Occupational Burnout, Psychological Status and Quality of Life in Primary Care Physicians Working in Outpatient Settings

Kardiologiia ◽  
2021 ◽  
Vol 61 (6) ◽  
pp. 69-78
Author(s):  
N. V. Pogosova ◽  
S. S. Isakova ◽  
O. Y. Sokolova ◽  
A. K. Ausheva ◽  
R. A. Zhetisheva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Emotional Exhaustion ◽  
Primary Care Physicians ◽  
Job Burnout ◽  
Psychological Status ◽  
Anxiety And Depression ◽  
High Level

Aim      To study features of the psychological status, job burnout syndrome (JBS)m and quality of life (QoL) in outpatient physicians.Material and methods  This cross-sectional study was performed at 16 randomly selected municipal outpatient hospitals of Moscow and included physicians (district physicians, primary care physicians, and cardiologists). The participants signed an informed consent form and then filled out a registration card that included major social and demographic (sex, age, education, position) and professional characteristics (specialization, work experience, qualification category), and questionnaires. The degree of job burnout was evaluated with the Maslach Burnout Inventory (MBI-HSS), and the presence of anxio-depressive symptoms was evaluated with the Hospital Anxiety and Depression Scale (HADS). The level of stress was assessed with a visual analogue scale (VAS) in a score range from 0 to 10. The QoL of physicians was assessed with the short version of the World Health Organization Quality of Life (HOQOL-BREF) questionnaire.Results This study included 108 physicians from 16 municipal outpatient clinics aged 24 to 70 years (mean age, 44.0±13.1 years), mostly women (87.0 %). Among JBS components, a high level of emotional exhaustion was observed in 50.0 % of physicians, a high level of depersonalization in 34.1 %, and a severe reduction of personal accomplishment in 37.5 %. A high level of stress (VAS score ≥7) was observed in 66.3 % of physicians; symptoms of anxiety and depression of any degree (HADS-A and HADS-D subscale score ≥ 8) were found in 23.8 and 22.7 % of participants, respectively. 42.0% of physicians evaluated their QoL lower than “good” and 41.6% of physicians evaluated their health condition lower than “good”. Most of the studied factors did not significantly depend on the gender and the duration of work, except for emotional exhaustion (55.3 % of women and 16.7 % of men; p=0.0086) and a high level of stress (72.2 % of women and 28.6 % of men; р=0.002).Conclusion      The study showed a high prevalence of personal factors that potentially adversely affect the work of outpatient physicians. These factors included high degrees of stress, anxio-depressive symptoms, job burnout, unsatisfactory QoL, and low satisfaction with own health. Management decisions and actions are required to create the optimum psychological climate at the workplace of physicians, to develop new strategies for prophylaxis and correction of their psychological condition, and to implement comprehensive programs for improving the professional environment to maintain and enhance the mental health and to increase the professional prestige of the medical speciality.

scholarly journals Addressing the relationship between perceived fear of COVID-19 virus infection and emergence of burnout symptoms in a sample of Egyptian physicians during COVID-19 pandemic: a cross-sectional study

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Mohamed Abdelghani ◽  
Hayam M. El-Gohary ◽  
Eman Fouad ◽  
Mervat S. Hassan
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Virus Infection ◽  
Emotional Exhaustion ◽  
Maslach Burnout Inventory ◽  
Cross Sectional Study ◽  
Personal Accomplishment ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background Physicians during the COVID-19 pandemic are working under relentless stress. This study aimed to identify the impact of the perceived fears of COVID-19 virus infection on the quality of life and the emergence of burnout syndrome among physicians in Egypt during the COVID-19 outbreak. This cross-sectional study was conducted between May 10th and June 9th, 2020, and included 320 Egyptian physicians who were working during the outbreak of the COVID-19 pandemic. The participants were interviewed using the Fear of COVID-19 scale (FCV-19S), Hospital Anxiety and Depression Scale (HADS), Maslach Burnout Inventory, and World Health Organization Quality of Life Scale (WHOQOL-BREF) for assessment of the perceived fears of COVID-19 virus infection, associated anxiety and depressive symptoms, burnout symptoms, and quality of life, respectively. Results Overall, most physicians were females (63%). Ideas about death, moderate-to-severe anxiety, and depressive symptoms were reported by 11, 28, and 29% of physicians, respectively. For burnout symptoms, high emotional exhaustion, high depersonalization, and low personal accomplishment were reported by 20, 71, and 39% of physicians, respectively. The perceived fear of COVID-19 virus infection was positively correlated with anxiety, depression, and burnout emotional exhaustion, and depersonalization symptoms, and negatively correlated with personal accomplishment and all quality of life domains. Conclusions Egyptian physicians experienced higher levels of COVID-19-related fears, anxiety, and depressive and burnout symptoms. There was a robust correlation between these perceived fears, and higher burnout symptoms, and poor quality of life among physicians. Specific interventions should be tailored to minimize the physical and mental burdens on the physicians during the COVID-19 pandemic.

