0Tashkent Medical Academy Integration of Science, Education and Practice in Modern Psychology,
Pedagogy: a Problem and Solutions
Toshkent tibbiyot akademiyasi Zamonaviy psixologiya, pedagogikada fan, ta'lim va amaliyot integratsiyasi:
muammo va yechimlar
SYNDROME OF EMOTIONAL BURNING OUT IN DOCTORS OF
VARIOUS SPECIALTIES
Nargiza Fakhritdinovna Yadgarova
Tashkent Medical Academy DSc.
ABSTRACT
The article presents the results of studying one of the professional personal disorders - syndrome of emotional burning out. Features of syndrome development in doctors of different age and professional groups are analyzed. Reliable gender and age distinctions are revealed: a total indicator of expressiveness of a phase of pressure is higher in the group of female doctors from 24 till 34 years, the resistance phase on a total indicator is observed in women at the age of 46-55 years. Weak direct correlation (p <0,05) of resistance phase and all its symptoms in men is revealed. In addition, the resistance phase is revealed in more than half of the respondents, phases of pressure and exhaustion is registered in almost every fifth doctor. Features of development of emotional burning out are seen in various professional groups. Oncologists and psychiatrists are more predisposed to emotional burning out syndrome.
Keywords: doctor, stress, syndrome of emotional burning out.
The professional activity of doctors is accompanied by constant psycho-emotional stress [3, 6]. It can be accompanied by professional personality disorders, i.e. depression, workaholic behavior disorders, emotional disorder syndromes, taking psychoactive substances (mainly alcohol, tobacco, various drugs based on the depressant mechanism). Also, this situation leads to the development of various psychosomatic and neurological diseases [1], alcoholism. In addition, in terms of possible health consequences, these processes can lead to disruption of professional flexibility and functional impairment within professionals and the entire community.
Nowadays, the increasing number of this syndrome indicates the need to pay attention to the development of the syndrome. Emotional exhaustion develops as a result of situations and events in human labor and is manifested in mental stress and somatic reactions [4].
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For several decades, occupational stress has been the center of attention of medical workers abroad, and it has been actively studied not only by medical psychologists, but also by clinicians of various specialties.
Purpose. The purpose of this work is to study the development of emotional exhaustion syndrome in groups of doctors of different gender, age and specialty.
MATERIALS AND METHODS
The study of indicators of the syndrome of "emotional exhaustion" was carried out using the questionnaire "Emotional exhaustion" (V.V. Boyko). Interpretation of the results was carried out in three stages, including four symptoms.
Aggravation of each symptom was scored as follows:
- 9 points or less - undeveloped symptom;
- 10-15 points - a developing symptom;
- A score of 16 or more is a definite sign.
Indicators by syndrome EBO stages:
- 36 points or less - was evaluated as an unformed phase;
- 37-60 points - a stage that continues to form;
- 61 points or more points - formed stage.
During the research, 500 people were studied. Among them, women made up 77.4% (387 people), men made up 22.6% (113 people). The average age of the subjects was 44.3±1.49 years (p<0.01).
When divided into age groups, the following age groups:
- 24-34 years old - 24.2%, average age - 29.86±0.79 years (p<0.01);
- 35-44 years old - 25.4%, average age - 39.58±0.75 years (p<0.01);
- 45-54 - 32.6%, average age - 49.85±0.66 years (p<0.01);
- 55-64 years old - 14.2%, average age - 58.36±1.02 years (p<0.01);
- 3.6% older than 65 years old, average age - 68.27±2.1 years (p<0.01).
The mean age of men and women did not differ significantly (p<0.05).
The specialists who participated in the study were distributed as follows: 32.2% of doctors (161 people) work in primary health care institutions, 67.8% (339 people) - participants work in hospitals. The highest percentage of narrow specialty doctors - 36% (180 people); therapists - 25% (125 people); pediatricians - 19% (95 people); obstetricians-gynecologists - 13% (65 people); surgeons - 7% (35 people).
RESULTS AND DISCUSSION
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A general analysis of the stages of emotional extinction yielded the following results (mean values for the entire population of subjects tested):
- tension phase - 41.5 points - this is the phase of the formation stage, the symptom that appears at this stage is psycho-emotional traumatic conditions.
- exhaustion stage - 42.5 points - enters the formation stage. In this case, all the signs listed above are evident (p<0.05).
- "Resistance" stage - 62.77 points - the main symptoms of this phase are considered to be "insufficient selective emotional response" and "reduced professional responsibility", and emerging symptoms are "emotional and moral disorientation" and feeling comes to the surface with "intensification of holding them".
