Estudio de la empatía y burnout de los médicos y enfermeras de Atención Primaria de la Región Sanitaria de Lleida y su relación con las variables clínicas

Introducción: Diversos estudios han relacionado el nivel de empatía y burnout , con una mejor competencia clínica y asistencial de sus pacientes. Objetivo: Analizar el nivel de empatía y burnout de los profesionales asistenciales de la Atención Primaria de la Región Sanitaria de Lleida y su relación con las variables clínicas asistenciales. Metodología: Estudio descriptivo en el que han participado todos los médicos de familia y enfermeras de la región sanitaria de Lleida con cupo asignado de las 23 Áreas Básicas de Salud de la Región Sanitaria de Lleida. Se ha utilizado la escala de Jefferson para la evaluación de la empatía y la escala de Maslach para el burnout. Se ha estratificado a los sanitarios en tres grupos según su grado de empatía y burnout en Bajo, medio y alto. Se ha realizado análisis descriptivos para resumir las características de la población de estudio, de los médicos y enfermeras analizados, y las respectivas variables de edad, sexo, características del cupo, niveles absolutos de resultados del ECA y ECPF, para los distintas variables clínicas por separado y las tasas de frecuentación de 301657 pacientes. El trabajo tiene la autorización del CEIC. Se ha garantizado la confidencialidad y el anonimato de los datos conforme a la Ley de Protección de Datos. Resultados: La empatía está asociada con los niveles de burnout. Los profesionales más empáticos tienen mejor control de enfermedades como la hipertensión arterial y realizan una mejor prescricpión farmacéutica. Además los profesionales más empáticos prescriben mayor número de bajas laborales.Introducció: Diferents estudis han relacionat el nivell d'empatía i burnout, amb una millor competència clínica i asssistencial dels seus pacients. Objetiu: Analitzar el nivell d'empatía i burnout dels professionals assistencials de l'atención primària de la regió Sanitaria de Lleida i la seva relació amb les variables clíniques i assistencials. Metodología: Estudi descriptiu en el qeu han participat tots els metges de familia i enfermeria de la regió santiaria de Lleida amb un cupo assignat de les 23 Àrees Bàsiques de Salut de la Regió Sanitària de Lleida. S'ha utilitzat l'escala de Jefferson per a l'avaluació de l'empatía i l'escala de Maslach per al burnout. S'ha estratificat als sanitaris en tres grups segons el seu grau d'empatia i burnout: Baix, mig i alt. S'ha realitzat anàlisi descriptiu per a resumir les característiques de la població d'estudi, dels metges i infermeres analitzats i les respectives variables d'edat, sexe, característiques del cupo, nivells absoluts dels resultats de l'ECA i l'ECPF, per a les dfierents variables clíniques per separat i les taxes de freqüentació de 301657 pacients. El treball té l'autorització del CEIC. S'ha garantit la confidencialitat i l'anonimat de les dades conforme a la Llei de Protecció de Dades. Resultats: L'empatía està associada amb els nivells de burnout. Els professionals més empàtics tenen millor control de les malalties com la hipertensió arterial i realitzen una millor prescripció farmacèutica. A més, els professionals més empàtics prescriuren un major número de baixes laborals.Introduction: Several studies have linked the level of empathy and burnout, with better clinical competence and with a better degree of clinical control of their patients. Objective: Analyze the level of empathy and burnout of health care professionals of Primary Health Care District of Lleida and its relation to health care clinical variables. Methodology: Descriptive study which involved all family doctors and nurses in the health region of Lleida assigned to the 23 Basic Health Areas of Lleida Health Region quota. We used the Jefferson Scale for assessing empathy and Maslach scale for burnout. It has been laminated to health in three groups according to their degree of empathy and burnout Low, medium and high. Descriptive analysis was performed to summarize the characteristics of the study population, doctors and nurses analyzed, and the respective variables of age, gender, characteristics of patients, absolute levels of ECA and ECPF, and results for the different clinical variables separately and attendance rate of 301657 patients. The work is authorized by the Catalan Ethical Comittee. It has ensured the confidentiality and anonymity of the data under the Protection Data Law. Results: Empathy is associated with levels of burnout. More empathetic professionals have better control of diseases such as hypertension and perform better pharmaceutical prescricpión. Further more empathetic professionals prescribe greater number of sick leave