Differences between primary care physicians and specialised neurotologists in the diagnosis of dizziness and vertigo in Japan

2020 ◽  
Vol 134 (9) ◽  
pp. 764-768
Author(s):  
T Ito ◽  
S Matsuyama ◽  
T Shiozaki ◽  
D Nishikawa ◽  
H Akioka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Patient Satisfaction ◽  
Diagnostic Accuracy ◽  
Medical Records ◽  
Primary Care Physicians ◽  
Symptom Relief ◽  
Accurate Diagnosis ◽  
High Quality

AbstractObjectiveVertigo and dizziness are frequent symptoms in patients at out-patient services. An accurate diagnosis for vertigo or dizziness is essential for symptom relief; however, it is often challenging. This study aimed to identify differences in diagnoses between primary-care physicians and specialised neurotologists.MethodIn total, 217 patients were enrolled. To compare diagnoses, data was collected from the reference letters of primary-care physicians, medical questionnaires completed by patients and medical records.ResultsIn total, 62.2 per cent and 29.5 per cent of the patients were referred by otorhinolaryngologists and internists, respectively. The cause of vertigo or dizziness and diagnosis was missing in 47.0 per cent of the reference letters. In addition, 67.3 per cent of the diagnoses by previous physicians differed from those reported by specialised neurotologists.ConclusionTo ensure patient satisfaction and high quality of life, an accurate diagnosis for vertigo or dizziness is required; therefore, methods or materials to improve the diagnostic accuracy are needed.

I am a total failure: associations between beliefs and anxiety and depression in patients with inflammatory bowel disease with poor mental quality of life

2019 ◽  
Vol 48 (1) ◽  
pp. 91-102 ◽  
Author(s):  
Floor Bennebroek Evertsz’ ◽  
Mirjam A.G. Sprangers ◽  
Laura M. de Vries ◽  
Robbert Sanderman ◽  
Pieter C.F. Stokkers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Depressive Symptoms ◽  
Psychiatric Disorders ◽  
Bowel Disease ◽  
Anxiety And Depression ◽  
Illness Beliefs ◽  
Dysfunctional Beliefs ◽  
Inflammatory Bowel

AbstractBackground:According to cognitive behavioural theory, cognitive factors (i.e. underlying general dysfunctional beliefs and (situation) specific illness beliefs) are theorized to lead to outcomes like anxiety and depression. In clinical practice, general dysfunctional beliefs are generally not tackled directly in short-term-therapy.Aims:The goal of the present study was to investigate the associations of general versus specific illness beliefs on anxiety and depressive symptoms and psychiatric disorders among a subgroup of patients with inflammatory bowel disease (IBD) with poor mental quality of life (QoL).Method:This study concerns cross-sectional data, collected at baseline from a randomized clinical trial. One hundred and eighteen patients, recruited at four Dutch hospitals, with poor QoL (score ≤23 on the mental health subscale of the Short-Form 36-item Health-Survey; SF-36) were included. General dysfunctional beliefs were measured by the Dysfunctional Attitude Scale (DAS), specific illness beliefs by the Illness Perceptions Questionnaire-Revised (IPQ-R), anxiety and depressive symptoms by the Hospital Anxiety and Depression Scale (HADS), and psychiatric disorders by the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I).Results:Univariate analyses showed associations between the level of anxiety and/or depression and general dysfunctional beliefs and four specific illness beliefs (consequences, personal control, emotional representations and treatment control). Among patients with IBD with psychiatric disorders, only the DAS was significantly associated with anxiety and depression (DAS added to IPQ-R and IPQ-R added to DAS).Conclusions:Psychological interventions may have to target general dysfunctional beliefs of patients with IBD with co-morbid psychiatric disorders to be effective. These patients with IBD are especially in need of psychological treatment.

