Objectives: To identify the prevalence of symptoms of burnout syndrome among Primary Health Care professionals in Toledo, state of Paraná, Brazil. Methods: This was a descriptive, quantitative, cross-sectional study. A sociodemographic questionnaire and the Maslach Burnout Inventory, Human Services Survey, were used to assess the outcomes. Results: The prevalence of high risk for the development of burnout syndrome was 10.6%, and, when dimensions were evaluated separately, it was found that 29.8, 52.1 and 22.3% of participants showed a high level of symptoms in the dimensions emotional exhaustion, reduced professional accomplishment, and depersonalization, respectively. Previous use of psychiatric medication due to another condition had a significant correlation with high risk for burnout. Conclusions: The results of this research corroborated other similar studies, contributing to knowledge on the subject in a region of the state of Paraná where there was still no research on the syndrome.

Introdução: A síndrome de burnout é decorrente de uma resposta ao estresse laboral crônico, responsável por gerar sintomas contidos em três dimensões: exaustão emocional, refletindo a sobrecarga do trabalho; despersonalização, caracterizada pelo distanciamento profissional e cinismo; e baixa realização profissional, relacionada à baixa produtividade do trabalhador. Frequentemente, o burnout está associado a cargos que exigem do profissional contato direto com os usuários, como os profissionais de saúde. A Atenção Primária em Saúde é o nível assistencial de maior contato com a comunidade e requer trabalho em equipe, expondo o trabalhador a potenciais estressores psicossociais. Objetivos: Este estudo objetivou identificar a prevalência dos sintomas da síndrome de burnout nos profissionais de saúde da Atenção Primária em Saúde do município de Toledo, estado do Paraná. Métodos: Tratou-se de um estudo descritivo de delineamento transversal, com análise quantitativa. Um questionário sociodemográfico e o Maslach Burnout Inventory, versão Human Services Survey, foram usados para avaliar o desfecho. Resultados: A prevalência de alto risco para o desenvolvimento da síndrome de burnout foi de 10,6%, e as dimensões, quando avaliadas separadamente, demonstraram que 29,8, 52,1 e 22,3% dos participantes obtiveram alto nível de sintomas nas dimensões exaustão emocional, baixa realização profissional e despersonalização, respectivamente. O uso prévio de medicação psiquiátrica por outra afecção teve correlação significativa com o alto risco da síndrome. Conclusões: Os resultados desta pesquisa corroboraram outros estudos semelhantes, contribuindo para o conhecimento sobre o assunto em uma região do Paraná onde ainda não havia pesquisas sobre a síndrome.

Burnout syndrome and minor mental disorders in public employees.

Introduction: The context of transformations the society has been going through, especially considering economic, political, and technological issues, has added strains to modern work relations. Objectives: This study aimed to assess the existence and levels of burnout and the prevalence of minor mental disorders in a sample of public administrative employees of the Social Security Agency of Mato Grosso do Sul, in Brazil. Methods: This is a cross-sectional study that used the following research instruments: the Maslach Burnout Inventory, the Self-Reporting Questionnaire, and a sociodemographic and occupational questionnaire developed specifically for this study. Results: The results showed a prevalence of 23.7% (n = 9) of suspected cases of minor mental disorders and extremely increased levels (91.4%) of one of the dimensions of burnout: reduced professional efficacy. Employees with suspected minor mental disorders presented higher levels of emotional exhaustion and lower levels of personal accomplishment. Conclusions: In addition to the reported evidence, we expect our findings to contribute to the development of strategies of preventive intervention and health promotion in this occupational sector.

Introdução: O contexto de transformações pelas quais a sociedade vem passando, sobretudo relacionadas a questões econômicas, políticas e tecnológicas, tem tensionado, contemporaneamente, as relações de trabalho. Objetivos: O presente estudo objetivou avaliar a existência e os níveis da síndrome de burnout e a prevalência de transtornos mentais menores em uma amostra de servidores públicos administrativos da Agência de Previdência Social de Mato Grosso do Sul, no Brasil. Métodos: Foi realizado um estudo transversal, e os seguintes instrumentos de pesquisa foram utilizados: o Inventário de Burnout de Maslach, o Self-Report Questionnaire e um questionário sociodemográfico e ocupacional, desenvolvido especialmente para este estudo. Resultados: Os resultados evidenciaram haver prevalência de 23,7% (n = 9) como casos suspeitos de apresentarem transtornos mentais menores e níveis extremamente acentuados (91,4%) em uma dimensão do burnout: baixa realização profissional. Servidores considerados suspeitos de apresentarem transtornos mentais menores apontaram maiores níveis de exaustão emocional e menores níveis de realização pessoal. Conclusões: Para além das evidências relatadas, espera-se que os achados cooperem para o desenvolvimento de estratégias de intervenção preventivas e promotoras de saúde nesse segmento ocupacional.

