Não informado.

Author(s)

Karina Pereira Lima

• Document type: Doctoral Thesis
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto (PCARP/BC)
• Defense date: 2018-08-08

Examining board members

Sonia Regina Loureiro; Cristina Marta Del Ben; Valdes Roberto Bollela; Mary Sandra Carlotto; Jair de Jesus Mari

• Advisor: Sonia Regina Loureiro; José Alexandre de Souza Crippa

Abstract

The high prevalence of burnout indicators and their associations with numerous negative consequences for doctors and their patients are well-recognized problems among resident physicians. A series of sociodemographic, organizational, personal, and mental health characteristics have been separately shown to be associated with resident burnout. However, a longitudinal evaluation of the independent contribution of each of these characteristics, when assessed simultaneously, for resident burnout remains a knowledge gap in the literature. The main objective of the present study was to examine the predictive capacity of sociodemographic characteristics, organizational variables, personality factors, social skills, and indicators of mental health problems concerning anxiety, depression, and alcohol intake on burnout in resident physicians, using both a cross-sectional and longitudinal design. In addition, this study had the objective of comparing burnout indicators and the characteristics related to these variables demonstrated by resident physicians at the beginning and end of residency programs. This study employed two different designs. The cross-sectional design included a sample of 270 resident physicians from 37 programs of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP. The longitudinal design included 120 resident physicians from 21 programs offered by the same institution, who were assessed at two different points in time: At the beginning and at the end of residency programs. The following standardized instruments, validated for use in the Brazilian population, were used: Burnout Syndrome Inventory, Neo-Five Factor Inventory, Social Skills Inventory, Patient Health Questionnaire-4, and the Alcohol Use Disorders Identification Test-3. Standard univariate analyses were used to characterize both samples included in the study. Subsequently, multivariable logistic regression was used to accomplish the main objective of the present study. Statistical significance was set at the .05 level. The longitudinal assessment of trajectories of burnout indicators over the course of residency training identified that 40% of resident physicians presented burnout indicators at the two points assessed, 20% only at the beginning of residency training, 19.2% only at the end of their programs, and 20.8% did not present indicators of burnout at any of the points assessed. Therefore, 59.2% of resident physicians complete their training with the presence of burnout indicators. Regarding the indicators of mental health problems, personality and social skills, there were no significant changes of such indicators between the two points assessed by the present study. A reduction in the weekly work hours at the end of residency training was verified. Multivariable models of burnout indicators, assessed through two different designs, identified both increased work hours and neuroticism as significant risk factors for burnout. Conversely, organizational conditions and social skills protected against the development of burnout. It was verified that burnout was a persistent problem throughout residency, and that residency training did not facilitate the development of protective factors, such as social skills, that could mitigate burnout for physicians as they face the stressful demands of their training. (AU)

• FAPESP's process: 14/06972-7 - Burnout: personality, social skills and mental health predictors during the medical residency
• Grantee: Karina Pereira Lima
• Support Opportunities: Scholarships in Brazil - Doctorate