A Refresher on Herpes Zoster, Current Status on Vaccination, and the Role of the Dermatologist

2011 ◽  
Vol 15 (4) ◽  
pp. 185-191 ◽  
Author(s):  
Lyn C. Guenther ◽  
Charles W. Lynde
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Herpes Zoster ◽  
Preventive Medicine ◽  
Primary Care Physicians ◽  
Current Status ◽  
Age Group ◽  
Increased Risk

Background: Herpes zoster (HZ) and postherpetic neuralgia (PHN) have a significant impact on quality of life. PHN is often chronic and difficult to treat. Dermatologists have always been involved in making the diagnosis of these conditions and, most recently, teaching the need for early antiviral therapy. Objective: With the introduction of a new vaccine, HZ and its difficult-to-treat complication PHN can be prevented or minimized. Preventive medicine is important and has been supported by dermatologists with sun safety programs. Patients receiving biologics are at increased risk of developing zoster. Conclusion: Dermatologists should embrace zoster vaccination and recommend routine vaccination of immunocompetent individuals > age 60 years, as well as patients of any age who are starting immunosuppressants, including biologics. Given that individuals over age 50 years are at risk for PHN and studies have shown that the vaccine's immunogenicity and safety are maintained in individuals age 50 to 59 years, vaccination in this age group may be considered. Some dermatologists may consider vaccinating their own patients, but most will likely recommend that vaccination be performed by their patients' primary care physicians.

scholarly journals Minimal-contact psychotherapy for sub-threshold depression in primary care

2004 ◽  
Vol 185 (5) ◽  
pp. 416-421 ◽  
Author(s):  
Godelief R. W. M. Willemse ◽  
Filip Smit ◽  
Pim Cuijpers ◽  
Bea G. Tiemens
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Primary Care Patients ◽  
Minimal Contact

BackgroundSub-threshold depression is a prognostic variable for major depression. Interventions in sub-threshold depression may prevent the onset of new cases of major depression.AimsTo examine the effects of minimal-contact psychotherapy in primary care patients with sub-threshold depression on the onset of major depression, on the reduction in depressive symptoms and on health-related quality of life.MethodWe conducted a randomised trial in primary care, in which patients screened for sub-threshold depression were randomly assigned to minimal-contact psychotherapy (n=107) or to usual care (n=109).ResultsOne year after baseline, the incidence of major depressive disorder was found to be significantly lower in the psychotherapy group (12%) than in those receiving usual care (18%). Small but significant effects were also found on depressive symptoms and on aspects of health-related quality of life.ConclusionsPrimary care patients with sub-threshold depression can benefit from minimal-contact psychotherapy.

scholarly journals Impact of superimposed nephrological care to guidelines-directed management by primary care physicians of patients with chronic kidney disease: a randomized controlled trial

2019 ◽  
Author(s):  
Patrick Saudan ◽  
Belen Ponte ◽  
Nicola Marangon ◽  
Chantal Martinez ◽  
Lena Berchtold ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Primary Care Physicians ◽  
Clinical Care ◽  
Randomised Trial ◽  
Dialysis Initiation ◽  
The Impact

Abstract Background: Optimal clinical care of patients with chronic kidney disease (CKD) requires collaboration between primary care physicians (PCP) and nephrologists. We undertook a randomised trial to determine the impact of superimposed nephrologist care compared to guidelines-directed management by PCPs in CKD patients after hospital discharge. Methods: Stage 3b-4 CKD patients were enrolled during a hospitalization and randomised in two arms: Co-management by PCPs and nephrologists (interventional arm) versus management by PCPs with written instructions and consultations by nephrologists on demand (standard care). Our primary outcome was death or rehospitalisation within the 2 years post-randomisation. Secondary outcomes were: urgent renal replacement therapy (RRT), decline of renal function and decrease of quality of life at 2 years. Results: From November 2009 to the end of June 2013, we randomised 242 patients. Mean follow-up was 51 + 20 months. Survival without rehospitalisation, GFR decline and elective dialysis initiation did not differ between the two arms. Quality of life was also similar in both groups . Compared to randomised patients, those who either declined to participate in the study or were previously known by nephrologists had a worse survival. Conclusion: These results do not demonstrate a benefit of a regular renal care compared to guided PCPs care in terms of survival or dialysis initiation in CKD patients. Increased awareness of renal disease management among PCPs may be as effective as a co-management by PCPs and nephrologists in order to improve the prognosis of moderate-to-severe CKD.

