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Panditrao MM, Panditrao MM. "Burnout syndrome" in anesthesiologists and remedial measures- A narrative review. J Anaesthesiol Clin Pharmacol 2024; 40:206-216. [PMID: 38919431 PMCID: PMC11196043 DOI: 10.4103/joacp.joacp_322_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 06/27/2024] Open
Abstract
Anesthesiology, as an occupation, has its own unique sets of challenges, problems, issues, and circumstances, all leading to "occupational stress," which by now should be unequivocally accepted as a well-established fact. It is futile to continue pursuing research questions like, if there "really" is stress existing among practicing anesthesiologists/trainees, by conducting questionnaire-based surveys and doing meta-analyses. A significantly high incidence of existence of occupational stress in anesthesiologists is an undisputable and practical reality, which, when longstanding, gets culminated into "burnout syndrome" with its disastrous outcomes. Rather than pursuing the often-trodden path of finding the incidence, sources, and other superficial issues, an in-depth study of available literary evidence in relation to burnout has been carried out. Objectifying it as a "syndrome," its etiopathogenesis, pathophysiology inclusive of the prevalent theories of its causality, typology, and progression into various stages of/continuum of the process as an evolving clinical entity have been described. The preventive measures and "coping strategies" have been discussed at length in the end. It is the fervent hope and the desire of the authors that this discourse will sensitize all anesthesiologists, especially the younger and upcoming future generation, and help them avoid becoming a prey to this dreadful entity!
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Affiliation(s)
- Mridul M. Panditrao
- Department of Anaesthesiology, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra, India
| | - Minnu M. Panditrao
- Department of Anaesthesiology, Adesh Institute of Medical Sciences and Research (AIMSR), Bathinda, Punjab, India
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Tümer M, Dalgar İ. The effects of hierarchical relationship on well-being of surgical team members in operating theaters: Prospective cohort study. Medicine (Baltimore) 2024; 103:e37327. [PMID: 38457579 PMCID: PMC10919512 DOI: 10.1097/md.0000000000037327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 03/10/2024] Open
Abstract
Although there are many studies about wellbeing on healthcare professionals, the relationship between hierarchy and well-being has not been studied much. In this study, we focused on surgical branch professionals (anesthesiologists, surgeons, nurses) as organized in a strict hierarchy. We explored the association between the position within the organizational hierarchy in operating theaters and well-being. Data were collected in 2 parts as cross-sectional (baseline) and daily surveys (for 15 days). A total of 226 participants participated in the baseline study and 156 participants in the daily surveys. How hierarchical positions, in-group identification and personality traits were related to the well-being and experiences of surgical team members were investigated. System justification, social dominance orientation, and personality theories were used to investigate personality traits. Emotional stability and identification with other healthcare professionals were positively associated with positive experience and well-being. Daily hierarchical relationship when the team members were in a superior position was positively associated with that day's well-being, positive experience, enjoying working, and motivation to work on the following day. Conversely, the negative effects of daily hierarchical relationships on outcomes were not seen when the participants were in a subordinate position. Our findings were parallel to the literature that perceived autonomy in the workplace has positive impacts on the well-being. Furthermore, we found that in-group identification can protect surgical branch professionals from the adverse effects of the organizational hierarchy. We suppose our findings can contribute to the literature to evaluate organizational structure of operating theaters.
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Affiliation(s)
- Murat Tümer
- VKV American Hospital, Department of Anesthesiology and Reanimation, İstanbul, Turkey
| | - İlker Dalgar
- Medipol University, Faculty of Administrative and Social Sciences, Department of Psychology, Ankara, Turkey
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Nelson O, Greenwood E, Simpao AF, Matava CT. Refocusing on work-based hazards for the anaesthesiologist in a post-pandemic era. BJA OPEN 2023; 8:100234. [PMID: 37942056 PMCID: PMC10630594 DOI: 10.1016/j.bjao.2023.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/18/2023] [Accepted: 10/03/2023] [Indexed: 11/10/2023]
Abstract
The coronavirus pandemic has raised public awareness of one of the many hazards that healthcare workers face daily: exposure to harmful pathogens. The anaesthesia workplace encompasses the operating room, interventional radiology suite, and other sites that contain many other potential occupational and environmental hazards. This review article highlights the work-based hazards that anaesthesiologists and other clinicians may encounter in the anaesthesia workplace: ergonomic design, physical, chemical, fire, biological, or psychological hazards. As the anaesthesia work environment enters a post-COVID-19 pandemic phase, anaesthesiologists will do well to review and consider these hazards. The current review includes proposed solutions to some hazards and identifies opportunities for future research.
