Burnout among primary care physicians: a systematic review
DOI:
https://doi.org/10.5712/rbmfc10(34)958Keywords:
Burnout, Professional, Physicians, Family, Primary Health Care, ReviewAbstract
Objectives: to analyze the associations between burnout syndrome and individual and work-related characteristics among primary care physicians. Methods: a systematic review was performed using the Medline (PubMed), SciELO, Lilacs and Cochrane databases. In November, 2013, we ran a search based on the descriptors: “professional burnout”, “health personnel”, and “primary care”. We assessed 2,416 titles and 18 studies were selected. Results: the prevalence of burnout was high among primary care physicians. Burnout was associated with physical illnesses, mental disorders, and alcohol and substance abuse. Physicians who had higher levels of emotional exhaustion were more likely to be absent from work, and to change their job. Physicians suffering from burnout were also more likely to increase pharmaceutical expenditure per patient. The work-related characteristics associated with burnout were: length of employment in primary care, number of working hours per week, number of patients attended, type of employment contract, teaching activity, holiday period, and difficulties in dealing with other staff. Conclusion: the high prevalence of burnout among primary care physicians is a major concern for policy makers, since primary care is the cornerstone of health systems, and burnout syndrome can jeopardize the quality of care provided to populations, and the effectiveness of the entire health care system. Understanding the factors associated with burnout allows the development of strategies for intervention and prevention.
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World Health Organization (WHO). Declaration of Alma-Ata [Internet].Geneva: WHO; 1978 [acesso em 2014 May 20]. Disponível em: http://www.who.int/publications/almaata_declaration_en.pdf
Rohde J, Cousens S, Chopra M, Tangcharoensathien V, Black R, Bhutta ZA, et al. 30 years after Alma-Ata: has primary health care worked in countries? Lancet. 2008;372:950–61.http://dx.doi.org/10.1016/S0140-6736(08)61405-1 DOI: https://doi.org/10.1016/S0140-6736(08)61405-1
Ministério da Saúde (BR). Histórico da cobertura da estratégia saúde da família. 2014. http://dab.saude.gov.br/portaldab/historico_cobertura_sf.php
Starfield B. Is primary care essential? Lancet. 1994;344:1129–33. http://dx.doi.org/10.1016/S0140-6736(94)90634-3 DOI: https://doi.org/10.1016/S0140-6736(94)90634-3
Maslach C, Jackson SE. The measurement of experienced burnout.J Occup Behav. 1981;2:99–113. http://dx.doi.org/10.1002/job.4030020205 DOI: https://doi.org/10.1002/job.4030020205
Willard-Grace R, Hessler D, Rogers E, Dubé K, Bodenheimer T, Grumbach K. Team structure and culture are associated with lower burnout in primary care. J Am Board Fam Med. 2014;27:229–38. http://dx.doi.org/10.3122/jabfm.2014.02.130215 DOI: https://doi.org/10.3122/jabfm.2014.02.130215
Ahola K, Hakanen J. Job strain, burnout, and depressive symptoms: A prospective study among dentists. J Affect Disord. 2007;104:103–10. http://dx.doi.org/10.1016/j.jad.2007.03.004 DOI: https://doi.org/10.1016/j.jad.2007.03.004
Silva ATC, Menezes PR. Burnout syndrome and common mental disorders among community-based health agents. Rev Saúde Pública. 2008;42:921–9. http://dx.doi.org/10.1590/S0034-89102008000500019 DOI: https://doi.org/10.1590/S0034-89102008000500019
Soler JK, Yaman H, Esteva M, et al. Burnout in European family doctors: the EGPRN study. Fam Pract. 2008;25:245–65. http://dx.doi.org/10.1093/fampra/cmn038 DOI: https://doi.org/10.1093/fampra/cmn038
Freudenberger HJ. Staff Burn-Out. J Soc Issues. 1974;30:159–65. http://dx.doi.org/10.1111/j.1540-4560.1974.tb00706.x DOI: https://doi.org/10.1111/j.1540-4560.1974.tb00706.x
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535. http://dx.doi.org/10.1136/bmj.b2535 DOI: https://doi.org/10.1136/bmj.b2535
Fletcher RH, Fletcher SW, Fletcher GS. Clinical Epidemiology. The essentials., Fifth. Phyladelphia:Willians& Wilkins; 2014. Chapter 1, Basic Principles; p. 7–11.
Fletcher RH, Fletcher SW, Fletcher GS. Clinical Epidemiology. The essentials., Fifth. Phyladelphia: Willians& Wilkins; 2014. Chapter 3, Performance of measurements; p. 32–5.
