Factores asociados con el <i>burnout</i> en un equipo multidisciplinar de un hospital oncológico

Saura, Ana Paula Neroni Stina; Valóta, Izabel Alves das Chagas; Silva, Rodrigo Marques da; Calache, Ana Lucia Siqueira Costa

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Sumário

Original Article • Rev. esc. enferm. USP 56 (spe) • 2022 • https://doi.org/10.1590/1980-220X-REEUSP-2021-0448en copiar

Factores asociados con el burnout en un equipo multidisciplinar de un hospital oncológico

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Identificar los factores asociados con el burnout en profesionales de un equipo multidisciplinar del campo de la oncología.

Método:

Estudio descriptivo, cuantitativo, con diseño observacional y transversal. Para la recolección de datos se utilizaron un cuestionario sociodemográfico, clínico y profesional elaborado por los autores y tres ítems del Instrumento de Calidad de Vida Profesional. Para el análisis de datos se utilizaron las pruebas de Kruskal-Wallis y Mann-Whitney. El nivel de significación adoptado fue del 5%.

Resultados:

Participaron en el estudio 442 profesionales del equipo multidisciplinar. Los equipos que mostraron mayores factores asociados con el burnout fueron los que presenciaron mayor número de muertes, conflictos en su entorno laboral, trabajaron en el turno de noche, consumían drogas y no practicaban creencias religiosas, entre otros.

Conclusión:

Aunque los profesionales tuvieron una puntuación media en el dominio de burnout, muchas variables tuvieron factores asociados con el burnout, lo que muestra un peligro inminente al trabajador y expone a pacientes y la institución. Es necesario buscar estrategias para minimizar estos riesgos.

DESCRIPTORES
Enfermería; Calidad de Vida; Agotamiento Psicológico; Distrés Psicológico; Oncología Médica; Grupo de Atención al Paciente

Characteristic		Risk of burnout
		I feel worn out because of my work				I feel overwhelmed by the amount of work				I feel ‘bogged down’ by the system
		N	%	Mean	P value	N	%	Mean	P value	N	%	Mean	P value
Age ^ Mann-Whitney test.	20–35 years	203	45.93%	3.24	0.001^* * Statistically significant association at 5%.	203	45.93%	2.89	0.566	202	45.70%	2	0.265
Age ^ Mann-Whitney test.	36 or more	233	52.71%	2.83	0.001^* * Statistically significant association at 5%.	235	53.17%	2.81	0.566	233	52.71%	1.83	0.265
Sex ^ Mann-Whitney test.	Male	72	16.29%	2.83	0.129	72	16.29%	2.57	0.041^* * Statistically significant association at 5%.	72	16.29%	1.71	0.081
Sex ^ Mann-Whitney test.	Female	363	82.13%	3.05	0.129	365	82.58%	2.90	0.041^* * Statistically significant association at 5%.	362	81.90%	1.94	0.081
Marital status ^* ***** Kruskall-Wallis test.	Single	157	35.52%	3.03	0.471	157	35.52%	2.95	0.694	156	35.29%	1.94	1
	Separated/Divorced	42	9.50%	2.76		42	9.50%	2.81		42	9.50%	1.98
	Married	223	50.45%	3.07		225	50.90%	2.78		223	50.45%	1.87
	Widow(er)	14	3.17%	2.93		14	3.17%	2.86		14	3.17%	2
Children ^ Mann-Whitney test.	Yes	227	51.36%	2.89	0.043^* * Statistically significant association at 5%.	229	51.81%	2.73	0.069	227	51.36%	1.79	0.057
Children ^ Mann-Whitney test.	No	206	46.61%	3.15	0.043^* * Statistically significant association at 5%.	206	46.61%	2.97	0.069	205	46.38%	2.03	0.057
Spirituality ^* ***** Kruskall-Wallis test.	Yes	300	67.87%	3.01	0.879	301	68.10%	2.83	0.748	299	67.65%	1.85	0.202
	More or less	26	5.88%	2.92		27	6.11%	2.74		26	5.88%	1.69
	No	106	23.98%	3.08		106	23.98%	2.92		106	23.98%	2.1
Religious practice ^ Mann-Whitney test.	Yes	423	95.70%	2.99	0.002^* * Statistically significant association at 5%.	424	95.93%	2.83	0.103	422	95.48%	1.88	0.032^* * Statistically significant association at 5%.
Religious practice ^ Mann-Whitney test.	No	13	2.94%	4.08	0.002^* * Statistically significant association at 5%.	14	3.17%	3.43	0.103	13	2.94%	2.85	0.032^* * Statistically significant association at 5%.
Economic classification (according to ABEP)****	A	27	6.11%	3.11	0.791	27	6.11%	2.48	0.191	27	6.11%	1.48	0.414
	B1	63	14.25%	3.22		63	14.25%	3.16		63	14.25%	2.11
	B2	179	40.50%	2.98		180	40.72%	2.79		180	40.72%	1.91
	C1	115	26.02%	2.98		116	26.24%	2.91		113	25.57%	1.91
	C2	45	10.18%	2.96		45	10.18%	2.73		45	10.18%	1.89
	D-E	7	1.58%	2.86		7	1.58%	2.57		7	1.58%	1.86

