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RESUMO - O burnout é um conceito multidimensional caracterizado essencialmente por três aspetos:
exaustão emocional elevada; desenvolvimento de atitudes e sentimentos de indiferença e
afastamento psicológico dos destinatários dos serviços prestados (despersonalização);
diminuição da realização pessoal ou desenvolvimento de sentimentos de ineficácia. A síndrome
de burnout tem sido descrita por diversos investigadores nacionais e estrangeiros como um
problema característico dos profissionais que lidam direta e intensamente com pessoas
necessitando de ajuda como médicos, enfermeiros, psicólogos, assistentes sociais, entre outros
(embora possa surgir em qualquer profissional, de qualquer classe profissional).
A pertinência do estudo deste fenómeno em médicos prende‐se não só com as repercussões
individuais desta síndrome mas, sobretudo, com as suas repercussões sociais e até de saúde
pública (uma vez que influencia o seu relacionamento com doentes e colegas), bem como as
repercussões na satisfação e qualidade do seu desempenho profissional.
Este trabalho focou‐se na especialidade de Medicina Geral e Familiar que, sendo uma área da
Medicina particularmente rica em agentes stressantes, internos e externos (tanto pela sua
natureza e essência da relação terapêutica do profissional médico com o outro, como pela longa
luta e procura da sua autodefinição, construção da identidade profissional e reconhecimento), se
constitui como terreno extremamente propício para o desenvolvimento deste fenómeno.
O seu objetivo fundamental foi o de caracterizar a prevalência e gravidade do burnout
manifestado pelos médicos de Medicina Geral e Familiar que aceitaram responder ao
questionário, procurando depois possíveis relações entre este e as suas características
sociodemográficas, e procurando por último caracterizar as suas intenções comportamentais no
que concerne à vida profissional.
Neste sentido, foi aplicado o instrumento de recolha de dados, constituído por uma escala de
avaliação do burnout (Maslach Burnout Inventory) e um conjunto de questões destinadas a fazer
uma caracterização sociodemográfica, profissional e de intenções comportamentais dos
elementos da amostra (adaptadas do Questionário de Satisfação Profissional de Graça (1999).
Este questionário foi distribuído a médicos de MGF que trabalham em unidades de saúde na área
metropolitana de Lisboa, pretendendo‐se, futuramente, desenvolver este estudo a nível nacional,
com uma amostra que permita retirar conclusões mais sólidas quanto a este fenómeno e às suas
implicações na sociedade.
Os resultados obtidos, ainda que condicionados pelo desenho do estudo e as suas inerentes
limitações, apontam de forma inequívoca para uma necessidade de repensar as condições de
trabalho e o suporte que é fornecido a uma especialidade que constitui a base do Sistema
Nacional de Saúde.
A continuar a ser ignorado, esta síndrome vai‐se constituir como uma verdadeira “epidemia
silenciosa”, que vai prejudicar de forma indelével a saúde dos nossos médicos e, em
consequência, a nossa própria saúde.
ABSTRACT - Burnout is a multidimensional concept essentially characterized by three aspects: high emotional exhaustion; development of attitudes and feelings of indifference and psychological remoteness of recipients of services (depersonalization); decreased personal achievement or development of feelings of ineffectiveness. The burnout syndrome has been described by various national and foreign researchers as being characteristic problem of professionals who deal directly and intensely with people needing help (doctors, nurses, psychologists, social workers, among others) although it can occur to any professional, from any professional class. The relevance of studying this phenomenon in doctors relates not only to the individual repercussions of this syndrome but above all with its social and even public health implications, as its consequences are reflected in their relationship with patients and colleagues, as well as satisfaction and quality of their professional performance. This study is focused on the specialty of family medicine, being an area of Medicine particularly rich in both internal and external stressors (arising from both its nature and essence of the therapeutic relationship the medical professional with each other, and from the long struggle for their self‐definition, construction of professional identity and recognition); it is an extremely fertile ground to the development of this phenomenon. Its ultimate objective was to characterize the prevalence and severity of burnout expressed by general practitioners who agreed to answer the questionnaire, searching for possible relationships between burnout and their socio‐demographic characteristics, and trying to characterize their behavioral intentions regarding their professional course. In this sense, the data collection instrument was applied, consisting of a burnout scale (Maslach Burnout Inventory) and a set of questions designed to characterize sociodemographic, professional and behavioral intentions of the sample elements (adapted from Job Satisfaction Survey from Graça (1999). This questionnaire was distributed to general practitioners working in health facilities in the Lisbon metropolitan area, and surroundings, intending to be developed to a nationwide study with a representative sample, thus allowing to draw more solid conclusions on this phenomenon and its implications for society. The results, although heavily conditioned by the study design and its inherent limitations, overwhelmingly point to an urgent need to rethink the working conditions and support that is provided to a specialty that constitutes itself as the basis of the National Health System. The longer we ignore it, the longer this “silent epidemic” will continue to grow, hurting indelibly the health of our doctors and, thus, our own health.
ABSTRACT - Burnout is a multidimensional concept essentially characterized by three aspects: high emotional exhaustion; development of attitudes and feelings of indifference and psychological remoteness of recipients of services (depersonalization); decreased personal achievement or development of feelings of ineffectiveness. The burnout syndrome has been described by various national and foreign researchers as being characteristic problem of professionals who deal directly and intensely with people needing help (doctors, nurses, psychologists, social workers, among others) although it can occur to any professional, from any professional class. The relevance of studying this phenomenon in doctors relates not only to the individual repercussions of this syndrome but above all with its social and even public health implications, as its consequences are reflected in their relationship with patients and colleagues, as well as satisfaction and quality of their professional performance. This study is focused on the specialty of family medicine, being an area of Medicine particularly rich in both internal and external stressors (arising from both its nature and essence of the therapeutic relationship the medical professional with each other, and from the long struggle for their self‐definition, construction of professional identity and recognition); it is an extremely fertile ground to the development of this phenomenon. Its ultimate objective was to characterize the prevalence and severity of burnout expressed by general practitioners who agreed to answer the questionnaire, searching for possible relationships between burnout and their socio‐demographic characteristics, and trying to characterize their behavioral intentions regarding their professional course. In this sense, the data collection instrument was applied, consisting of a burnout scale (Maslach Burnout Inventory) and a set of questions designed to characterize sociodemographic, professional and behavioral intentions of the sample elements (adapted from Job Satisfaction Survey from Graça (1999). This questionnaire was distributed to general practitioners working in health facilities in the Lisbon metropolitan area, and surroundings, intending to be developed to a nationwide study with a representative sample, thus allowing to draw more solid conclusions on this phenomenon and its implications for society. The results, although heavily conditioned by the study design and its inherent limitations, overwhelmingly point to an urgent need to rethink the working conditions and support that is provided to a specialty that constitutes itself as the basis of the National Health System. The longer we ignore it, the longer this “silent epidemic” will continue to grow, hurting indelibly the health of our doctors and, thus, our own health.
Descrição
Trabalho Final do Curso de Especialização em Administração Hospitalar
Palavras-chave
Burnout Médico Exaustão emocional Despersonalização Realização pessoal Medicina Geral e Familiar Saúde Burnout Doctor Emotional exhaustion Depersonalization Personal fulfillment Family medicine Health
Contexto Educativo
Citação
Editora
Universidade Nova de Lisboa, Escola Nacional de Saúde Pública