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[The professional burnout syndrome in resident physicians in hospital medical specialties]. / Síndrome de agotamiento profesional en médicos residentes de especialidades médicas hospitalarias.

BACKGROUND: To evaluate the existence of burnout among medicine residents of hospitality specialties, and the relationship with sundry factors. METHODS: A transversal study was made among internal medicine residents of La Fe Hospital with more than one year in their job. For this purpose two questionnaires were used: a) the Maslach Burnout Inventory and a general questionnaire about social, demographic, residency, laborer and economic factors. RESULTS: Fifty-six (81.1%) internal medicine residents participated. Comparing with Spanish sample established with medical specialists, we found 7.1% or the residents with high scores on emotional exhaustion, while 17.8% scored high on depersonalization and 23.2% scored low on personal accomplishment. But the levels were lower on residents sample than in the medical specialties sample. Factors associated with burnout were social and demographic compass (be single), like on residency compass (the chosen specialty was not the first option), like properly laborer (low laborer satisfaction, to feel low recognition from boss or patients). We didn't find relationship with economic factors. CONCLUSIONS: There are hospitality internal medicine residents who suffer burnout and exist relationship with social, demographic, residency and laborer factors.

Síndrome de agotamiento profesional en médicos residentes de especialidades médicas hospitalarias / The professional burnout syndrome in resident physicians in hospital medical specialties

Fundamento: Valorar si existe síndrome de agotamiento profesional entre médicos residentes de especialidades médicas hospitalarias, y su relación con diversos factores. Sujetos y Métodos: Se realizó un estudio transversal con médicos residentes de especialidades médicas con más de un año de trabajo en el Hospital Universitari La Fe de Valencia. Para ello se utilizaron dos cuestionarios: a) el Maslach Burnout Inventory y b) un cuestionario general donde se planteaban preguntas sobre datos sociodemográficos, datos relacionados con la residencia y factores laborales y económicos. Resultados: Participaron 56 MIR (81,1 porciento). Comparando con una muestra española de médicos especialistas encontramos el 7,1 porciento de MIR en categoría alta de cansancio emocional, en categoría alta de despersonalización se encontraban el 17,8 porciento y el 23,2 porciento en baja categoría de autorrealización personal. Pero tras realizar un estudio de homogeneidad de medias obtuvimos unos niveles de agotamiento profesional inferiores en el grupo de residentes. En cuanto a los factores asociados con cansancio emocional, despersonalización y autorrealización los encontramos tanto en el ámbito sociodemográfico (estar soltero), como en el relacionado con la residencia (cuando la especialidad elegida era una de las segundas opciones), como en el propiamente laboral (poca satisfacción laboral, sentirse poco reconocido por los jefes o por los pacientes etc). No encontramos relación con factores económicos. Conclusiones: Existen MIR de especialidades médicas hospitalarias que sufren síndrome de agotamiento profesional y este se relaciona con factores sociodemográficos, factores relacionados con la residencia y factores laborales (AU)

[Organizational models for the hematology areas of the district hospitals of Catalonia]. / Modelos de organización en las áreas de hematología de los hospitales comarcales de Catalunya.

PURPOSE: The haematological assistance in Catalonia is based upon the district hospitals, in the first step, and the stage III hospitals located usually in higher population nuclei, in the second step. The purpose of this work was to analyse the resources of the "primary haematological assistance" network provided by the district hospitals, to evaluate them and to propose a model for their organisation. MATERIAL AND METHODS: An enquiry was carried out to all members of the Grup de Treball d'Hospitals Comarcals de Catalunya (Catalonia's District Hospitals Task Force). The evaluable data included demographic figures of the population assisted, personnel of each haematological area, organising structure, clinical activity, cytomorphology, blood banks, laboratories and continuous formation activities. RESULTS: The enquiry was answered by 15 of the 21 district hospitals (71.4%) with haematologists in Catalonia. The population assisted in those hospitals is 2,100,000 (ranging between 55,000 an 450,000). All centres are integrated in the National Health network. Eleven of the hospitals analysed have only one haematologist (73.3%). If his dedication is 100% of the time, this would represent a doctor for 105,000 people. The time devoted to work is 690 hours a week for all the population, with a mean of 3,043. Four patients assisted per hour. The total number of hospital beds is 3,353 (50-450), with a mean number of 1 haematologist for every 167.6 beds. The number of patients hospitalized due to blood diseases ranges between 3 and 13 per month. Six of the 15 centres are adjunct to the outpatient clinic. Two centres have a blood bank and 7 have developed an autotransfusion programme. All the centres but one perform oral anticoagulant treatment follow-up, the number of patients assisted ranging from 20 to 210 per week. None of the hospitals has a separate Haematology Service; in most of them haematology is structurally and functionally dependent from Laboratories and in some there is a mixed Laboratory/Internal Medicine functional organisation, depending of the Medical Direction. No haematologist is ever on call specifically for his specialty. Continuous formation activities are carried out in 9 of the 15 centres (60%). COMMENT: Several measures are proposed to improve the haematological assistance, acting on different levels: continuous formation, patient flows and circuits, resident doctors training, anticoagulant treatment network, organisation models, credit cards from the Spanish Association of Haematology.