During the study, the total score of the stress phase was significantly higher (p<0.05) in the group of female doctors aged 24 to 34 years, and the symptom of "falling into a cage" developed mainly due to "experiencing psycho-traumatic situations". In the group of male doctors aged 35-44 and over 55, the rate of development of "self-dissatisfaction" symptoms was significantly higher. The stage of resistance was formed as a general indicator among women aged 46-55, and the values of the following signs were significantly higher in this group: "adequate selective emotional response", "increased expression of emotions", "reduction of professional obligations" ". In older men, 55 years old - identified symptoms: "adequate selective emotional response" and "decreased professional responsibility". A weak direct correlation was established between the increasing stage of resistance and all its symptoms and the age of men (p<0.05). 24-35; 36-45; In the 46-55 age groups, the resistance phase is in the process of formation, and in people over 56 years of age, the phase has been formed.
Among the symptoms of this stage in all age groups, "adequate selective emotional response" prevailed, mainly in men. Also, in the groups of 46-55 years old, over 56 years old and people, as a sign of "adequate selective emotional reaction" it was manifested in the form of a decrease in professionalism, a decrease in responsibility, and a violation of relations with partners. In the age group of 45-54, the fading stage prevails due to the appearance of "psychosomatic and psychovegetative diseases" in men, and in those over 55 - due to "personal separation" or depersonalization.
Significant gender differences were found in general indicators: women significantly higher "due to experiencing psychological traumatic situations", the phase of the resistance stage and all its symptoms are formed, in men - in the stage of
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formation, fatigue and its symptoms: "emotional deficiency", symptoms of "psychosomatic and psychovegetative diseases", "personal separation or depersonalization" developed. The analysis of the results showed that 35.4% of the studied individuals have signs of emotional exhaustion, and 8.6% have all three stages fully formed. Most of the doctors (58.2±2.5% of women and 55±4.7% of men) developed a resistance phase. 18.4±1.9% of women and 18±3.6% of men developed a tension stage. Fatigue phase was formed in 19.4±2.0% of women and 18±3.6% of men. All three phases of the formation stage were identified in one out of three doctors: tension (36% of men, 38% of women), resistance (30% of men, 36% of women), fading (40% of men, 37% of women) (p<0 .05) (Figure 1). This shows that many professionals experience psycho-emotional tension and stress during their work, and this condition causes the development of symptoms of emotional exhaustion.
Analysis of the characteristics of different stages of ESB among doctors showed some characteristics of specialists. Of the total number of doctors, only 6% of specialists do not have ESB. Differences in the characteristics, development and severity of EBO syndrome stages were observed among doctors of different specialties. Thus, 16% of general practitioners have ESB and are formed at all three stages. More than half of those in the precursor and tension phase are dominated by the formation phase: surgeons (65%), obstetricians and gynecologists (56%) and pediatricians (53%). The leaders in the presence of the formed tension stage were groups of oncologists (44%) and 1/3 of psychiatrists (31%).
Analyzing the mean scores revealed the following: the tension phase corresponds to the formation phase on average among physicians. All specialties and general practitioners, surgeons, obstetrician-gynecologists, pediatricians found clear confirmation (p<0.05). It was found that general specialists, in particular, anesthesiologists-reanimatologists and a group of laboratory doctors, had higher rates than the narrow group, but lower than the group of oncologists and psychiatrists. It was found that psychiatrists and oncologists had a significantly (p<0.05) higher level of severity of this stage than all other groups. The resistance stage develops as a direct result of stress resistance to growth, most oncologists (81%), more than half of surgeons (62), psychiatrists (62), therapists (60%), pediatricians (60%), obstetricians-gynecologists (56%) and specialized specialists (54%) were more common. At the same formation stage, the group of anesthesiologists-reanimatologists (57%) and general practitioners (40%), narrow specialists (36%) was less covered.
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The severity of resistance stage (mean number of points) was significantly higher (p<0.05) among oncologists and psychiatrists compared to all groups, which is consistent with the formation indicator. More than half of psychiatrists (62%), obstetricians-gynecologists (52%), almost half of therapists (49%), oncologists (49%), 1/3 of anesthesiologists-reanimatologists (43%), surgeons (41%) , narrow specialists (44%), pediatricians (37%) corresponded to the formation stage of burnout. Among all doctors, the largest number of doctors who have reached the stage of burnout is "oncology" specialty (31%), followed by general practitioners (26%), surgeons (24%) and pediatricians (20%). It should be noted that in the group of psychiatrists there are no respondents with a formed stage of fatigue.
CONCLUSION
Thus, the highest indicators of EBO phases are observed in the group of oncologists of the stress phase. Their tension phase is estimated as 57.2±4.0 points, which is significantly higher than the general population (p<0.05). A similar situation is observed in the phases of resistance (p<0.05) and exhaustion (p<0.05). In addition, this group led by significant numbers in the characters of each stage. Psychiatrists in second place, their work implies the need to work with different populations. It is closely related to patients with mental imbalance or deviant behavior that differs from the general population.
All of the above identified changes confirm the connection between responsible activities, people's health, life and professional nature. These changes develop as a result of long-term occupational stress.
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