Structural validity of the Maslach Burnout Inventory and influence of depressive symptoms in banking workplace: Unfastening the occupational conundrum.

Burnout and mental disorders have been reported in the financial industry. This study aims to examine the structural validity of the Maslach Burnout Inventory (MBI) and to investigate the connection between the dimensions of burnout and depressive symptoms in a sample of 1046 bank employees from North Brazil who completed the MBI and the Patient Health Questionnaire-9 (PHQ-9. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to cross-check the factorial structure of the MBI. One-way analysis of variance and correlation analysis were applied to elucidate the relationship between burnout and depressive symptoms. Both 3-factor and 4-factor oblique solutions were plausible EFA models of the burnout syndrome. Results of CFA supported the 19-item 4-factor structure as the best fitting model to data, with two exhaustion factors ("exhausted" and "strained"), depersonalization, and personal accomplishment. The PHQ-9 total score and individual score of depressive items were significantly correlated with all MBI dimensions, notably with the emotional exhaustion dimension. The moderate-to-high correlation observed between burnout and depression suggest the potential utility of the MBI for evaluating burnout among bank employees as well as to point out the need to evaluate systematically the burnout and depressive symptoms given to their potential association.

Psychosocial Work Conditions and Burnout Among Brazilian Bank Employees: A Cross-Sectional Study.

OBJECTIVES: Changes in the modern economy have affected the financial sector. Time pressures, excessive work demands, and job stress are frequent concerns among bank employees, which might predispose them to burnout symptoms. The objective of the present study was to investigate the association between burnout symptoms and exposure to psychosocial work conditions in bank employees. METHODS: A cross-sectional study of 1046 bank employees was carried out in Pará and Amapá, northern Brazil. We applied a self-administered questionnaire evaluating socio-demographic characteristics, burnout (Maslach Burnout Inventory), and two job stress models (Demand-Control-Support and Effort-Reward Imbalance). Two levels of burnout symptoms were analysed: moderate level of burnout (MLB) and high level of burnout (HLB). Logistic regression models were used to estimate associations between the two levels of burnout and the two stress models, controlling for relevant covariates. RESULTS: The overall prevalence of burnout was 71.8% (31.1% for HLB; 40.7% for MLB), regardless of gender. Exposure to adverse psychosocial conditions in the workplace, such as high strain, low social support at work, high effort/low reward, and over commitment showed strong association with HLB and MLB, and these associations were independent of age, gender, and other occupational characteristics. CONCLUSIONS: We found that psychosocial conditions in the financial sector involving high strain, low social support at work, high effort/low reward, and over commitment represent possible risk factors for moderate and HLB symptoms in bank employees.

Depressão e esgotamento profissional em bancários / Depression and burnout among bank employees

INTRODUÇÃO: A depressão é uma doença crônica recorrente que pode levar à incapacidade. Burnout ou esgotamento profissional é uma síndrome psicológica caracterizada por exaustão emocional, cinismo e ineficácia. Estresse crônico no trabalho tem sido vinculado à depressão e ao esgotamento. OBJETIVOS: Este estudo tem o objetivo de investigar a associação entre exposição a estressores psicossociais do trabalho, quando avaliados pelos modelos Demanda-Controle-apoio social no trabalho e Desequilíbrio Esforço-Recompensa-comprometimento excessivo, com dois desfechos: depressão (depressão maior e outras depressões) e esgotamento (níveis moderado e alto), entre bancários. METODOLOGIA: Estudo de corte transversal com 1.046 bancários do estado do Pará e do Amapá. Foi utilizado um questionário autoaplicável contendo características sociodemográficas, de depressão (Questionário sobre a Saúde do Paciente-9 ou PHQ-9), de esgotamento (Maslash Burnout Inventory) e de estresse no trabalho (Demand-Control-Support Questionnaire e Effort-Reward Imbalance Questionnaire). Como desfechos foram considerados dois níveis de depressão [depressão maior (DM) e outras depressões (OD)] e dois de esgotamento [nível alto de esgotamento (NAE) e nível moderado de esgotamento (NME)]. Modelos de regressão logística foram utilizados para estimar associações entre níveis de depressão e os dois modelos de estresse, controlando para as covariáveis relevantes, e para estimar as associações entre os níveis de esgotamento e os dois modelos de estresse, também controlando para as covariáveis relevantes. RESULTADOS: Em relação à depressão, a prevalência geral foi de 32,0%, sendo 17,6% de DM e 14,4% de OD, não havendo diferença estatisticamente significante entre os sexos. Atividades de alta demanda e baixo controle, bem como baixo apoio social estiveram associados a OD e DM, mesmo após ajuste para sexo, idade e outras condições de trabalho. Risco de DM e OD também foi associado ao alto esforço/baixa...