Characteristic		Risk of burnout
		I feel worn out because of my work				I feel overwhelmed by the amount of work				I feel ‘bogged down’ by the system
		N	%	Mean	P value	N	%	Mean	P value	N	%	Mean	P value
Diabetes^ Mann-Whitney test.	Yes	13	2.94%	3	0.935	13	2.94%	3.08	0.567	13	2.94%	2.31	0,156
Diabetes^ Mann-Whitney test.	No	423	95.70%	3.02	0.935	425	96.15%	2.84	0.567	422	95.48%	1.9	0,156
Hypertension^ Mann-Whitney test.	Yes	60	13.57%	3.07	0.676	60	13.57%	2.97	0.424	60	13.57%	2.12	0,187
Hypertension^ Mann-Whitney test.	No	376	85.07%	3.01	0.676	378	85.52%	2.83	0.424	375	84.84%	1.88	0,187
Smoking habit^ Mann-Whitney test.	Yes	27	6.11%	2.93	0.809	28	6.33%	2.75	0.61	27	6.11%	1.59	0,073
Smoking habit^ Mann-Whitney test.	No	409	92.53%	3.03	0.809	410	92.76%	2.85	0.61	408	92.31%	1.93	0,073
Alcohol consumption^ Mann-Whitney test.	Yes	207	46.83%	3.11	0.153	209	47.29%	3.02	0.008^* * Statistically significant association at 5%.	208	47.06%	1.99	0,084
Alcohol consumption^ Mann-Whitney test.	No	229	51.81%	2.94	0.153	229	51.81%	2.69	0.008^* * Statistically significant association at 5%.	227	51.36%	1.84	0,084
General medication^ Mann-Whitney test.	Yes	152	34.39%	3.16	0.049^* * Statistically significant association at 5%.	152	34.39%	2.99	0.071	152	34.39%	2.05	0,060
General medication^ Mann-Whitney test.	No	284	64.25%	2.94	0.049^* * Statistically significant association at 5%.	286	64.71%	2.77	0.071	283	64.03%	1.83	0,060
Sleeping pill^ Mann-Whitney test.	Yes	31	7.01%	3.68	0.002^* * Statistically significant association at 5%.	31	7.01%	3.32	0.038^* * Statistically significant association at 5%.	31	7.01%	2.45	0,024^* * Statistically significant association at 5%.
Sleeping pill^ Mann-Whitney test.	No	405	91.63%	2.97	0.002^* * Statistically significant association at 5%.	407	92.08%	2.81	0.038^* * Statistically significant association at 5%.	404	91.40%	1.87	0,024^* * Statistically significant association at 5%.

