Síndrome de desgaste profesional en los médicos de atención primaria de Ávila / Burnout syndrome in general practitioners of Avila

Objetivo. Analizar el nivel de desgaste profesional o burnout que presentaban los médicos de atención primaria de Ávila y la influencia de factores sociales, laborales y de salud en la aparición del mismo. Material y métodos. Se realizó un estudio epidemiológico transversal y descriptivo dirigido a todo el personal médico de atención primaria de Ávila durante el primer semestre de 2011, mediante 2 cuestionarios: el Maslach Burnout Inventory y otro de variables sociodemográficas, laborales y de salud. Resultados. Se obtuvo una tasa de respuesta del 51,8%. La edad media fue de 48,55 ± 8,16. El 52% eran varones, casados el 77%, con plaza en propiedad el 45%, trabajando en centros rurales el 78% y realizando guardias más consulta el 82%. La prevalencia en nuestro estudio resultó ser baja, 16% en su grado grave. Constatamos una alta prevalencia de la enfermedad, 68%, en su grado grave o moderado/grave. Estar casado (p = 0,012), no hacer guardias (p < 0,0001), trabajar en zona rural (p = 0,008) y ser médico de área (p = 0,03) predispone a padecer burnout en grado grave o moderado/grave. Conclusiones. Encontramos un nivel moderado de burnout. Al contrario de lo que pensaban muchos facultativos, la prevalencia de la enfermedad en su forma grave fue baja, pero sí fue elevada al considerar en conjunto los grados grave y moderado/grave. Por tanto, se deberían extender medidas para reducir el estrés laboral de los médicos con el fin de una mejor práctica laboral y eficiencia profesional (AU)

Objective. To determine the level of burnout in general practitioners of Avila and the influence of social, occupational and health factors. Material and methods. A descriptive cross-sectional epidemiological study was conducted and aimed at all Primary Care medical staff of Avila during the first half of 2011, using two questionnaires: the Maslach Burnout Inventory and other sociodemographic, health and occupational variables. Results. A response rate of 51.8% was obtained. The mean age was 48.55 ± 8.16, and 52% were male, 77% married, 45% with tenure, 78% worked in rural centres, and, 82% performed out of hours home visits plus clinics. The prevalence of severe burn out was low (16%) in our study was low. A high prevalence (68%) of moderate/severe level of the condition was found. Being married (P = .012), do not guards (P < .0001), working in rural areas (P = .008), and to be an area doctor (p=.03), predisposes to suffer burnout in severe or moderate/severe burnout. Conclusions. A moderate level of burnout was found. Contrary to what many doctors thought, the prevalence of the condition in its severe form was low, but was high when taking the severe and moderate/severe forms together. Therefore, measures should be extended to reduce occupational stress of doctors, in order to improve working practices and professional efficiency (AU)

[Burnout syndrome in general practitioners of Avila]. / Síndrome de desgaste profesional en los médicos de atención primaria de Ávila.

OBJECTIVE: To determine the level of burnout in general practitioners of Avila and the influence of social, occupational and health factors. MATERIAL AND METHODS: A descriptive cross-sectional epidemiological study was conducted and aimed at all Primary Care medical staff of Avila during the first half of 2011, using two questionnaires: the Maslach Burnout Inventory and other sociodemographic, health and occupational variables. RESULTS: A response rate of 51.8% was obtained. The mean age was 48.55±8.16, and 52% were male, 77% married, 45% with tenure, 78% worked in rural centres, and, 82% performed out of hours home visits plus clinics. The prevalence of severe burn out was low (16%) in our study was low. A high prevalence (68%) of moderate/severe level of the condition was found. Being married (P=.012), do not guards (P<.0001), working in rural areas (P=.008), and to be an area doctor (p=.03), predisposes to suffer burnout in severe or moderate/severe burnout. CONCLUSIONS: A moderate level of burnout was found. Contrary to what many doctors thought, the prevalence of the condition in its severe form was low, but was high when taking the severe and moderate/severe forms together. Therefore, measures should be extended to reduce occupational stress of doctors, in order to improve working practices and professional efficiency.