BACKGROUND: Depression is a chronic, recurrent disease, which may lead to disability. Burnout is a psychological syndrome with emotional exhaustion, cynicism and inefficacy. Work-related chronic stress has been associated with depression and burnout. AIM: This study investigated the association between exposure to psychosocial stressors in the workplace, as assessed by the Job Demand-Control-Support and the Effort-Reward Imbalance-Overcommitment models, with two outcomes: depression (major depression and other forms of depression) and burnout (moderate and high levels). METHODS: This is a cross-sectional study with 1,063 bank employees in the states of Pará and Amapá, Brazil. A self-applied questionnaire was used containing characteristics on sociodemographic indicators, depression [(Patient Health Questionnaire-9 (PHQ-9)], burnout (Maslash Burnout Inventory), and work-related stress (Demand-Control-Support Questionnaire and Effort-Reward Imbalance Questionnaire). As outcomes, two levels of depression [(major depression (MD) and other forms of depression (OD)] and burnout [moderate level (MLB) and high level (HLB)] were considered. Logistic regression models were used to estimate associations between the two levels of depression and the two stress models, controlling for relevant covariates, and to estimate associations between the two levels of burnout and the two stress models, also controlling for relevant covariates. RESULTS: The overall prevalence of depression was 32.0%, with 17.6% for MD and 14.4% for OD, with no statistically significant difference between genders. Highly demanding activities, low levels of control, and low social support at work were associated with MD and OD, even after adjusting for gender, age, and other work-related conditions. The risk of MD and OD also was associated with high effort/low reward, overcommitment and effort-reward imbalance after model adjustment. In relation to burnout, the overall prevalence was 71.8%, with 31.1...

[Thalidomide used by patients with erythema nodosum leprosum]. / Talidomida usada por pacientes com eritema nodoso hansênico.

INTRODUCTION: Thalidomide is a drug currently used in Brazil for treating erythema nodosum leprosum. METHODS: This was a prospective study to follow up clinical evolution, record adverse events and determine plasma thalidomide levels from a dose of 100 mg/day, among 20 patients with clinical manifestations of erythema nodosum leprosum, divided into two groups: during or after leprosy multidrug therapy. RESULTS: No significant differences between the groups were seen during the study, either in relation to favorable clinical evolution among the patients (70% and 90%), or in relation to the adverse events recorded, which were dizziness and somnolence. The plasma thalidomide levels on D7 and D14 were 0.82 + or - 0.4 microg/ml and 0.79 + or - 0.3 microg/ml in group 1 and 0.82 + or - 0.4 and 1.55 + or - 1.0 in group 2, respectively. CONCLUSIONS: In this sample, the multidrug therapy had no effect on the clinical evolution, incidence of adverse events and plasma thalidomide levels.