Sindrome de burnout, atividade física e fatores ocupacionais que afetam os servidores púbicos de uma universidade federal do sul do Brasil / Burnout syndrome, physical activity and occupational factors that affect public servants at a federal university in southern Brazil / Síndrome de burnout, actividad física y factores ocupacionales que afectan a los servidores públicos de una universidad federal del sur de Brasil

O estudo buscou identificar a prevalência de Síndrome de Burnout (SB), bem como verificar se existe uma associação da SB com fatores ocupacionais e a prática de atividade física (AF) em servidores técnico-administrativos (STA) de uma universidade federal do sul do Brasil. A amostra foi composta por 203 STA. Foram coletados dados sociodemográficos, ocupacionais, nutricional, SB e prática de AF. A prevalência de SB entre os STA foi de 50%, sendo que a mesma esteve associada inversamente com a faixa etária (p=0,02) e com as atividades administrativas ou de escritório (p=0,008), ambas com proteção superior a 30%. Conclui-se que a prevalência de SB é elevada entre os STA e que políticas voltadas a redução dos fatores que levam a SB entre STA devem ser criadas e implementadas pela instituição, auxiliando na redução do adoecimento (AU).

The study sought to identify the prevalence of Burnout Syndrome (BS), as well as to verify if there is an association of BS with occupational factors and the practice of physical activity (PA) in technical-administrative servers (TAS) of a federal university in south of Brazil. The sample was composed by 203 STA. Sociodemographic, occupational, nutritional, SB and PA practice data were collected. The prevalence of BS among the TAS was 50%, being that it was inversely associated with age group (p=0.02) and with administrative or desk activities (p=0.008), both with protection greater than 30 %. It was concluded that the prevalence of BS is high among the TAS and policies aimed at reducing two factors that lead to BS among TAS should be created and implemented by the institution helping in the reduction of the treatment (AU).

El estudio buscó identificar la prevalencia del Síndrome de Burnout (SB), así como verificar si existe asociación del SB con actores ocupacionales y la práctica de actividad física (AF) en servidores técnico-administrativos (STA) de una universidad federal en el sur de Brasil. La muestra fue compuesta por 203 STA. Fueron colectados datos sociodemográficos, ocupacionales, nutricional, SB y práctica de AF. La prevalencia de SB entre os STA foi de 50%, siendo que la misma estuvo asociada inversamente com el grupo de edad (p=0,02) y com las actividades administrativas o- de oficina (p=0,008), ambas con protección superior a 30 % Se concluyo que la prevalencia de SB es elevada entre los STA y políticas específicas de disminución de los factores que llevam a SB entre STA deven ser creadas y aplicadas por la institución auxiliando en la disminución de dolencias (AU).

Sindrome de burnout, atividade física e fatores ocupacionais que afetam os servidores púbicos de uma universidade federal do sul do Brasil / Burnout syndrome, physical activity and occupational factors that affect public servants at a federal university in southern Brazil / Síndrome de burnout, actividad física y factores ocupacionales que afectan a los servidores públicos de una universidad federal del sur de Brasil

O estudo buscou identificar a prevalência de Síndrome de Burnout (SB), bem como verificar se existe uma associação da SB com fatores ocupacionais e a prática de atividade física (AF) em servidores técnico-administrativos (STA) de uma universidade federal do sul do Brasil. A amostra foi composta por 203 STA. Foram coletados dados sociodemográficos, ocupacionais, nutricional, SB e prática de AF. A prevalência de SB entre os STA foi de 50%, sendo que a mesma esteve associada inversamente com a faixa etária (p=0,02) e com as atividades administrativas ou de escritório (p=0,008), ambas com proteção superior a 30%. Conclui-se que a prevalência de SB é elevada entre os STA e que políticas voltadas a redução dos fatores que levam a SB entre STA devem ser criadas e implementadas pela instituição, auxiliando na redução do adoecimento.

The study sought to identify the prevalence of Burnout Syndrome (BS), as well as to verify if there is an association of BS with occupational factors and the practice of physical activity (PA) in technical-administrative servers (TAS) of a federal university in south of Brazil. The sample was composed by 203 STA. Sociodemographic, occupational, nutritional, SB and PA practice data were collected. The prevalence of BS among the TAS was 50%, being that it was inversely associated with age group (p=0.02) and with administrative or desk activities (p=0.008), both with protection greater than 30 %. It was concluded that the prevalence of BS is high among the TAS and policies aimed at reducing two factors that lead to BS among TAS should be created and implemented by the institution helping in the reduction of the treatment.

