Aprendiendo a cuidaranálisis desde la perspectiva de género de los determinantes del burnout para mejorar el bienestar del personal de salud de Huelva

Abstract

A poor work environment can bring about negative effects on people’s quality of life, both at a physical and an emotional level. Among these negative effects, one can develop a kind of chronic occupational stress known as burnout syndrome. This disorder includes both emotional and work spheres and has serious physical and psychological effects on people who suffer from it (Gil-Monte, 2005). Health personnel, especially those in specialized care, frequently have to deal with life-or-death situations, so their job can become physically and emotionally exhausting. The stress derived from this context involves the development of behavioral, health, and psychological problems (anxiety, depression, etc.) (García-Campayo, Puebla-Guedea, Herrera-Mercadal y Daudén, 2016). Exhaustion, low self-esteem, depersonalization and professional isolation are its main characteristics (Gil-Monte, 2005). In addition, there is also an issue that affects almost one-third of the Spanish population, the difficulties concerning labor and family reconciliation (Prada, Bocija, Luque, Reina, García, y Moreno, 2016). Furthermore, the study of social determinants with a gender approach can contribute to the prevention of some conditions, improving the quality and efficiency of health care services (Castañeda, 2013). Therefore, the adoption of a gender perspective in health care is still necessary and provides information about the existence and characteristics of structural aspects of health systems, training, and biomedical, epidemiological, and sociological research, as well as their manifestations in daily clinical practice (Amo, 2008). The effects of a sanitary alert caused by a pandemic, the Coronavirus (COVID-19), starting in March 2020 just add to the aforementioned important issues. This aggravates the psychological distress suffered by many male and female workers, being a primary example the health professionals (Santamaría et al., 2020). Therefore, the overall goals of this research have two main focuses. The first one is knowing the prevalence of burnout in men and women who carry out their profession at specialized care in Huelva’s public health, as well as the dimensions of this problem (emotional exhaustion, depersonalization, and low self-esteem) in a pandemic, bearing in mind a series of socio-demographic variables. The second is, using the collected and analyzed data from the aforementioned population, presenting a training proposal that allows for actions in the prevention and management of burnout, addressing causal determinants of this occupational disease. Methods A quantitative, descriptive, and correlational research was carried out on 4 healthrelated professional categories at two specialized care centers from Huelva’s public health care. The sample was made up of professionals from the Juan Ramón Jiménez Hospital Complex (Juan Ramón Jiménez Hospital and Vázquez Díaz Hospital), and included 22 male and 106 female doctors, 30 males and 171 female nurses, 29 male and 168 female nursing assistants, and 57 male and 27 female porters. It was also comprised of professionals from the Infanta Elena Hospital, in which there were 50 doctors (30 men and 16 women), 181 male nurses, 99 female nurses, 116 female nursing assistants, 21 male porters and 19 female porters. The tools used for the data gathering were the MBI-HSS (Maslach & Jackson, 1998), the SWING (Geurts and others, 2005), and the GHQ-12 (Goldberg & Williams, 1988). For the data gathering a series of sociodemographic variables were considered, like sex, age, marital status, parenthood, occupation, seniority, work place, and experiences dealing with COVID-19 situations at the work place. The field work was conducted in March, April, and June 2020. Results The analysis of the information reveals that, in spite of the pandemic, Huelva’s health workers are dealing with it remarkably well. The prevalence of burnout has not been very high in either sex (6% in women and 17’5% in men). This does not mean they were immune to this situation, as the dependence between the sex variable and the burnout syndrome and its dimensions has been corroborated (p<0,05 at the Chi-cuadrado test). Almost half of the male and female sample (>41% in both sexes) shows high emotional exhaustion. Half of the male sample (>40%) shows high depersonalization and half of the female sample (>44%) shows high self-realization. A similar number of the examined population shows possible non-psychotic psychiatric disorders (47% of women and 45% of men). It should also be pointed out that the dependency between the workfamily interactions variables and suffering burnout, as well as the impact of the dimensions of emotional exhaustion and depersonalization, has been ratified (p<0,05 at the Chicuadrado test). The data obtained confirms the power of daily and cultural experiences. This is corroborated by the dependency between the variables of marital status, dealing with a COVID-19 situation in the work place, sex and suffering burnout and the impact of its dimensions. (p<0,05 at the Chi-cuadrado test). The results also demonstrate the dependency between marital status or professional group and possible non-psychotic psychiatric disorders (p<0,05 at Chi-cuadrado test). Besides, the dependency between the contact with COVID-19 variable and these possible disorders has been confirmed (p<0,05 at Chi-cuadrado test). As for the different interactions between work and family environment, the positive interaction of family over work shows a higher percentage in both genders (54’5% in women and 57’30% in men). Conclusions The conclusions of this research bring to light the differences concerning sex in the suffering from burnout and the impact of its dimensions. Men show higher percentages of burnout, emotional exhaustion, depersonalization, and low self-esteem than women. People who suffer from burnout also show a higher percentage of negative interaction of work over family than those who don’t suffer from this syndrome. Most men that show high emotional exhaustion also display a higher percentage of negative interaction of work over family than those people that are not highly affected by this dimension. This is in addition to the fact that people who had contact with some COVID-19 situation in their work place also show a higher percentage of negative interaction of work over family than those who didn’t have any contact with these situations. Regarding the presence of possible non-psychotic psychiatric disorders, people who show signs of being affected by this variable also display higher percentages of burnout, high emotional exhaustion and high depersonalization. It is worth mentioning that widows and widowers are the ones with a higher representation in these possible disorders. Finally, if we consider the occupational group, both male and female porters (most of them men [58,98%]) are the ones that show a higher impact in these possible disorders. These workers also showed the highest proportion of burnout, high emotional exhaustion, high depersonalization and low self-esteem. Following the idea of the previous paragraph, with regards to people with possible non psychotic psychiatric disorders, it is worth mentioning that people who had contact with any COVID-19 situation in their work place, show a higher percentage of impact than those who didn’t have any contact with the pandemic. In order to realize the intervention proposal, different action plans have been put forward according to incidence variables within affected collectives, with the aim of improving the life standards of the studied population.