Characteristic		Risk of burnout
		I feel worn out because of my work				I feel overwhelmed by the amount of work				I feel ‘bogged down’ by the system
		N	%	Mean	P value	N	%	Mean	P value	N	%	Mean	P value
Professional category^* ***** Kruskall-Wallis test. %	Nurse/Nursing Technician	311	70.36%	3.02	0.814	313	70.81%	2.84	0.263	310	70.14%	1.9	0.387
	Physical Therapist/ Occupational Therapist/ Physical Educator	50	11.31%	3.04		50	11.31%	3.08		50	11.31%	2.06
	Pharmacist/ Nutritionist	39	8.82%	3.13		39	8.82%	2.92		39	8.82%	2.05
	Psychologist/ Social Worker	36	8.14%	2.89		36	8.14%	2.53		36	8.14%	1.67
Highest training level^* ***** Kruskall-Wallis test. %	Technician	141	31.90%	2.85	0.196	142	32.13%	2.74	0.417	141	31.90%	1.85	0.461
	Undergraduate	61	13.80%	3.18		61	13.80%	2.93		61	13.80%	1.98
	Specialization	234	52.94%	3.08		235	53.17%	2.89		233	52.71%	1.93
Professional training time^* ***** Kruskall-Wallis test. %	1–6 years	139	31.45%	3.1	0.163	139	28.05%	2.76	0.058	138	31.22%	1.91	0.362
	6–11 years	123	27.83%	3.15		124	35.52%	3.08		123	27.83%	2.05
	Over 11 years	156	35.29%	2.88		157	32.58%	2.76		156	35.29%	1.84
Time between home and work^* ***** Kruskall-Wallis test. %	Up to 50 min	144	32.58%	2.99	0.818	144	32.58%	2.82	0.992	143	32.35%	1.92	0.885
	51 to 80 min	128	28.96%	3.05		128	28.96%	2.87		128	28.96%	1.91
	Over 81 min	159	35.97%	3.01		161	36.43%	2.86		159	35.97%	1.9
Time in oncology^* ***** Kruskall-Wallis test. %	Up to 45 months	132	29.86%	2.96	0.786	132	29.86%	2.58	0.015^* * Statistically significant association at 5%.	130	29.41%	1.82	0.339
	46 to 88 months	148	33.48%	3.07		148	33.48%	3.01		148	33.48%	2.03
	Over 88 months	154	34.84%	3.03		156	35.29%	2.92		155	35.07%	1.88
Time in training area^* ***** Kruskall-Wallis test. %	Up to 80 months	145	32.81%	3.20	0.037^* * Statistically significant association at 5%.	145	32.81%	2.75	0.438	143	32.35%	1.91	0.517
	81 to 140 months	145	32.81%	3.04		146	33.03%	2.93		146	33.03%	1.99
	Over 140 months	144	32.58%	2.83		145	32.81%	2.86		144	32.58%	1.85
Prior work^* ***** Kruskall-Wallis test. %	Admission	113	25.57%	2.88	0.305	113	25.57%	2.96	0.108	113	25.57%	1.87	0.757
	Outpatient	142	32.13%	3.15		143	32.35%	2.73		142	32.13%	1.89
	Critical care	97	21.95%	3.04		98	22.17%	2.71		96	21.72%	1.82
	Other	44	9.95%	2.82		44	9.95%	3.16		44	9.95%	2.09