El estudio buscó identificar la prevalencia del Síndrome de Burnout (SB), así como verificar si existe asociación del SB con factores ocupacionales y la práctica de actividad física (AF) en servidores técnico-administrativos (STA) de una universidad federal en el sur de Brasil. La muestra fue compuesta por 203 STA. Fueron colectados datos sociodemográficos, ocupacionales, nutricional, SB y práctica de AF. La prevalencia de SB entre os STA foi de 50%, siendo que la misma estuvo asociada inversamente com el grupo de edad (p=0,02) y com las actividades administrativas o- de oficina (p=0,008), ambas con protección superior a 30 % Se concluyo que la prevalencia de SB es elevada entre los STA y políticas específicas de disminución de los factores que llevam a SB entre STA deven ser creadas y aplicadas por la institución auxiliando en la disminución de dolencias.

Ambiente de prática profissional e Burnout em instituições hospitalares no contexto da pandemia da COVID-19 / Professional practice environment and Burnout in hospital institutions in the context of the COVID-19 pandemic

O ambiente de trabalho interfere na qualidade e na segurança do cuidado fornecido, bem como situações e transformações no mundo do trabalho são precursoras do burnout, afetando a qualidade do serviço e o bem-estar geral dos profissionais de saúde, especialmente durante a pandemia da COVID-19. Esse estudo buscou analisar o ambiente da prática profissional, e os níveis de Burnout percebido pelos enfermeiros e explorar a associação entre o ambiente de prática profissional e a Síndrome de Burnout (SB) de instituições hospitalares no contexto pandêmico. Trata-se de um estudo observacional, analítico, transversal, realizado nas unidades de internação clínicas e cirúrgicas de uma instituição hospitalar de grande porte, a população constituída por 187 enfermeiros assistenciais, na maioria mulheres (80,6%). Utilizou-se questionários autoaplicáveis e as variáveis de interesse foram mensuradas pelos instrumentos, Practice Environment Scale (PES) - Versão brasileira, e pelo Inventário de Burnout de Copenhagen (Copenhagen Burnout Inventory - Brazilian version- CBI-Br), características demográficas foram coletadas. Verificou-se que a instituição hospitalar estudada é um local de trabalho misto, pontuando o PES em 2,5 em duas subescalas. O valor médio do total das escalas CBI-Br foi ligeiramente inferior ao ponto médio (50), indicando que os enfermeiros não experienciam o Burnout, sendo limítrofe (47,9). Houve associação significativa na análise bivariada entre as subescalas da PES, e as variáveis sexo com o teste de associação pelo x2, sendo a participação dos enfermeiros na discussão dos assuntos hospitalares (p=0,017), fundamentos de enfermagem voltados para a qualidade do cuidado (p=0,008), adequação da equipe e de recursos (p=0,035), habilidade, liderança e suporte dos coordenadores (p=0,022). Para o instrumento o CBI e o sexo utilizando o mesmo teste de associação indicou diferença significativa, em todas as subescalas Burnout Pessoal (BP) (p<0,001), Burnout relacionado ao Trabalho (BT) (p=0,001), Burnout relacionado ao Colega (BC) (p=0,031). O teste Mann-Whitney indicou associação significativa entre o tempo de experiencia na instituição para as subescalas BC (p=0,031). Houve ainda associação significativa entre todas as subescalas do PES e do CBI por meio do teste de associação pelo x2. Ambientes considerados não favoráveis para a prática profissional, independente da subescala da PES, apresentaram quantitativo maior de profissionais que experienciavam o BT e o BP, menor BC nos ambientes considerados favoráveis. Para estatística inferencial, foi utilizado o teste de correlação de Spearman, que indicou correlação significativa e negativa entre as cinco subescalas do PES, e os três domínios do CBI-Br (p < 0,001 em todos os casos), logo quanto maior participação dos enfermeiros nos assuntos hospitalares, maior o uso de fundamentos de enfermagem para a qualidade do atendimento, melhor a capacidade dos gerentes de enfermagem, liderar e apoiar os enfermeiros e equipe, quanto mais adequado forem os recursos e melhores as relações entre enfermeiros e médicos, ocorre redução dos níveis de Burnout em relação ao trabalho, colegas e pessoal. Constatou-se assim que o ambiente de trabalho do enfermeiro está associado a presença do Burnout e que medidas que aprimorem o ambiente de trabalho das instituições podem suportar e garantir o bem-estar da enfermagem nas instituições de saúde.