Factor structure of the Maslach Burnout Inventory Human Services Survey in Spanish urgency healthcare personnel: a cross-sectional study

Background: The Maslach Burnout Inventory (MBI) is an instrument commonly used to evaluate burnout syndrome. The goal of the present study was to assess the internal reliability and the performance of the items and the subscales of the MBI-HSS (the version for professionals working in human services) by validating its factorial structure in Spanish urgency healthcare personnel. Methods: Cross-sectional study including 259 healthcare emergency professionals (physicians and nurses) in the Spanish health region of Lleida and the Pyrenees. Burnout was measured using the Spanish validated version of the MBI-HSS. Internal reliability was estimated using Cronbach’s alpha coefcient. The sampling adequacy was assessed using the Kaiser-Meyer-Olkin measure along with the Bartlett’s test of sphericity. A principal axis exploratory factor analysis with an oblique transformation of the solution and a confrmatory factor analysis with maximum likelihood estimation were performed. Goodness-of-ft was assessed by means of the chi-square ratio by the degrees of free dom, the standardized root mean square residual (SRMR), the root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative ft index (CFI). Results: The three subscales showed good internal reliability with Cronbach’s alpha coefcients exceeding the critical value of 0.7. Exploratory factor analysis revealed fve factors with eigenvalues greater than 1. Nevertheless, confrmatory factor analysis showed a relatively satisfactory ft of the three-factor structure (χ2 /df=2.6, SRMR=0.07, RMSEA=0.08, TLI=0.87, CFI=0.89), which was improved when several items were removed (χ2 /df=1.7, SRMR=0.04, RMSEA=0.05, TLI=0.97, CFI=0.98). Conclusions: Although it is necessary exploring new samples to get to more consistent conclusions, the MBI-HSS is a reliable and factorially valid instrument to evaluate burnout syndrome in health professionals from the Spanish emergency services

Lack of protective effect of chloroquine derivatives on COVID-19 disease in a Spanish sample of chronically treated patients

Background The search for a SARS-CoV-2 treatment has emerged as a worldwide priority. We evaluated the role of chloroquine and its derivatives in COVID-19 in Spanish individuals. Methods We performed a survey addressed to patients regularly taking chloroquine and its derivatives for the control of their autoimmune diseases. The survey was distributed with special attention to Spanish patient associations centred on autoimmune diseases and rheumatology and to the general population. A sample of untreated subjects was matched to the treated group according to sex, age range and incidence region. COVID-19 disease prevalence was compared between treated and untreated-matched control sample. Results A total of 319 surveys of patients regularly taking chloroquine and its derivatives were recovered for further analysis. The prevalence of declared COVID-19 status in the treated group was 5.3% and the mean prevalence among the untreated-matched groups was 3.4%. A community exposition to COVID-19 was associated with a greater prevalence of COVID-19 in both, treated (17.0% vs. 3.2%; p-value<0.001) and untreated groups (13.4% vs. 1.1%; p-value = 0.027). Conclusion We did not find differences of reported COVID-19 cases between treated and untreated groups, indicating a lack of protection by regular administration of chloroquine and its derivative drugs on COVID-19 infection. Of relevance, data indicates that patients that regularly take chloroquine derivatives are exposed to SARS-CoV-2 infection and must take the same protection measures as the general population

Increase of burnout among emergency department professionals due to emotional exhaustion during the SARS-Cov2 pandemic: Evolution from 2016 to 2021