Current unit^* ***** Kruskall-Wallis test. %	Admission	184	41.63%	2.93	0.047^* * Statistically significant association at 5%.	184	41.63%	3.01	0.023^* * Statistically significant association at 5%.	183	41.40%	2.04	0.024^* * Statistically significant association at 5%.
	Outpatient	92	20.81%	2.88		92	20.81%	2.55		91	20.59%	1.67
	Critical care	160	36.20%	3.21		162	36.65%	2.83		161	36.43%	1.89
Weekly hours^ Mann-Whitney test.	Up to 36 hours	194	43.89%	2.99	0.307	195	44.12%	2.86	0.736	192	43.44%	1.89	0.68
Weekly hours^ Mann-Whitney test.	Over 36 hours	210	47.51%	3.12	0.307	211	47.74%	2.89	0.736	211	47.74%	1.95	0.68
Daily number of patients on average^* ***** Kruskall-Wallis test. %	Up to 7 patients	146	33.03%	3.05	0.198	148	33.48%	0.87	0.366	146	33.03%	1.92	0.039^* * Statistically significant association at 5%.
	8–16 patients	149	33.71%	2.95		149	33.71%	2.9		148	33.48%	1.81
	Over 16	65	14.71%	3.25		65	14.71%	3.12		65	14.71%	2.18
Shift^ Mann-Whitney test.	Day	327	73.98%	3	0.342	327	73.98%	2.68	<0.001^* * Statistically significant association at 5%.	325	73.53%	1.85	0.126
Shift^ Mann-Whitney test.	Night	104	23.53%	3.12	0.342	106	23.98%	3.38	<0.001^* * Statistically significant association at 5%.	105	23.76%	2.12	0.126
Fixed working hours^ Mann-Whitney test.	Yes	405	91.63%	3.01	0.141	407	92.08%	2.84	0.579	404	91.40%	1.9	0.358
Fixed working hours^ Mann-Whitney test.	No	27	6.11%	3.37	0.141	27	6.11%	2.96	0.579	27	6.11%	2.15	0.358
Employment bond^ Mann-Whitney test.	Yes	77	17.42%	3.08	0.628	78	17.65%	2.92	0.582	77	17.42%	1.96	0.951
Employment bond^ Mann-Whitney test.	No	357	80.77%	3.02	0.628	358	81.00%	2.84	0.582	356	80.54%	1.9	0.951
Vacations in the previous year^ Mann-Whitney test.	Yes	365	82.58%	3.10	0.004^* * Statistically significant association at 5%.	367	83.03%	2.91	0.015^* * Statistically significant association at 5%.	365	82.58%	1.98	0.016^* * Statistically significant association at 5%.
Vacations in the previous year^ Mann-Whitney test.	No	68	15.38%	2.62	0.004^* * Statistically significant association at 5%.	68	15.38%	2.5	0.015^* * Statistically significant association at 5%.	67	15.16%	1.57	0.016^* * Statistically significant association at 5%.
Reason for working in oncology^ Mann-Whitney test.	Specific reason	259	58.60%	3.03	0.806	260	58.82%	2.81	0.470	259	58.60%	2.01	0.151
Reason for working in oncology^ Mann-Whitney test.	Non-specific reason	165	37.33%	3.02	0.806	166	37.56%	2.9	0.470	164	37.10%	1.74	0.151