The work environment has an impact on the quality and safety of provided care. Additionally, changes and developments in the world of work act as precursors of burnout, affecting the quality of service and the overall well-being of healthcare professionals, particularly during the COVID-19 pandemic. This study aimed to assess the professional practice environment and levels of perceived Burnout among nurses, as well as explore the relationship between the professional practice environment and Burnout Syndrome (BS) within hospital institutions during the pandemic. This was an observational, analytical, cross-sectional study conducted in the clinical and surgical inpatient units of a large hospital institution. The population consisted of 187 clinical nurses, the majority being women (80.6%). Self-administered questionnaires were used, measuring the variables of interest through the Practice Environment Scale (PES) - Brazilian version, and the Copenhagen Burnout Inventory (Copenhagen Burnout Inventory - Brazilian version- CBI-Br). Demographic characteristics were also collected. It was found that the studied hospital institution is a mixed workplace, scoring 2.5 on the PES in two subscales. The mean value of the total CBI-Br scales was slightly below the midpoint (50), suggesting that nurses did not experience Burnout significantly, but were borderline (47.9). In the bivariate analysis, there was a significant association between the PES subscales and gender variables using the x2 association test. Participation of nurses in hospital discussions (p=0.017), focus on nursing fundamentals for quality care (p=0.008), adequacy of the team and resources (p=0.035), and leadership and support from coordinators (p=0.022) were all positively associated with the PES subscales. Regarding the CBI instrument, there was a significant difference in all subscales: Personal Burnout (BP) (p<0.001), Work-related Burnout (BT) (p=0.001), and Colleague-related Burnout (BC) (p=0.031), when analyzed in relation to gender using the association test. The Mann-Whitney test indicated a significant association between the length of experience at the institution and the BC subscales (p=0.031). Additionally, there was a significant association between all PES and CBI subscales using the x2 association test. Unfavorable work environments, regardless of the PES subscale, were linked to higher levels of Personal and Work-related Burnout, and less Colleague-related Burnout in favorable environments. The Spearman correlation test revealed a significant and negative correlation between all five PES subscales and the three domains of the CBI-Br (p < 0.001 in all cases). Thus, a greater nurse participation in hospital matters, focus on nursing fundamentals for quality care, effective leadership and support from nursing managers, adequate resources, and improved relationships between nurses and physicians were all associated with reduced Burnout levels related to work, colleagues, and staff. In conclusion, this study suggests that the work environment of nurses is linked to the presence of Burnout. Measures aimed at improving the work environment in institutions can support and ensure the well-being of nursing professionals in healthcare settings.

Estados afectivos emocionales y desgaste profesional durante la atención de pacientes con covid-19 / Emotional affective states and professional burnout during the care of patients with covid-19

Introducción: Los efectos directos de la Covid-19 fueron más allá del espectro de manifestaciones clínicas propias de la enfermedad, también se evidenciaron cambios en los estados afectivos de la persona. Objetivo: Determinar la relación de los estados afectivos emocionales con el desgaste profesional al atender a pacientes afectados por la Covid-19, en el Hospital Materno Infantil, durante el 2020. Métodos: Fue un estudio con enfoque cuantitativo, de tipo observacional, transversal, prospectivo y analítico. Se trabajó con una población censal de 180 trabajadores asistenciales, a quienes se les aplicó un inventario de desgaste profesional y una escala de ansiedad, estrés y depresión (DASS-21), las cuales fueron previamente validadas. En la contrastación de hipótesis se utilizó la prueba X2, con un p < 0,05. Resultados: Se halló relación entre el nivel de ansiedad y el nivel de desgaste laboral del personal de salud (X2 = 18,533; p = 0,000). Hubo relación entre el nivel de estrés y el nivel de desgaste laboral entre dichas variables (X2 = 12,808; p = 0,000). Finalmente, se halló relación entre el nivel de depresión y el desgaste laboral (X2 = 13,618; p = 0,000). Conclusiones: Se evidenció que el 5,6 % (10) presentaron estados afectivos alterados y desgaste laboral.

Introduction: The direct effects of Covid-19 went beyond the spectrum of clinical manifestations of the disease, changes in the affective states of the person were also evidenced. Objective: To determine the relationship between emotional affective states and professional burnout when attending patients affected by Covid-19, in Hospital Materno Infantil, during 2020. Methods: It was a quantitative, observational, cross-sectional, prospective, and analytical study. It worked with a census population of 180 healthcare workers, who were applied an inventory of professional burnout and a scale of anxiety, stress, and depression (DASS-21), which were previously validated.The X2 test was used for hypothesis testing, with a p < 0.05. Results: We found a relationship between the level of anxiety and the level of professional burnout of health personnel (X2 = 18.533; p = 0.000). There was a relationship between the level of stress and the level of professional burnout between these variables (X2 = 12.808; p = 0.000). Finally, we found a relationship between the level of depression and professional burnout (X2 = 13.618; p = 0.000). Conclusions: It was evident that 5.6% (10) presented altered affective states and professional burnout.

