Ispitivanje sindroma sagorevanja kod zdravstvenih radnika i saradnika zaposlenih u onkološkoj ustanovi

Abstract

Sindrom sagorevanja (eng. burnout) je okupacioni fenomen koji utiče na svakodnevno životno i profesionalno funkcionisanje osobe, a može imati i negativan uticaj na bezbednost pacijenta i kvalitet pružene usluge. Sindrom sagorevanja je definisan kao psihološko stanje koje karakteriše emocionalna iscrpljenost, depersonalizacija i smanjeno lično postignuće. Cilj: Cilj ovog rada je bio procena prevalencije sindroma sagorevanja kod zdravstvenih radnika i zdravstvenih saradnika zaposlenih u najvećem referentnom onkološkom centru u Srbiji i prepoznavanje osetljivih subkohorti zaposlenih koji su u najvećem riziku za nastanak sindroma sagorevanja. Metod: Studija preseka sprovedena je u Institutu za onkologiju i radiologiju Srbije u periodu od maja 2019. do jula 2019. godine. Upotrebom standardizovanih upitnika evaluirali smo stepen sindroma sagorevanja, depresivnost, zamor, socijalno demografske i profesionalne karakteristike i kvalitet života kod lekara, medicinskih sestara/tehničara i zdravstvenih saradnika. Od 576 distribuiranih upitnika, 432 ispitanika je prihvatilo učešće u istraživanju (75%). Rezultati: Prevalencija sindroma sagorevanja kod zdravstvenih radnika i zdravstvenih saradnika je bila 43.4%, sa najvećim stepenom sagorevanja u domenu emocionalne iscrpljenosti (66.9%). U nekorigovanom modelu, rezultati multivarijantne regresione analize pokazali su da medicinske sestre/tehničari imaju 1.41 puta veću verovatnoću da razviju sindrom sagorevanja u odnosu na lekare (OR=1.41, 95% CI 1.16-7.10),i da svaka godina radnog staža u onkologiji povećava rizik za oko 2% (OR=1.02, 95% CI 1.00-1.92). Takođe, utvrđeno je da sa svakim bodom PHQ-9 skora verovatnoća za nastanak sindroma sagorevanja se povećava 14% (OR=1.14, 95% CI 1.07-1.94). Na kraju, nakon kontrole svih potencijalnih pridruženih varijabli, pokazano je da kompozitni skor mentalnog zdravlja ima nezavisnu prognostičku vrednost u proceni sindroma sagorevanja i da sa svakim bodom ovog skora verovatnoća za nastanak sindroma sagorevanja raste 17% (OR=1.17, p=0.002). Zaključak: Naše istraživanje je pokazalo da postoji značajan stepen sindroma sagorevanja kod zdravstvenih radnika i zdravstvenih saradnika, naročito u populaciji medicinskih sestara i zdravstvenih tehničara. Neophodno je razviti efikasne modele podrške na individualnom i sistemskom nivou za zdravstvene radnike i saradnike koji leče i pružaju zdravstvenu negu onkološkim pacijentima.

Burnout is an occupational phenomenon that affects the psychological well-being and quality of life of healthcare professionals with potential negative impact on patients’ safety and quality of health care. It has been defined as a psychological state of emotional exhaustion, depersonalization and reduced personal accomplishment. Objective: The aim of this study was to investigate the level of burnout and identify who is at highest risk among healthcare professionals (HCPs) working at the largest referent national institution. Methods: A cross-sectional survey was conducted at the Institute of Oncology and Radiology of Serbia from May 2019 to July 2019, evaluating the level of burnout, depression, fatigue, socio-demographic, behavioural and professional characteristics, and quality of life among healthcare professionals. Of the 576 distributed questionnaires among physicians, nurses/technicians and healthcare co-workers, 432 participants returned their questionnaires (75%). All instruments used in our study had been validated and cross-culturally adapted to Serbian language. Results:The overall prevalence of burnout was 42.4%, with the greatest proportion of burned out in emotional exhaustion domain (66.9%). The multivariable-adjusted model analysis showed that nurses/technicians had a 1.41 times greater chance of experiencing burnout, compared to physicians (OR=1.41, 95% CI 1.16-7.10), and that with each year of work experience, the chance of burnout increased by about 2% (OR=1.02, 95% CI 1.00-1.92). Furthermore, it was shown that, with each point in the PHQ-9 score for depression, probability of burnout increased by 14% (OR=1.14, 95% CI 1.07-1.94). Finally, after controlling all these potential confounders, the Mental Composite Score of SF-36 score showed an independent prognostic value in exploring the burnout presence among HCPs (OR=1.17, 95% CI 1.03-2.47). Conclusion: Our research showed a significant level of burnout among healthcare professionals working in oncology, especially among nurses/technicians. The development of effective interventions at both individual and organizational level toward specific risk groups is needed.