Goehring C, BouvierGallacchi M, Künzi B, Bovier P. Psychosocial and professional characteristics of burnout in Swiss primary care practitioners: a cross-sectional survey. SwissMedWkly. 2005 [acesso em 2014 May 20];135(7-8):101–8. Disponível em: http://www.smw.ch/docs/pdf200x/2005/07/smw-10841.pdf
Muñoz AM de la C. Estudio sobre la prevalencia del burnout en los médicos del Área Sanitaria de Talavera de la Reina. Atención Primaria. 2003;32:343–8. http://dx.doi.org/10.1016/S0212-6567(03)79294-4 DOI: https://doi.org/10.1016/S0212-6567(03)79294-4
Al-Sareai NS, Al-Khaldi YM, Mostafa O a, Abdel-Fattah MM. Magnitude and risk factors for burnout among primary health care physicians in Asir Province, Saudi Arabia.East Mediterr Health J. 2013;19:426–34. DOI: https://doi.org/10.26719/2013.19.5.426
Tena PS, Soriano JS. Desgaste profesional en los médicos de atención primaria de Barcelona. Medifam. 2002;12:613–9. http://dx.doi.org/10.4321/S1131-57682002001000002 DOI: https://doi.org/10.4321/S1131-57682002001000002
Marcelino G, Cerveira JM, Carvalho I, et al. Burnout levels among Portuguese family doctors: a nationwide survey. BMJ Open. 2012;2:1–6. http://dx.doi.org/10.1136/bmjopen-2012-001050 DOI: https://doi.org/10.1136/bmjopen-2012-001050
Prieto Albino L, Robles Agüero E, Salazar Martínez LM, Daniel Vega E. Burnout in primary care doctors of the province of cáceres. Atención Primaria. 2002;29:294–302. http://dx.doi.org/10.1016/S0212-6567(02)70567-2 DOI: https://doi.org/10.1016/S0212-6567(02)70567-2
Cebrià J, Sobrequés J, Rodríguez C, Segura J. Influencia del desgaste profesional en el gasto farmacéutico de los médicos de atención primaria. Gac Sanit. 2003;17:483–9. http://dx.doi.org/10.1016/S0213-9111(03)71795-6 DOI: https://doi.org/10.1016/S0213-9111(03)71795-6
Aranda Beltrán C. Diferencias por sexo, Síndrome de burnout y manifestaciones clínicas, en los médicos familiares de dos instituciones de salud, Guadalajara, México. Rev Costarric Salud Pública. 2006;15(29):1–7.
Aguilera EC, García JEGA. Prevalencia del síndrome de agotamiento profesional (burnout) en médicos familiares mexicanos: análisis de factores de riesgo. Rev Colomb Psiquiatr. 2010;39:67–84. http://dx.doi.org/10.1016/S0034-7450(14)60237-7 DOI: https://doi.org/10.1016/S0034-7450(14)60237-7
Matía Cubillo AC, Cordero Guevara J, Mediavilla Bravo JJ, Pereda Riguera MJ, González Castro ML, González Sanz A. Evolution of burnout and associated factors in primary care physicians. Atención Primaria. 2012;44:532–9. http://dx.doi.org/10.1016/j.aprim.2010.05.021 DOI: https://doi.org/10.1016/j.aprim.2010.05.021
Stanetic K, Tesanovic G. Influence of age and length of service on the level of stress and burnout syndrome. Med Pregl. 2013;66:153–62. http://dx.doi.org/10.2298/MPNS1304153S DOI: https://doi.org/10.2298/MPNS1304153S
Aranda Beltrán C, Pando Moreno M, Salazar Estrada JG, Torres López TM, Aldrete Rodríguez MG, Pérez Reyes MB. Síndrome de Burnout en médicos familiares del Instituto Mexicano del Seguro Social, Guadalajara, México. Rev Cubana Salud Pública. 2005 [acessado em 2014 Jun 23];31(2). Disponível em: http://scielo.sld.cu/scielo.php?script=sci_arttextπd=S0864-34662005000200005&lng=es&nrm=iso&tlng=es
Bovier PA, Arigoni F, Schneider M, Gallacchi MB. Relationships between work satisfaction, emotional exhaustion and mental health among Swiss primary care physicians. Eur J Public Health. 2009;19:611–7. http://dx.doi.org/10.1093/eurpub/ckp056 DOI: https://doi.org/10.1093/eurpub/ckp056
Cebrià J, Segura J, Corbella S, et al. Rasgos de personalidad y burnout en médicos de familia. Atención Primaria. 2001;27:459–68. http://dx.doi.org/10.1016/S0212-6567(01)78836-1 DOI: https://doi.org/10.1016/S0212-6567(01)78836-1
Sánchez-Cruz J, Mugártegui-Sánchez S. [Burnout síndrome among family physicians]. Rev Med Inst Mex Seguro Soc. 2013;51:428–31.
Aranda Beltrán C. Factores psicosociales y síndrome de burnout em médicos de familia. México. An Fac Med. 2005;66:225–31. DOI: https://doi.org/10.15381/anales.v66i3.1346
Sobrequés J, Cebrià J, Segura J, Rodríguez C, García M, Juncosa S. La satisfacción laboral y el desgaste profesional de los médicos de atención primaria. [Job satisfaction and burnout in general practitioners]. Atención Primaria. 2003;31:227–33.
http://dx.doi.org/10.1016/S0212-6567(03)79164-1 DOI: https://doi.org/10.1016/S0212-6567(03)79164-1
Ahola K, Honkonen T, Kivimäki M, et al. Contribution of burnout to the association between job strain and depression: the health 2000 study. J Occup Environ Med.2006;48:1023–30. http://dx.doi.org/10.1097/01.jom.0000237437.84513.92 DOI: https://doi.org/10.1097/01.jom.0000237437.84513.92
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