Ambiente de prática profissional e Burnout em instituições hospitalares no contexto da pandemia da COVID-19 / Professional practice environment and Burnout in hospital institutions in the context of the COVID-19 pandemic

O ambiente de trabalho interfere na qualidade e na segurança do cuidado fornecido, bem como situações e transformações no mundo do trabalho são precursoras do burnout, afetando a qualidade do serviço e o bem-estar geral dos profissionais de saúde, especialmente durante a pandemia da COVID-19. Esse estudo buscou analisar o ambiente da prática profissional, e os níveis de Burnout percebido pelos enfermeiros e explorar a associação entre o ambiente de prática profissional e a Síndrome de Burnout (SB) de instituições hospitalares no contexto pandêmico. Trata-se de um estudo observacional, analítico, transversal, realizado nas unidades de internação clínicas e cirúrgicas de uma instituição hospitalar de grande porte, a população constituída por 187 enfermeiros assistenciais, na maioria mulheres (80,6%). Utilizou-se questionários autoaplicáveis e as variáveis de interesse foram mensuradas pelos instrumentos, Practice Environment Scale (PES) - Versão brasileira, e pelo Inventário de Burnout de Copenhagen (Copenhagen Burnout Inventory - Brazilian version- CBI-Br), características demográficas foram coletadas. Verificou-se que a instituição hospitalar estudada é um local de trabalho misto, pontuando o PES em 2,5 em duas subescalas. O valor médio do total das escalas CBI-Br foi ligeiramente inferior ao ponto médio (50), indicando que os enfermeiros não experienciam o Burnout, sendo limítrofe (47,9). Houve associação significativa na análise bivariada entre as subescalas da PES, e as variáveis sexo com o teste de associação pelo x2, sendo a participação dos enfermeiros na discussão dos assuntos hospitalares (p=0,017), fundamentos de enfermagem voltados para a qualidade do cuidado (p=0,008), adequação da equipe e de recursos (p=0,035), habilidade, liderança e suporte dos coordenadores (p=0,022). Para o instrumento o CBI e o sexo utilizando o mesmo teste de associação indicou diferença significativa, em todas as subescalas Burnout Pessoal (BP) (p<0,001), Burnout relacionado ao Trabalho (BT) (p=0,001), Burnout relacionado ao Colega (BC) (p=0,031). O teste Mann-Whitney indicou associação significativa entre o tempo de experiencia na instituição para as subescalas BC (p=0,031). Houve ainda associação significativa entre todas as subescalas do PES e do CBI por meio do teste de associação pelo x2. Ambientes considerados não favoráveis para a prática profissional, independente da subescala da PES, apresentaram quantitativo maior de profissionais que experienciavam o BT e o BP, menor BC nos ambientes considerados favoráveis. Para estatística inferencial, foi utilizado o teste de correlação de Spearman, que indicou correlação significativa e negativa entre as cinco subescalas do PES, e os três domínios do CBI-Br (p < 0,001 em todos os casos), logo quanto maior participação dos enfermeiros nos assuntos hospitalares, maior o uso de fundamentos de enfermagem para a qualidade do atendimento, melhor a capacidade dos gerentes de enfermagem, liderar e apoiar os enfermeiros e equipe, quanto mais adequado forem os recursos e melhores as relações entre enfermeiros e médicos, ocorre redução dos níveis de Burnout em relação ao trabalho, colegas e pessoal. Constatou-se assim que o ambiente de trabalho do enfermeiro está associado a presença do Burnout e que medidas que aprimorem o ambiente de trabalho das instituições podem suportar e garantir o bem-estar da enfermagem nas instituições de saúde.

