EMOTIONAL BURNOUT SYNDROME: EFFECT ON CLINICAL INERTIA AND MEDICAL PRACTICE STEREOTYPES
https://doi.org/10.20996/1819-6446-2009-5-1-12-22
Abstract
Aim. To estimate the prevalence of burnout in primary care physicians and its influence on medical practice stereotypes and on clinical inertia.
Material and Methods. The anonymous single-stage poll was carried out among 184 primary care physicians. The questionnaire included information about sex, age, period and conditions of work, established stereotypes of practices. Burnout was evaluated by Russian analog of Maslach Burnout Inventory. It was defined in high level of emotional exhaustion and depersonalization and low level of personal accomplishment 11 questions were developed to reveal of suboptimal medical practice (for example, “I do not discuss treatment options with patient and do not give full answers to his questions” or “I make diagnostic and treatment errors despite of my professional knowledge and inexperience”).
Results. The burnout syndrome (or extreme grade of emotional burnout) occurs in 13,1% and high level of emotional burnout – in 49,7% of primary care physicians. Features of suboptimal medical practice are usually found in 24,2% of primary care physicians at least monthly. It expresses more often in improper attitude to paqtients and their problems associated with a disease. Thus, burnout contributes to improper attitude to patients. Professional burnout affects established work stereotypes and can promote development of physician’s clinical inertia.
Conclusion. As the burnout is common among primary care physicians, an adequate monitoring and prevention of this state is necessary in medical labour management.
About the Authors
R. A. KhokhlovRussian Federation
Chair of Hospital Therapy
Studencheskaya ul. 10, Voronezh, 394000
E. V. Minakov
Russian Federation
Moskovsky prosp. 151-2, Voronezh, 394082
G. I. Furmenko
Russian Federation
Moskovsky prosp. 151-2, Voronezh, 394082
N. M. Akhmedzhanov
Russian Federation
Petroverigsky per. 10, Moscow, 101990
References
1. Sabate E. Adherence to long-term therapies: evidence for action. Geneva: WHO; 2003.
2. Neutel J.M., Smithy D.H. Improving patient compliance: a major goal in the management of hypertension. J Clin Hypertens (Greenwich) 2003;5(2):127-32.
3. Oganov R.G., Maslennikova G.Y. Prevention of cardiovascular and other non-communicable diseases - a basis for Russian demographic situation improvement. Cardiovascular Therapy and Prevention 2005;(3 Pt 1):4-9. [Оганов Р.Г., Масленникова Г.Я. Профилактика сердечно-сосудистых и других неинфекционных заболеваний – основа улучшения демографической ситуации в России. Кардиоваскулярная терапия и профилактика 2005;(3):4-9.]
4. Paramore L. C., Halpern M. T., Lapuerta P. et al. Impact of poorly controlled hypertension on healthcare resource utilization and cost. Am J Manag Care 2001;7(4):389-98.
5. Pogosova G.V., Koltunov I.E., Roslavceva A.N. Improvement of compliance to arterial hypertension therapy and ischemic heart disease - key condition of cardiovascular mortality reduction. Kardiologiia 2007;47(3):79-84. [Погосова Г.В., Колтунов И.Е., Рославцева А.Н. Улучшение приверженности к лечению артериальной гипертонии и ишемической болезни сердца – ключе- вое условие снижения сердечно-сосудистой смертности. Кардиология 2007;(3):79-84.]
6. Phillips L.S., Branch W.T., Cook C.B. et al. Clinical inertia. Ann Intern Med 2001;135(9):825-34.
7. Shanafelt T. D., Bradley K. A., Wipf J. E., Back A. L. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 2002;136(5):358-67.
8. Maslach C., Jackson S. The Maslach Burnout Inventory (2nd ed.). Palo Alto, CA: Consulting Psychologists Press; 1986.
9. Vodopianova N.E., Starchenkova E.S. Burnout syndrome: diagnostics and preventing, St Petersburg; 2005. [Водопьянова Н.Е., Старченкова Е.С. Синдром выгорания: диагностика и профилактика. СПб.: Питер; 2005.]
10. Vodopianova N.E. Burnout syndrome in occupations of "person-person" type. Editors: Nikiforov G.S., Dmitrieva M.A., Snetkov V.M. Practical training on management psychology and professional activity. М: Rech; 2003. [Водопьянова Н.Е. Синдром «выгорания» в профессиях системы «человек-человек». В: Никифоров Г.С., Дмитриева М.А., Снетков В.М., редакторы. Практикум по психологии менеджмента и профессиональной деятельности. М.: Речь; 2003.]
11. Schaufeli W. B., Enzman D. The burnout companion to study and practice: a critical analysis. London: Taylor & Francis; 1998.
12. Larentsova L.I. Professional burnout syndrome in dentists. Russian Dentist Journal 2006;(4):35- 9. [Ларенцова Л. И. Профессиональный синдром выгорания у врачей-стоматологов. Российский стоматологический журнал 2006; 4:35-39.]
13. Goehringa C., Gallacchib M.B., Künzi B., Bovierd P. Psychosocial and professional characteristics of burnout in Swiss primary care practitioners: a cross-sectional survey Swiss Med Wkly 2005;135(7-8):101–8.
14. Embriaco N., Azoulay E., Barrau K. et al. High level of burnout in intensivists: prevalence and associated factors. Am J Respir Crit Care Med 2007;175(7):686–92.
15. Gopal R., Glasheen J.J., Miyoshi T.J., Prochazka A.V. Burnout and internal medicine resident work-hour restrictions. Arch Intern Med 2005;165(22):2595-600.
16. West C.P., Huschka M.M., Novotny P.J., et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA 2006;296(9):1071-8.
17. Poncet M.C., Toullic Ph., Papazian L. et al. Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med 2007;175(7):698–704.
18. Rebrova O.U. Statistical analysis of the medical data. Application of STATISTICA program package. М.: Mediasphera; 2002. [Реброва О. Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ STATISTICA. М.: МедиаСфера; 2002.]
19. Vid V.D., Lozinskaya E.I. Burnout syndrome in psychiatry and its dependence on therapeutic ideology. Russian Psychiatric Journal 1998;(1):19-21. [Вид В.Д., Лозинская Е.И. Синдром перегорания в психиатрии и его зависимость от терапевтической идеологии. Российский психиатрический журнал 1998;(1):19-21.]
Review
For citations:
Khokhlov R.A., Minakov E.V., Furmenko G.I., Akhmedzhanov N.M. EMOTIONAL BURNOUT SYNDROME: EFFECT ON CLINICAL INERTIA AND MEDICAL PRACTICE STEREOTYPES. Rational Pharmacotherapy in Cardiology. 2009;5(1):12-22. https://doi.org/10.20996/1819-6446-2009-5-1-12-22