Burnout in anesthesiology

Sousa, Ana Rafaela Campos; Mourão, Joana Irene de Barros

doi:10.1016/j.bjane.2018.04.007

Brasil

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Review Article • Rev. Bras. Anestesiol. 68 (5) • Sep-Oct 2018 • https://doi.org/10.1016/j.bjane.2018.04.007 linkcopy

Burnout in anesthesiology

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background and objectives Burnout is a chronic condition caused by high levels of stress and anesthesiology is a stressful medical specialty with more vulnerability to burnout. The aim of this study is to review the characteristics and impact of burnout in anesthesiology.

Contents In this review, the stressors and risk factors, manifestations, assessment, complications, management and prevention of burnout as well as the inconsistent research found in the state-of-art are approached.

Conclusions Anesthesiologists are in a high-risk group to develop burnout, with different manifestations and consequences such as suicide or medical errors. Although there is no specific treatment yet, there are a lot of helpful measures to cope this condition. Prevention is considered an important step in order to reduce the prevalence of burnout.

KEYWORDS Burnout; Anesthesiology

Subtypes of burnout	Level of dedication at work	Main value	Characteristics
Frenetic	High	Involvement	Overload
			Grandiosity
			Highly applied and committed individuals
			Works to the point of exhaustion
			Neglecting own needs
			Increasingly greater efforts in the face of difficulties
			High involvement in work
			Ambition and need for achievements
			Inability to acknowledge failure
			Anxiety and irritability
Under-challenged	Intermediate	Indifference	Lack of development
			Indifference and superficiality in tasks
			Boredom
			Negatively affected by monotonous work
			Absence of overload-induced stress
			Contemplating another job
			Lack of challenges, motivation or desire for engagement
Worn-out	Low	Neglect	Lack of control
			Lack of recognition
			Difficulties in performing tasks
			Lack of involvement in work
			Difficulties in performing tasks
			Neglecting responsibilities
			Depressive symptoms
			Give up apathetic lack of enthusiasm

Physical illness	Emotional deterioration	Behavioral aberrations	Intellectual dysfunction
Hypertension	Chronic anxiety	Abuse of substances	Poor task performance
Increased heart rate	Depression	Impulsive or overly aggressive actions	Difficulty in concentration
Coronary heart disease	Irritable or labile personality	Hyperactivity	Forgetfulness or diminished alertness
Headache	Changing mood	Compulsive complaining
Nausea	Fatigue
Muscle tension syndromes	Frustration
Chronic lumbar or cervical syndromes	Anger
Gastritis	Undefined fears
Peptic ulcer disease
Colitis
Spontaneous abortion
Weight change depression of immune system
Hyperventilation
Acceleration of the aging process

Intrinsic factors	Extrinsic factors
Frequent activation of the hypothalamic-pituitary-adrenal axis	Work conditions (e.g. malfunction or insufficient resources)
Chronic activation of autonomic nervous system	Schedule/task changes
High permanent levels of neuromediators	Work/personal life requirements (e.g. high demands or responsibility)
Predisposition to psychiatric/psychological pathology
Own personality/trait (e.g. perfectionism)
Previous history of psychiatric/psychological pathology
Difficulty to copy with stressful situations

Dimensions of burnout	Low burnout	Moderate burnout	High burnout
Emotional exhaustion	<17	18-29	>30
Personal accomplishment	>40	34-39	<33
Depersonalization	<5	6-11	>12

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Sociedade Brasileira de Anestesiologia R. Professor Alfredo Gomes, 36, 22251-080 Botafogo RJ Brasil, Tel: +55 21 2537-8100, Fax: +55 21 2537-8188 - Campinas - SP - Brazil
E-mail: bjan@sbahq.org

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