The work environment has an impact on the quality and safety of provided care. Additionally, changes and developments in the world of work act as precursors of burnout, affecting the quality of service and the overall well-being of healthcare professionals, particularly during the COVID-19 pandemic. This study aimed to assess the professional practice environment and levels of perceived Burnout among nurses, as well as explore the relationship between the professional practice environment and Burnout Syndrome (BS) within hospital institutions during the pandemic. This was an observational, analytical, cross-sectional study conducted in the clinical and surgical inpatient units of a large hospital institution. The population consisted of 187 clinical nurses, the majority being women (80.6%). Self-administered questionnaires were used, measuring the variables of interest through the Practice Environment Scale (PES) - Brazilian version, and the Copenhagen Burnout Inventory (Copenhagen Burnout Inventory - Brazilian version- CBI-Br). Demographic characteristics were also collected. It was found that the studied hospital institution is a mixed workplace, scoring 2.5 on the PES in two subscales. The mean value of the total CBI-Br scales was slightly below the midpoint (50), suggesting that nurses did not experience Burnout significantly, but were borderline (47.9). In the bivariate analysis, there was a significant association between the PES subscales and gender variables using the x2 association test. Participation of nurses in hospital discussions (p=0.017), focus on nursing fundamentals for quality care (p=0.008), adequacy of the team and resources (p=0.035), and leadership and support from coordinators (p=0.022) were all positively associated with the PES subscales. Regarding the CBI instrument, there was a significant difference in all subscales: Personal Burnout (BP) (p<0.001), Work-related Burnout (BT) (p=0.001), and Colleague-related Burnout (BC) (p=0.031), when analyzed in relation to gender using the association test. The Mann-Whitney test indicated a significant association between the length of experience at the institution and the BC subscales (p=0.031). Additionally, there was a significant association between all PES and CBI subscales using the x2 association test. Unfavorable work environments, regardless of the PES subscale, were linked to higher levels of Personal and Work-related Burnout, and less Colleague-related Burnout in favorable environments. The Spearman correlation test revealed a significant and negative correlation between all five PES subscales and the three domains of the CBI-Br (p < 0.001 in all cases). Thus, a greater nurse participation in hospital matters, focus on nursing fundamentals for quality care, effective leadership and support from nursing managers, adequate resources, and improved relationships between nurses and physicians were all associated with reduced Burnout levels related to work, colleagues, and staff. In conclusion, this study suggests that the work environment of nurses is linked to the presence of Burnout. Measures aimed at improving the work environment in institutions can support and ensure the well-being of nursing professionals in healthcare settings.

Ambiente de prática profissional e Burnout em instituições hospitalares no contexto da pandemia da COVID-19 / Professional practice environment and Burnout in hospital institutions in the context of the COVID-19 pandemic

O ambiente de trabalho interfere na qualidade e na segurança do cuidado fornecido, bem como situações e transformações no mundo do trabalho são precursoras do burnout, afetando a qualidade do serviço e o bem-estar geral dos profissionais de saúde, especialmente durante a pandemia da COVID-19. Esse estudo buscou analisar o ambiente da prática profissional, e os níveis de Burnout percebido pelos enfermeiros e explorar a associação entre o ambiente de prática profissional e a Síndrome de Burnout (SB) de instituições hospitalares no contexto pandêmico. Trata-se de um estudo observacional, analítico, transversal, realizado nas unidades de internação clínicas e cirúrgicas de uma instituição hospitalar de grande porte, a população constituída por 187 enfermeiros assistenciais, na maioria mulheres (80,6%). Utilizou-se questionários autoaplicáveis e as variáveis de interesse foram mensuradas pelos instrumentos, Practice Environment Scale (PES) - Versão brasileira, e pelo Inventário de Burnout de Copenhagen (Copenhagen Burnout Inventory - Brazilian version- CBI-Br), características demográficas foram coletadas. Verificou-se que a instituição hospitalar estudada é um local de trabalho misto, pontuando o PES em 2,5 em duas subescalas. O valor médio do total das escalas CBI-Br foi ligeiramente inferior ao ponto médio (50), indicando que os enfermeiros não experienciam o Burnout, sendo limítrofe (47,9). Houve associação significativa na análise bivariada entre as subescalas da PES, e as variáveis sexo com o teste de associação pelo x2, sendo a participação dos enfermeiros na discussão dos assuntos hospitalares (p=0,017), fundamentos de enfermagem voltados para a qualidade do cuidado (p=0,008), adequação da equipe e de recursos (p=0,035), habilidade, liderança e suporte dos coordenadores (p=0,022). Para o instrumento o CBI e o sexo utilizando o mesmo teste de associação indicou diferença significativa, em todas as subescalas Burnout Pessoal (BP) (p<0,001), Burnout relacionado ao Trabalho (BT) (p=0,001), Burnout relacionado ao Colega (BC) (p=0,031). O teste Mann-Whitney indicou associação significativa entre o tempo de experiencia na instituição para as subescalas BC (p=0,031). Houve ainda associação significativa entre todas as subescalas do PES e do CBI por meio do teste de associação pelo x2. Ambientes considerados não favoráveis para a prática profissional, independente da subescala da PES, apresentaram quantitativo maior de profissionais que experienciavam o BT e o BP, menor BC nos ambientes considerados favoráveis. Para estatística inferencial, foi utilizado o teste de correlação de Spearman, que indicou correlação significativa e negativa entre as cinco subescalas do PES, e os três domínios do CBI-Br (p < 0,001 em todos os casos), logo quanto maior participação dos enfermeiros nos assuntos hospitalares, maior o uso de fundamentos de enfermagem para a qualidade do atendimento, melhor a capacidade dos gerentes de enfermagem, liderar e apoiar os enfermeiros e equipe, quanto mais adequado forem os recursos e melhores as relações entre enfermeiros e médicos, ocorre redução dos níveis de Burnout em relação ao trabalho, colegas e pessoal. Constatou-se assim que o ambiente de trabalho do enfermeiro está associado a presença do Burnout e que medidas que aprimorem o ambiente de trabalho das instituições podem suportar e garantir o bem-estar da enfermagem nas instituições de saúde.