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Affiliation(s)
- Olivia Nelson
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Eric Greenwood
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Allan F. Simpao
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Clyde T. Matava
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Khuwaja A, Tabassum R, Soomro A, Diloo R, Kumar K, Ahmed J, Khan F. Assessment of anaesthesia workforce capacity in district and tehsil (taluka) hospitals in Sindh province of Pakistan: a survey. BMJ Open 2023; 13:e072807. [PMID: 37236667 DOI: 10.1136/bmjopen-2023-072807] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES Our objective was to determine the current availability of human resource at secondary care hospitals in Sindh province and to identify gaps in term of appropriate number of anaesthesiologists available for delivery of safe anaesthesia care. DESIGN A cross-sectional survey of anaesthesia workforce. SETTING All district and taluka hospitals in the Sindh province of Pakistan. PARTICIPANTS Administrative anaesthesia leaders in the hospitals. OUTCOME MEASURES Standard descriptive statistics (percentages and numbers) of anaesthesia workforce in these hospitals including both full-time and part-time physician anaesthesiologists, and non-specialist physicians providing anaesthesia services as well as technician support. RESULTS Only 54 (75%) hospitals had a full-time anaesthesia physician, and 32 of these had only one. Two hundred and one operating rooms were present in 72 (80%) hospitals with an average of three operating rooms/hospital. CONCLUSIONS This study has identified a deficit of anaesthesiology personnel in district-level and tehsil-level hospitals of Sindh province of Pakistan.
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Affiliation(s)
- Amin Khuwaja
- Department of Anaesthesia, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Rafia Tabassum
- Department of Anaesthesia, Peoples University of Medical and Health Sciences for Women, Faculty of Medicine and Allied Sciences, Nawabshah, Pakistan
| | - Ahmed Soomro
- Department of Anaesthesia, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan
| | - Raja Diloo
- Department of Anaesthesia, Tabba Kidney Institute, Karachi, Pakistan
| | - Kelash Kumar
- Department of Anaesthesia, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Jamil Ahmed
- Department of Anaesthesia, Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Pakistan
| | - Fauzia Khan
- Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan
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Sidhoum L, Dormegny L, Neumann N, Rouby AF, Sauer A, Gaucher D, Lejay A, Chakfé N, Bourcier T. [Assessment method of cognitive load and stress inducer factors of surgeons and anesthetists in the operating room]. J Fr Ophtalmol 2023; 46:536-551. [PMID: 37068974 DOI: 10.1016/j.jfo.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 04/19/2023]
Abstract
INTRODUCTION For many years, surgeons and anesthetists have recognized that stress can be present in their daily professional practice. The goal of this study was to identify tools for assessing stress and cognitive load in the operating room. MATERIAL AND METHODS We conducted a literature review in the PubMed database of scientific articles published on the subject without date limit using the keywords anesthesia, surgery, surgeon, cognitive workload, definition, pathophysiology, physiological measurement, objective, subjective, stress. RESULTS Nineteen articles were selected, focusing on cardiac surgery, gastrointestinal surgery, vascular surgery and urology. No publications concerning ophthalmology were found through the literature search. The means of measurement found were either subjective, such as questionnaires, or objective, such as the study of heart rate variability (HRV), reaction time, eye movements, electrical conductivity of the skin, biological markers and electroencephalogram. Of all these measurement tools, the NASA-TLX questionnaire, used in four articles, and the HRV study, used in eight articles, appear to be the most widely used and are strongly correlated with stress. CONCLUSION The articles reviewed use only some of the available tools for assessment of stress and cognitive load. The main objective is to improve the quality of care and the quality of life of caregivers. It would be interesting to develop other methods to identify and better characterize the risk factors that increase stress and cognitive load.
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Affiliation(s)
- L Sidhoum
- Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, nouvel hôpital Civil, Strasbourg, France.