The objective is to establish there have been any significant changes in the evolution of levels of burnout and empathy at the different Emergency Department in our region, bearing the severe acute respiratory syndrome coronavirus 2 pandemic. This cross-sectional observational study was conducted in a healthy region between November 2020 and January 2021. Lleida emergency care centers. All the doctors and nurses of the health were contacted by email. Empathy was measured using the Spanish version of the Jefferson scale of physician empathy. Burnout was measured using the Maslach Burnout Inventory (MBI) in the version validated in Spanish. Sociodemographic data were also recorded. We compared the data with 2016 results. A total of 159 professionals agreed to participate in this study. A significant increase in the MBI score was observed in the 2020 to 2021 sample (39.5 vs 49.7), mostly due to an increase in the MBI-EE (21.5 vs 28.5), as well as an increase in the Jefferson scale of physician empathy score (112 vs 116). (P = .039). There were no differences when analyzing the association between professions (nurses or doctors) or years worked, burnout, and empathy. For 2020 to 2021, the 41 to 50 years age group showed the highest burnout (MBI score). Emergency department practitioners suffered more burnout compared to 2016, especially due to emotional exhaustion (P < .001). Despite practitioners’ improved degree of empathy, which had been described as being preventative against burnout, during the COVID-19 pandemic, over-involvement may have led to empathic stress and emotional exhaustion, giving rise to greater burnout

La empatía médica, ¿nace o se hace? Evolución de la empatía en estudiantes de medicina

Introducción y objetivos: La empatía es una de las competencias básicas en el aprendizaje de la medicina, relacionándose con mejor relación médico-paciente, mejor competencia profesional y menor estrés profesional. Algunos estudios en el ámbito anglosajón muestran una disminución de la empatía durante el aprendizaje de la medicina. El presente estudio pretende medir el grado de empatía en estudiantes de medicina de nuestro medio, comparándolo con una serie de variables sociodemográficas y su evolución durante los estudios de medicina. Material y método: Se administra el cuestionario TECA de medida de empatía, que mide 4 subescalas (comprensión empática, adopción de perspectivas, alegría empática y estrés empático), así como un cuestionario sociodemográfico, a 191 estudiantes de 1.◦, 3.◦ y segundo ciclo (4.◦ y 5.◦) de Medicina de la Facultad de Medicina de Lleida. Resultados: En nuestra muestra se aprecia una progresión de la empatía durante los cursos de medicina. Presentan mayor empatía las estudiantes femeninas, también mayor estrés empático. Los estudiantes masculinos presentan menor empatía, menor progresión de esta durante los cursos y menor estrés empático. Presentan menor empatía los estudiantes que prefieren la serie House y los que tienen familiares médicos. Presentan mayor empatía los estudiantes que han realizado voluntariado, y los que han tenido un amigo enfermo. No se halla relación entre empatía y especialidad deseada. Conclusiones: Existen diversas variables que se relacionan con mayor empatía en estudiantes de medicina: mujeres, estudiantes de cursos avanzados, vivencias cercanas de enfermedades graves y los implicados en actividades de voluntariad

Assessment of the length of sick leave in patients with ischemic heart disease

Background The prevalence of ischemic heart disease is high. Few recent studies have investigated the periods of sick leave of these patients. Our aim is to determine the length of sick leave after an acute coronary syndrome, its costs, associated factors and to assess the use of antidepressants and/or anxiolytics. Methods An observational study of a retrospective cohort of patients on sick leave due to ischemic heart disease in a health region between 2008-2011, with follow-up until the first return to work, death, or end of the study (31/12/2012). Measurements: length of sick leave, sociodemographic variables and medical prescriptions. Results Four hundred and ninety-seven patients (mean age 53 years, 90.7% male), diagnosed with acute myocardial infarction (60%), angina pectoris (20.7%) or chronic form of ischemic heart disease (19.1%). Thirty-seven per cent of patients took anxiolytics the year after diagnosis and 15% took antidepressants. The average duration of sick leave was 177 days (95% CI: 163-191 days). Patients diagnosed with acute myocardial infarction returned to work after a mean of 192 days, compared to 128 days in cases with angina pectoris. Patients who took antidepressants during the year after diagnosis returned to work after a mean of 240 days. The mean work productivity loss was estimated to be 9,673 euros/person. Conclusions The mean duration of sick leave due to ischemic heart disease was almost six months. Consumption of psychotropic medication doubled after the event. Older age, suffering an acute myocardial infarction and taking antidepressants were associated with a longer sick leave period