The work environment has an impact on the quality and safety of provided care. Additionally, changes and developments in the world of work act as precursors of burnout, affecting the quality of service and the overall well-being of healthcare professionals, particularly during the COVID-19 pandemic. This study aimed to assess the professional practice environment and levels of perceived Burnout among nurses, as well as explore the relationship between the professional practice environment and Burnout Syndrome (BS) within hospital institutions during the pandemic. This was an observational, analytical, cross-sectional study conducted in the clinical and surgical inpatient units of a large hospital institution. The population consisted of 187 clinical nurses, the majority being women (80.6%). Self-administered questionnaires were used, measuring the variables of interest through the Practice Environment Scale (PES) - Brazilian version, and the Copenhagen Burnout Inventory (Copenhagen Burnout Inventory - Brazilian version- CBI-Br). Demographic characteristics were also collected. It was found that the studied hospital institution is a mixed workplace, scoring 2.5 on the PES in two subscales. The mean value of the total CBI-Br scales was slightly below the midpoint (50), suggesting that nurses did not experience Burnout significantly, but were borderline (47.9). In the bivariate analysis, there was a significant association between the PES subscales and gender variables using the x2 association test. Participation of nurses in hospital discussions (p=0.017), focus on nursing fundamentals for quality care (p=0.008), adequacy of the team and resources (p=0.035), and leadership and support from coordinators (p=0.022) were all positively associated with the PES subscales. Regarding the CBI instrument, there was a significant difference in all subscales: Personal Burnout (BP) (p<0.001), Work-related Burnout (BT) (p=0.001), and Colleague-related Burnout (BC) (p=0.031), when analyzed in relation to gender using the association test. The Mann-Whitney test indicated a significant association between the length of experience at the institution and the BC subscales (p=0.031). Additionally, there was a significant association between all PES and CBI subscales using the x2 association test. Unfavorable work environments, regardless of the PES subscale, were linked to higher levels of Personal and Work-related Burnout, and less Colleague-related Burnout in favorable environments. The Spearman correlation test revealed a significant and negative correlation between all five PES subscales and the three domains of the CBI-Br (p < 0.001 in all cases). Thus, a greater nurse participation in hospital matters, focus on nursing fundamentals for quality care, effective leadership and support from nursing managers, adequate resources, and improved relationships between nurses and physicians were all associated with reduced Burnout levels related to work, colleagues, and staff. In conclusion, this study suggests that the work environment of nurses is linked to the presence of Burnout. Measures aimed at improving the work environment in institutions can support and ensure the well-being of nursing professionals in healthcare settings.

O uso excessivo da Internet na saúde mental de estudantes universitários de enfermagem / Excessive use of the Internet on the mental health of nursing university students

O uso da internet cresce em 4% até 2023 e tornou-se uma ferramenta fundamental em nossa vida cotidiana, no entanto, seu uso excessivo pode contribuir para problemas de saúde mental, como ansiedade, depressão e esgotamento, especialmente em estudantes universitários de saúde. Este estudo teve como objetivo determinar o risco de ansiedade e esgotamento devido ao uso excessivo da internet em estudantes universitários do curso de enfermagem. A pesquisa teve uma abordagem quantitativa não experimental, com um design explicativo. O estudo contou com a participação de 337 estudantes de enfermagem da Universidad Privada San Carlos SAC de Puno, com uma idade média de 30,35 ± 9,274 anos; 15,70% (n=53) eram homens e 84,30% (n=284) eram mulheres. Os estudantes que usaram a Internet excessivamente por mais de quatro horas por dia tiveram um risco 3,160 vezes maior de desenvolver ansiedade (IC 95%: 1,519-6,577); 1,704 vezes maior de desenvolver esgotamento emocional (IC 95%: 0,925-3,215); 1,786 vezes maior de desenvolver distúrbios de despersonalização (IC 95%: 0,931-3,413) e 2,101 vezes maior de desenvolver a falta de realização pessoal em comparação com os estudantes que usam a internet por menos de três horas diárias. Os níveis de ansiedade estão positivamente associados ao esgotamento emocional (rho=0,765; p<0.001); despersonalização (rho=0,744; p<0.001); falta de realização pessoal (rho=0,631; p<0.001), o que indica que o uso excessivo da internet por estudantes universitários teve efeitos negativos prejudiciais para a saúde mental.