Autopercepción de salud en ancianos no institucionalizados / Self-perception of health of the non-institutionalised elderly

Objetivo. Evaluar la autopercepción de salud (AS) de los mayores de 65 años no institucionalizados. Relacionar dicha AS con edad, sexo, nivel socioeconómico (NSE) y utilización de servicios sanitarios (USS).Diseño. Descriptivo transversal sobre muestra estratificada por edad y sexo. Emplazamiento. Ciudad de Ávila. Participantes. Un total de 425 entrevistas representativas de la población censal de mayores de 65 años utilizando el Cuestionario de Salud SF-36 y un cuestionario complementario que recoge información sobre NSE y USS. Resultados principales. El índice de bienestar QWB es de 0,67 (0,69 varones; 0,65 mujeres), decreciendo con la edad (0,70 en 84 años). Las mejores puntuaciones en el cuestionario se dan en las dimensiones función social (81,1) y rol emocional (79,8) y las peores en salud general (51,9) y vitalidad (58,5), con mejores valores siempre en varones (p < 0,05 excepto en función física [p = 0,05] y salud general [p = 0,47]). A mayor edad siguen peores puntuaciones, afectándose más función física (-50,6 por ciento) y rol físico (-45,7 por ciento) y menos salud mental (-12,1 por ciento), salud general (-16,1 por ciento) y rol emocional (-17,8 por ciento). Los varones perciben más estable su salud que las mujeres (63,7 por ciento frente a 44,6 por ciento; p < 0,001). Hay mejor AS cuanto mayor es el NSE (p < 0,05 en todas las dimensiones), mayor es el nivel de estudios (p < 0,05 excepto en función social) y menor es la USS (p < 0,05 excepto en salud mental-ingreso hospitalario). Conclusiones. El índice de bienestar de nuestros ancianos es comparable al de otras poblaciones. Los varones presentan mejor AS que las mujeres y perciben que su salud se mantiene estable en mayor proporción. La AS empeora con la edad significativamente. Un mayor NSE y una menor USS se relacionan con una mejor AS (AU)

[Indicators of drug provision and cost in the Avila health sector (1995)]. / Indicadores de la prestación farmacéutica y coste en el Area de Salud de Avila (1995).

OBJECTIVES: To analyse the prescription patterns in rural, urban and semi-urban Primary Care teams (PCT) and to study the variables which are correlated with the pharmaceutical cost, with special reference to medicines of low therapeutic value (LTV). DESIGN: Descriptive, crossover study. SETTING: Avila Health Area, 1995. PATIENTS AND OTHER PARTICIPANTS: Prescription profiles of 199 Primary Care doctors from Avila's 21 Health Districts, using the number of holders of the Individual Health Card (IHC) to determine population size. MAIN RESULTS: There were notable differences in prescription patterns between urban, rural and semi-urban PCTs, with the "Drug cost per inhabitant per year" higher in rural than in urban PCTs (24,082 pesetas vs. 14,804), and the "Cost per prescription" less (1,417 vs. 1,577). In the simple regression analysis, there was a significant correlation between the variables "Number of LTV packages per inhabitant per year" and "Drug cost per inhabitant per year" (r = 0.68, 0.51 and 0.64 for urban, semi-urban and rural PCTs); between "Number of LTV packages per inhabitant per year" and "Number of prescriptions per inhabitant per year" (r = 0.79, 0.80 and 0.82); between "Drug cost per inhabitant per year" and "Number of prescriptions per inhabitant per year" (r = 0.81, 0.85 and 0.88); between "Number of IHCs per doctors" and "Drug cost per inhabitant per year" (r = -0.62, -0.57 and -0.31) and between "Number of IHCs per doctor" and "Number of prescriptions per inhabitant per year" (r = -0.51, -0.62 and -0.36). In the multiple regression analysis, if "Drug cost per inhabitant per year" was used as a dependent variable, the variable "Number of LTV packages per inhabitant per year" entered the model in urban and rural PCTs (Adjusted r2 = 0.55 and 0.60). If "Number of prescriptions per inhabitant per year" was used as dependent variable, the variable "Number of LTV packages per inhabitant per year" again explained, for all kinds of PCT, most of the variability (Adjusted r2 = 0.65, 0.65 and 0.76). CONCLUSIONS: The drug cost per inhabitant per year is less in urban than in rural Centres, while the cost per prescription is greater. The cost per inhabitant per year and the number of prescriptions per inhabitant per year have an inverse relationship to the population size. LTV medicines behave as pharmacy cost predictors, since a consistent relationship between their prescription, the cost per inhabitant per year and the number of prescriptions per inhabitant per year can be shown.