Characteristc		Risk of burnout
		I feel worn out because of my work				I feel overwhelmed by the amount of work				I feel ‘bogged down’ by the system
		N	%	Mean	P value	N	%	Mean	P value	N	%	Mean
Death^* ***** Kruskall-Wallis test.	None	143	32.35%	2.8	0.007^* * Statistically significant association at 5%.	143	32.35%	2.48	<0.001^* * Statistically significant association at 5%.	141	31.90%	1.7	0.015^* * Statistically significant association at 5%.
	1 to 5	129	29.19%	2.99		130	29.41%	3.02		130	29.41%	1.92
	More than 5	134	30.32%	3.27		135	30.54%	3.10		134	30.32%	2.12
Conflicts at work^* ***** Kruskall-Wallis test.	None	152	34.39%	2.83	0.003^* * Statistically significant association at 5%.	153	34.62%	2.6	0.005^* * Statistically significant association at 5%.	153	34.62%	1.68	0.003^* * Statistically significant association at 5%.
	1 to 7	125	28.28%	2.98		125	28.28%	2.87		124	28.05%	1.95
	More than 7	120	27.15%	3.32		121	27.38%	3.11		119	26.92%	2.11
Satisfaction with work unit^* ***** Kruskall-Wallis test.	Low	40	9.05%	3.88	<0.001^* * Statistically significant association at 5%.	41	9.28%	3.9	<0.001^* * Statistically significant association at 5%.	41	9.28%	3.1	<0.001^* * Statistically significant association at 5%.
	Moderate	182	41.18%	3.35		183	41.40%	3.11		181	40.95%	2.11
	High	212	47.96%	2.58		212	47.96%	2.42		211	47.74%	1.51
Work accident^ Mann-Whitney test.	Yes	16	3.62%	3.5	0.113	16	3.62%	2.88	0.941	16	3.62%	2.06	0.567
Work accident^ Mann-Whitney test.	No	419	94.80%	3	0.113	421	95.25%	2.85	0.941	418	94.57%	1.91	0.567
Willing to give up work^ Mann-Whitney test.	Yes	63	14.25%	3.95	<0.001^* * Statistically significant association at 5%.	63	14.25%	3.62	<0.001^* * Statistically significant association at 5%.	63	14.25%	3.02	<0.001^* * Statistically significant association at 5%.
Willing to give up work^ Mann-Whitney test.	No	372	84.16%	2.87	<0.001^* * Statistically significant association at 5%.	374	84.62%	2.72	<0.001^* * Statistically significant association at 5%.	371	83.94%	1.72	<0.001^* * Statistically significant association at 5%.
Willing to give up the profession^ Mann-Whitney test.	Yes	79	17.87%	3.7	<0.001^* * Statistically significant association at 5%.	79	17.87%	3.76	<0.001^* * Statistically significant association at 5%.	79	17.87%	2.7	<0.001^* * Statistically significant association at 5%.
	No	354	80.09%	2.86	<0.001^* * Statistically significant association at 5%.	356	80.54%	2.64	<0.001^* * Statistically significant association at 5%.	353	79.86%	1.72	<0.001^* * Statistically significant association at 5%.
Leave from work in last 12 months^ Mann-Whitney test.	Yes	86	19.46%	3.34	0.011^* * Statistically significant association at 5%.	86	19.46%	3.14	0.019 ^* * Statistically significant association at 5%.	85	19.23%	2.19	0.012^* * Statistically significant association at 5%.
	No	350	79.19%	2.94	0.011^* * Statistically significant association at 5%.	352	79.64%	2.78	0.019 ^* * Statistically significant association at 5%.	350	79.19%	1.84	0.012^* * Statistically significant association at 5%.
Want to change to another healthcare area^ Mann-Whitney test.	Yes	110	24.89%	3.54	<0.001^* * Statistically significant association at 5%.	111	25.11%	3.41	<0.001^* * Statistically significant association at 5%.	110	24.89%	2.48	<0.001^* * Statistically significant association at 5%.
	No	324	73.30%	2.84	<0.001^* * Statistically significant association at 5%.	325	73.53%	2.65	<0.001^* * Statistically significant association at 5%.	323	73.08%	1.72	<0.001^* * Statistically significant association at 5%.
No longer want to work in the healthcare field^ Mann-Whitney test.	Yes	107	24.21%	3.6	<0.001^* * Statistically significant association at 5%.	107	24.21%	3.43	<0.001^* * Statistically significant association at 5%.	107	24.21%	2.38	<0.001^* * Statistically significant association at 5%.
	No	329	74.43%	2.83	<0.001^* * Statistically significant association at 5%.	331	74.89%	2.66	<0.001^* * Statistically significant association at 5%.	328	74.21%	1.76	<0.001^* * Statistically significant association at 5%.

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E-mail: reeusp@usp.br

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[1] Corresponding author: Ana Paula Neroni Stina Saura, Rua Dr Luiz Migliano, 1870, apto 32 A, 05711-001 – Jd Caboré, São Paulo, SP, Brazil, ana.stina@usp.br