Talidomida usada por pacientes com eritema nodoso hansênico / Thalidomide used by patients with erythema nodosum leprosum

INTRODUÇÃO: A talidomida é um fármaco utilizado atualmente no tratamento do eritema nodoso hansênico no Brasil. MÉTODOS: Estudo prospectivo para acompanhar a evolução clínica, registrar os eventos adversos e determinar as concentrações plasmáticas de talidomida em dose diária de 100mg/dia, em 20 pacientes com manifestações clínicas de eritema nodoso hansênico, divididos em dois grupos: após ou em curso da poliquimioterapia para hanseníase. RESULTADOS: Não foram observadas diferenças significativas nos grupos no decorrer do estudo, tanto na evolução clínica favorável dos pacientes, de 70 por cento e 90 por cento, quanto nos eventos adversos registrados que foram tontura e sonolência. Os teores plasmáticos de talidomida em D7 e D14 foram de 0,82±0,4μg/mL e 0,79±0,3μg/mL no grupo 1 e de 0,82±0,4 e 1,55±1,0 no grupo 2, respectivamente. CONCLUSÕES: Na amostra estudada, a poliquimioterapia não interferiu na evolução clínica, na incidência dos efeitos adversos e nos níveis plasmáticos de talidomida.

INTRODUCTION: Thalidomide is a drug currently used in Brazil for treating erythema nodosum leprosum. METHODS: This was a prospective study to follow up clinical evolution, record adverse events and determine plasma thalidomide levels from a dose of 100 mg/day, among 20 patients with clinical manifestations of erythema nodosum leprosum, divided into two groups: during or after leprosy multidrug therapy. RESULTS: No significant differences between the groups were seen during the study, either in relation to favorable clinical evolution among the patients (70 percent and 90 percent), or in relation to the adverse events recorded, which were dizziness and somnolence. The plasma thalidomide levels on D7 and D14 were 0.82 ± 0.4μg/ml and 0.79 ± 0.3 μg/ml in group 1 and 0.82 ± 0.4 and 1.55 ± 1.0 in group 2, respectively. CONCLUSIONS: In this sample, the multidrug therapy had no effect on the clinical evolution, incidence of adverse events and plasma thalidomide levels.

Thalidomide levels in patients with erythema nodosum leprosum.

Thalidomide is used for the acute treatment and suppression of the cutaneous manifestations of erythema nodosum leprosum (ENL). In this study, comparisons were made regarding the plasma concentrations of thalidomide in patients with ENL on the course or after leprosy therapy in a prospective clinical trial. Thalidomide concentrations were measured by liquid chromatography on days 1, 3, and 14 of treatment. After 100 mg/d, the thalidomide concentrations ranged from 0.82 to 1.03 and 0.43 to 0.80 microg/mL, on the course or after leprosy therapy, respectively. No differences were observed in thalidomide concentrations between and within the groups. Our results suggested that leprosy multidrug therapy does not seem to affect the plasma concentrations of thalidomide in patients with ENL.

Câncer de endométrio: análise de cinco anos no INCa / Endometrial cancer: five years analysis in the INCa

No período de janeiro de l98l a dezembro de 1985, foram analisadas 133 pacientes portadoras de adenocarcinoma de endométrio, que receberam radioterapia em alguma fase de seu tratamento. Noventa e cinco por cento das pacientes foram à resposta completa e, posteriormente, foram seguidas por tempo mediano de 40 meses. Treze por cento das pacientes falharam localmente e nove por cento falharam à distância. Vagina e pulmao foram os sítios de falha mais freqüentes, local e à distância, respectivamente. Posteriormente, as pacientes tiveram suas sobrevidas analisadas segundo os seguintes fatores prognósticos: estadiamento clínico, grau de infiltraçao miometrial e grau de díferenciaçao histológica. A sobrevída global atuarial aos 48 meses foi de 78 por cento. A sobrevida livre de doença locorregional foi de 81 por cento e a sobrevida livre absoluta foi de 74 por cento. Ainda que nao exista significância estatística nos três parâmetros prognósticos analisados, existe tendência de polarizaçao entre infiltraçao profunda em contraposiçao à infiltraçao superficial e média do miométrio. O mesmo ocorrendo com o grau I em contraposiçao aos graus II e III, como também EC-II-III em contraposiçao a EC-I.O presente estudo demonstrou a importância do agrupamento prognóstico dos vários segmentos de uma populaçao portadora de tumor de endométrio. Os autores fazem breve revisao de literatura sobre o assunto.