[Job stress perceived by hospital medical staff]

Reliability and Validity of Job Content Questionnaire in Chinese Petrochemical Employees

To evaluate psychometric properties the Chinese (mainland) version of the 30-item Job Content Questionnaire was administered to 889 employees in 4 industries of PetroChina. A retest at 3 months with 296 randomly chosen employees showed reliabilities ranged from .76 to .93. Cronbach coefficients alpha for the 8 dimensions ranged from .43 to .88, indicating that the Job Insecurity subscale had low internal consistency. Exploratory factor analysis showed 8 meaningful factors corresponding to the 8 theoretical dimensions of this questionnaire. This version has variable a but suitable retest to be a reliable and valid measure of job strain, applicable to the Chinese industrial working population of PetroChina.

Autonomy, consent and responsability. Part 1: limitations of the principle of autonomy as a foundation of informed consent

Legal recognition of patient's rights aspired to change clinical relationship and medical lex artis. However, its implementation has been hampered by the scarcity of resources and the abundance of regulations. For several years, autonomy, consent, and responsibility have formed one of the backbones of the medical profession. However, they have sparked controversy and professional discomfort. In the first part of this article, we examine the conceptual and regulatory limitations of the principle of autonomy as the basis of informed consent. We approach the subject from philosophical, historical, legal, bioethical, deontological, and professional standpoints. In the second part, we cover the viability of informed consent in health care and its relationship with legal responsibility.

Burnout in cancer professionals: a systematic review and meta-analysis

Burnout syndrome is typified by three dimensions: emotional exhaustion (EE), depersonalization (DP) and low personal accomplishment (PS), and is prevalent among cancer care providers. The objective is to conduct a systematic review and meta-analysis of studies that evaluated the presence of burnout syndrome in professionals dedicated to the care of cancer patients. A search was conducted of the MEDLINE, LILACS and COCHRANE databases. Articles were selected that had used the Maslach questionnaire to assess burnout syndrome prevalence, had evaluated at least 35 subjects (including physicians), had at least a 20% questionnaire response rate, and that were published in English, Spanish or Portuguese. Ten studies (2375 participants) were included in this analysis. Severe involvement by any one of the three dimensions ranged from 8% to 51%. The overall prevalence of EE was found to be 36% [95% confidence interval (CI) (31-41)], while for DP this was 34% [95% CI (30-39)] and for PS 25% [95% CI (0.16-34)], demonstrating considerable heterogeneity across studies. The prevalence of burnout syndrome is elevated among cancer professionals throughout the world but varies substantially among studies. Further research is needed to better understand and prevent this syndrome.

Desgaste profesional en el personal sanitario y su relación con los factores personales y ambientales

OBJECTIVES

High rates of professional burnout syndrome have been found among health service professionals. Our objective was to study the prevalence of burnout syndrome in hospital health workers and to determine its relationship with personal and environmental factors.

METHODS

A total of 2290 health workers from five hospitals in the province of Girona (Spain) were invited to participate. Interviewees were given a specifically designed questionnaire, a questionnaire on organizational climate, and the Spanish version of the Maslach Burnout Inventory, which includes three scales: emotional exhaustion, depersonalization, and reduced personal accomplishment.

RESULTS

Responses were received from 1095 health workers (a response rate of 47.8%). A high level of emotional exhaustion was found in 41.6% of staff members, especially among doctors and nurses; a high level of depersonalization was found in 23%, mainly among doctors, and reduced personal accomplishment was found in 27.9%, mainly among technicians and doctors. Multiple logistic regression revealed that a high level of emotional exhaustion was associated with frequent consumption of tranquilizers or antidepressants, whereas optimism and job satisfaction showed an inverse association. The variables that were inversely associated with a high level of depersonalization were the number of years in the profession, optimism, evaluation of work as being useful and the perception of being valued by others. Reduced personal accomplishment was also inversely associated with optimism, satisfaction with the usefulness of one's work, and satisfaction with teamwork.

CONCLUSIONS

In view of the results obtained, to reduce professional burnout in hospitals, optimism and a sense of self-worth among individuals should be encouraged and the organizational environment should be improved.

Sentimentos de profissionais dos serviços de pronto-socorro pediátrico: reflexões sobre o burnout

OBJETIVOS: conhecer os sentimentos de profissionais dos serviços de pronto-socorro infantil diante das situações de trabalho, focalizando os componentes do burnout: exaustão emocional, falta de envolvimento pessoal e despersonalização. MÉTODOS: pesquisa qualitativa realizada, na cidade do Recife, de março a julho de 2003, em cinco unidades públicas de referência, utilizando análise de conteúdo para compreender os "núcleos de sentido" das mensagens de 40 entrevistas semi-estruturadas com pediatras e sete enfermeiras da urgência/emergência. RESULTADOS: nesses relatos convivem sentimentos díspares: cansaço, esgotamento, angústia e revolta pela sobrecarga e limitações dos recursos frente às situações que envolvem risco de vida, permeados pela satisfação de gostar do que fazem e reconhecimento da própria utilidade; temor de cometer enganos fatais; desqualificação profissional quando comparam remuneração com responsabilidade e esforço empregado; exposição ao risco de agressão e indiciamento judicial alimentando desesperança e vulnerabilidade; e vínculo afetivo com trabalho. Esboçam-se, sobretudo entre médicos com menor tempo de formados, o descrédito nas possibilidades de mudanças e a vontade de desistir. CONCLUSÕES: apesar do estresse laboral crônico, os profissionais entrevistados mantêm o compromisso de contribuir na solução dos problemas cotidianos. Existe tendência para exaustão emocional, desânimo e sentimentos de inadequação e fracasso, reforçando a importância da promoção e prevenção em saúde no ambiente de trabalho.

Características métricas del Cuestionario de Calidad de Vida Profesional (CVP-35)

OBJECTIVE

To assess the internal consistency, discriminative capacity and factorial composition of the Professional Quality of Life Questionnaire (QPL-35) in a population of primary care professionals.

METHODS

We performed a cross-sectional analytical study in a primary care area in Madrid from 2001 to 2003. Random sampling of 450 healthcare professionals was performed on 2 occasions. The sample was stratified into 3 groups: group I (clinicians, pharmacologists, psychologists), group II (nurses, midwives, physiotherapists, social workers) and group III (administrative staff, porters, auxiliary nurses). The self-administered questionnaire QPL-35 was sent in January 2001 and January 2003 and on each occasion the questionnaire was sent again 1 month later. The percentages of total responses and responses per item were studied. We also studied the distribution of each answer by examining the floor effect and ceiling effect, as well as the factorial composition based on a previous validation study.

RESULTS

Five hundred sixty-three questionnaires (62.6%) were returned. All the questions had a response rate of more than 96%. At least one unanswered question was found in 22.0% of the questionnaires, and at least 2 were unanswered in 7.1%. The distribution of the answers did not fit normal distribution in any of the cases. The floor effect was present in questions related to management support and the ceiling effect was found in those related to motivation. The factorial analysis found 3 factors that explained 39.6% of the variance in the total number of questions. These factors were very similar to those of the previous validation study: management support, perception of workload and intrinsic motivation explained 17.0%, 13.2% and 9.4% of the variance, respectively. Internal consistency was high for each factor (Cronbach's alpha > 0.7) and for the total score (Cronbach's alpha = 0.81).

CONCLUSIONS

The metric properties of the QPL-35 are maintained in different environments. This questionnaire can be recommended as a tool to measure and compare quality of professional life in primary care.