| | - L Dormegny
- Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, nouvel hôpital Civil, Strasbourg, France; Département éducation, Gepromed, Strasbourg, France
| | - N Neumann
- Département éducation, Gepromed, Strasbourg, France
| | - A F Rouby
- Service de chirurgie vasculaire, hôpitaux universitaires de Strasbourg, nouvel hôpital Civil, Strasbourg, France; Département éducation, Gepromed, Strasbourg, France
| | - A Sauer
- Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, nouvel hôpital Civil, Strasbourg, France; Département éducation, Gepromed, Strasbourg, France
| | - D Gaucher
- Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, nouvel hôpital Civil, Strasbourg, France; Département éducation, Gepromed, Strasbourg, France
| | - A Lejay
- Service de chirurgie vasculaire, hôpitaux universitaires de Strasbourg, nouvel hôpital Civil, Strasbourg, France; Département éducation, Gepromed, Strasbourg, France
| | - N Chakfé
- Service de chirurgie vasculaire, hôpitaux universitaires de Strasbourg, nouvel hôpital Civil, Strasbourg, France; Département éducation, Gepromed, Strasbourg, France
| | - T Bourcier
- Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, nouvel hôpital Civil, Strasbourg, France; Département éducation, Gepromed, Strasbourg, France
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Job Satisfaction and Its Determinants among Nurse Anesthetists in Clinical Practice: The Botswana Experience. Anesthesiol Res Pract 2021; 2021:5739584. [PMID: 34539779 PMCID: PMC8443374 DOI: 10.1155/2021/5739584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/10/2021] [Accepted: 08/30/2021] [Indexed: 11/26/2022] Open
Abstract
Job satisfaction (JS) correlates positively with patients' satisfaction and outcomes and employees' well-being. In Botswana, the level of job satisfaction and its determinants among nurse anesthetists were not investigated. A cross-sectional study was conducted from January 2020 to June 2020 encompassing all nurse anesthetists in clinical practice in Botswana. A self-administered questionnaire was used that incorporated demographic data, reasons to stay on or leave their job, and a validated 20-item short form of the Minnesota Satisfaction Questionnaire which was pretested on five of our nurse anesthetists. Percentage is used to describe the data. The independence of categorical variables was examined using chi-square or Fisher's exact test. p value <0.05 was considered statistically significant. In Botswana, a total of 76 nurse anesthetists were in clinical practice during the study period. Sixty-six (86.9%) responded to the survey. Gender distribution was even, 50.0%. The overall JS was 36.4%. Males had significantly higher JS than females, p = 0.001. Significantly higher job satisfaction was found in married nurse anesthetists (p = 0.039), expatriate nurse anesthetists (p = 0.001), nurse anesthetists in non-referral hospitals (p = 0.023), and nurse anesthetists with ≥10 years' experience (p = 0.019). Nurse anesthetists were satisfied with security, social service, authority, ability utilization, and responsibility in ≥60.0% of the cases. They were not satisfied in compensation, working condition, and advancement in a similar percentage. The main reason to stay on their job was to serve the public in 68.2%. In Botswana, employers should make an effort to address the working conditions, compensation, and advancement of nurse anesthetists in clinical practice.
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Yetneberk T, Firde M, Eshetie D, Tiruneh A, Moore J. The prevalence of burnout syndrome and its association with adherence to safety and practice standards among anesthetists working in Ethiopia. Ann Med Surg (Lond) 2021; 69:102777. [PMID: 34522375 PMCID: PMC8424445 DOI: 10.1016/j.amsu.2021.102777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 08/23/2021] [Accepted: 09/02/2021] [Indexed: 11/27/2022] Open
Abstract
Background Burnout amongst healthcare professionals is a serious challenge affecting health care practice and quality of care. The ongoing pandemic has highlighted this on a global level. This study aimed to determine the prevalence of burnout syndrome and its association with adherence to safety and practice standards among non-physician anesthetists in Ethiopia. Methods A cross-sectional survey was conducted amongst non-physician anesthetists throughout Ethiopia in January 2020 utilizing an online validated questionnaire containing sociodemographic characteristics, symptoms of burnout using the 22 items of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) scale, 10 questions designed to evaluate the best practice of providers, and 7 questions evaluating self-reported errors. The MBI-HSS questions assessed depersonalization, emotional exhaustion, and personal accomplishment. A high level of burnout was defined as a respondent with an emotional exhaustion score ≥27, a depersonalization score ≥10, and a personal accomplishment score ≤33 in the MBI-HSS subscales. Bi-variable and multivariable logistic regression were used to identify factors associated with burnout. Results Out of a total of 650 anesthetists approached, 400 responded, a response rate of 61.5%. High levels of burnout were identified in 17.3% of Ethiopian anesthesia providers. Significant burnout scores were found in academic anesthetists (p = 0.01), and were associated with less years of anesthesia experience (p < 0.001), consuming >5 alcoholic drinks per week (p = 0.02), and parenthood (p = 0.01). Conclusion We found that non physician anesthetists working in Ethiopia is suffering by high levels of burnout. The problem is alarming in those working at academic environments and less experienced. Burnout were identified in 17.3% of Ethiopian anesthesia providers. Significant burnout scores were found in academic anesthetists. Anesthetists who have high burnout score committed medical malpractice.