Internet use has grown by 4% by 2023 and has become a fundamental tool in our everyday lives, however, its excessive use can contribute to mental health problems such as anxiety, depression and burnout, especially in university health students. This study aimed to determine the risk of anxiety and burnout due to excessive internet use in university nursing students. The research had a non-experimental quantitative approach, with an explanatory design. The study had the participation of 337 nursing students from the Universidad Privada San Carlos SAC de Puno, with an average age of 30.35 ± 9.274 years; 15.70% (n=53) were men and 84.30% (n=284) were women. Students who used the internet excessively for more than four hours a day had a 3.160 times greater risk of developing anxiety (95% CI: 1.519-6.577); 1.704 times more likely to develop emotional exhaustion (95% CI: 0.925-3.215); 1.786 times more likely to develop depersonalization disorders (95% CI: 0.931-3.413) and 2.101 times more likely to develop a lack of personal fulfillment compared to students who use the internet for less than three hours a day. Anxiety levels are positively associated with emotional exhaustion (rho=0.765; p<0.001); depersonalization (rho=0.744; p<0.001); lack of personal fulfillment (rho=0.631; p<0.001), which indicates that excessive internet use by university students had harmful negative effects on mental health.

Allostatic load and physiological responses to work stress: an integrative review.

Assessing the allostatic load of workers in the context of COVID -19 is of vital importance to elucidate the physiological responses to social and work stress. This is an integrative review of the literature including seven established steps: 1) identification of the topic and the guiding question; 2) definition of MeSH terms and search equations; 3) search in databases following defined criteria; 4) data collection according to inclusion criteria; 5) evaluation of the studies included in the integrative review; 6) discussion of results; and 7) presentation of the review/synthesis of knowledge. Seventeen studies were included, of which 15 were cross-sectional observational studies and two were longitudinal studies. Heterogeneity in the measurement of allostatic load was the common denominator of the studies. Allostatic load is mentioned in all of them as a parameter of measurement, but they measured it diferently; therefore, the relationship between burnout, work environment, and allostatic load, although positive in most studies, was highly variable. In conclusion, it is necessary to conduct studies that combine both biological markers and clinimetric tests, trying to standardize the batery of tests of allostatic load, so that the correlation with work stress is significant and reliable. Similarly, allostatic load requires a systemic and interdisciplinary approach, since this condition puts chronic stress on all organs and physiological compensation mechanisms. Therefore, the allostatic load invites to a comprehensive care of people, considering the work, social, psychological, and biological domains.

Valorar la carga alostática de los trabajadores en el contexto de la Covid-19 es de vital importancia para dilucidar las respuestas fisiológicas al estrés social y laboral. Esta es una revisión integrativa de la literatura, de siete pasos establecidos: 1) identificación del tema y de la pregunta orientadora; 2) definición de términos MeSH y ecuaciones de búsqueda; 3) búsqueda en bases de datos siguiendo criterios definidos; 4) recopilación de datos acorde a criterios de inclusión; 5) evaluación de los estudios incluidos en la revisión integradora; 6) discusión de resultados; 7) presentación de la revisión/síntesis de conocimientos. Se incluyeron 17 estudios, de los cuales 15 fueron estudios observacionales transversales y dos estudios longitudinales. La heterogeneidad en la medición de la carga alostática fue el común denominador de los estudios. En todos se menciona la carga alostática como parámetro de medición. Sin embargo, todos la midieron de formas diferentes, por lo que la relación entre desgaste ocupacional y carga alostática, aunque positiva en la mayoría de los estudios, fue muy variable. Se concluye que es necesario realizar estudios que combinen tanto los marcadores biológicos como las pruebas clinimétricas, tratando de estandarizar la batería de exámenes de la carga alostática, para que la correlación con estrés laboral sea significativa y confable. De igual forma, la carga alostática requiere un abordaje sistémico e interdisciplinario, dado que se ponen en tensión crónica todos los órganos y mecanismos de compensación fisiológicos. Por lo tanto, la carga alostática hace una invitación a un cuidado integral de las personas, desde los ámbitos laboral, social, psicológico y biológico.