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Affiliation(s)
- Tikuneh Yetneberk
- Department of Anesthesia and Critical Care, Debre Tabor University, Debre Tabor, Ethiopia
| | - Meseret Firde
- Department of Anesthesia and Critical Care, Debre Tabor University, Debre Tabor, Ethiopia
| | - Dinberu Eshetie
- Department of Anesthesia and Critical Care, Debre Tabor University, Debre Tabor, Ethiopia
| | - Abebe Tiruneh
- Department of Anesthesia and Critical Care, Debre Tabor University, Debre Tabor, Ethiopia
| | - Jolene Moore
- School of Medicine Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Dave N, Varghese E, Jacob R. Challenges and Opportunities Facing Pediatric Anesthesia Providers in Low- and Middle-Income Countries (LMICs), India. Paediatr Anaesth 2021; 31:47-52. [PMID: 33119926 DOI: 10.1111/pan.14053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 12/01/2022]
Abstract
India is a vast, populous country with a huge variability in the standards of health care. While the cities have state of the art hospitals with trained doctors, rural areas where most of the population lives, have a severe shortage of resources. Children form nearly 40% of India's population, and there is a great demand for pediatric surgical and anesthesia services. Specialty training in pediatric anesthesia, however, is still in its infancy, with the majority of children being administered anesthesia by general anesthesiologists. This review discusses the reasons behind India's ailing healthcare system and the shortage of qualified pediatric anesthesiologists. Anesthesiologists face multiple challenges in their daily work including inadequate infrastructure, paucity of medications and working equipment, nonavailability of trained help, and poor remuneration. All these factors contribute to work-related stress. On the other hand, the dearth of anesthesiologists offers ample opportunities to serve the underserved, improve the safety and quality of perioperative care in the rural areas, and improve the self-image of the anesthesiologist. A paucity of data regarding anesthesia, surgery, and work-related issues makes writing an article like this very difficult. However, it highlights the need for professional bodies to take note of these facts and play an active role in encouraging documentation, data collection, and improving standards of teaching and practice.
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Affiliation(s)
- Nandini Dave
- Department of Paediatric Anaesthesiology, NH SRCC Children's Hospital, Mumbai, India
| | - Elsa Varghese
- Indian Association of Paediatric Anaesthesiologists, India.,Department of Anaesthesiology, Kasturba Medical College, Manipal, India
| | - Rebecca Jacob
- Indian Association of Paediatric Anaesthesiologists, India.,Anaesthesia Education Co-ordinator, Columbia Asia Referral Hospital, Bangalore, India.,Asian Society of Paediatric Anaesthesiologists, India.,Christian Medical College, Vellore, India
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Misiolek-Marín A, Soto-Rubio A, Misiolek H, Gil-Monte PR. Influence of Burnout and Feelings of Guilt on Depression and Health in Anesthesiologists. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9267. [PMID: 33322399 PMCID: PMC7764134 DOI: 10.3390/ijerph17249267] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE The WHO has included burnout as an occupational phenomenon in the ICD-11. According to the WHO, burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. The study aimed to evaluate the influence of feelings of guilt and burnout on health in Polish anesthesiologists. Alcohol and tobacco intake, psychosomatic disorders, and depression were assessed. METHODS The study had a non-randomized cross-sectional character. The sample consisted of 372 Polish anesthesiologists. Burnout was measured by the Spanish burnout inventory. RESULTS Post hoc analysis for burnout consequences: depression (F(5,366) = 17.51, p < 0.001, ηp2 = 0.193), psychosomatic disorders (F(5,366) = 13.11, p < 0.001, ηp2 = 0.152), and tobacco intake (F(5,366) = 6.23, p < 0.001, ηp2 = 0.078), showed significant differences between burnout with and without the highest levels of feelings of guilt. All the instruments applied were reliable. CONCLUSIONS Depression, psychosomatic disorders, and alcohol and tobacco intake are suspected to be consequences of the highest guilt levels related to burnout, i.e., Profile 2 according to the burnout model of Gil-Monte. Participation in prevention programs is recommended for these cases.
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Affiliation(s)
| | - Ana Soto-Rubio
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain
| | - Hanna Misiolek
- Department of Anesthesiology and Intensive Therapy, Medical University of Silesia in Katowice, Poniatowskiego 15, 40-055 Katowice, Poland;
| | - Pedro R. Gil-Monte
- Department of Social Psychology, Faculty of Psychology, Unidad de Investigación Psicosocial de la Conducta Organizacional (UNIPSICO), University of Valencia, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain;
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Kalboussi H, Chouchane A, Ferhi F, Nsiri L, Maoua M, El Guedri S, Aroui H, Kacem I, Brahem A, Chatti S, El Maalel O, Ben Jazia K, Mrizak N. Facteurs associés au burn-out chez les techniciens supérieurs d’anesthésie réanimation dans un centre hospitalo-universitaire au centre tunisien. ANNALES MEDICO-PSYCHOLOGIQUES 2020. [DOI: 10.1016/j.amp.2019.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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