scholarly journals Impact of superimposed nephrological care to guidelines-directed management by primary care physicians of patients with stable chronic kidney disease: a randomized controlled trial

2019 ◽  
Author(s):  
Patrick Saudan ◽  
Belen Ponte ◽  
Nicola Marangon ◽  
Chantal Martinez ◽  
Lena Berchtold ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Primary Care Physicians ◽  
Clinical Care ◽  
Randomised Trial ◽  
Dialysis Initiation ◽  
The Impact

Abstract Background: Optimal clinical care of patients with chronic kidney disease (CKD) requires collaboration between primary care physicians (PCP) and nephrologists. We undertook a randomised trial to determine the impact of superimposed nephrologist care compared to guidelines-directed management by PCPs in CKD patients after hospital discharge. Methods: Stage 3b-4 CKD patients were enrolled during a hospitalization and randomised in two arms: Co-management by PCPs and nephrologists (interventional arm) versus management by PCPs with written instructions and consultations by nephrologists on demand (standard care). Our primary outcome was death or rehospitalisation within the 2 years post-randomisation. Secondary outcomes were: urgent renal replacement therapy (RRT), decline of renal function and decrease of quality of life at 2 years. Results: From November 2009 to the end of June 2013, we randomised 242 patients. Mean follow-up was 51 + 20 months. Survival without rehospitalisation, GFR decline and elective dialysis initiation did not differ between the two arms. Quality of life was also similar in both groups . Compared to randomised patients, those who either declined to participate in the study or were previously known by nephrologists had a worse survival. Conclusion: These results do not demonstrate a benefit of a regular renal care compared to guided PCPs care in terms of survival or dialysis initiation in CKD patients. Increased awareness of renal disease management among PCPs may be as effective as a co-management by PCPs and nephrologists in order to improve the prognosis of moderate-to-severe CKD.

scholarly journals Stress, anxiety, and depression in patients with vitiligo

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Marwa Abd El Malk Nasser ◽  
Samar Mohamed Raggi El Tahlawi ◽  
Zahra Abbas Abdelfatah ◽  
Mohamed Ramadan Soltan
Keyword(s):  
Quality Of Life ◽  
Life Quality ◽  
Psychological Status ◽  
Anxiety And Depression ◽  
Control Group ◽  
Depression Anxiety Stress Scale ◽  
Life Index ◽  
Stress Scale ◽  
Quality Of Life Index

Abstract Background Vitiligo has a significant effect on patients’ quality of life; they feel stigmatized and disturbed by their condition. A lot of vitiligo patients, according to reports, suffer from psychological disturbances. The aim of the study is to find the relation between vitiligo and stress, anxiety, and depression and to measure how vitiligo affects the quality of life index. This study included 50 vitiligo patients and 50 matched healthy control groups. All patients were assessed by the Depression Anxiety Stress Scale (DASS) to determine the severity of anxiety, depression, and stress symptoms and the Dermatology Life Quality Index (DLQI) scale to evaluate their quality of life while the control group underwent only the Depression Anxiety Stress Scale. Results The prevalence of stress was 76% (n=38), anxiety was 78% (n=39), and depression was 80% (n=40); the difference was statistically significant between patient group and control group regarding stress, anxiety, and depression. Gender had a significant relationship with stress, anxiety, and depression (p < 0.05) (female affected more than male). Also, there was a statistically significant relation between the degree of vitiligo and anxiety (p < 0.05). Vitiligo has a moderate to very severe effect on the quality of life index. There was a statistically significant positive correlation between stress and feeling of embarrassment from vitiligo and clothes choice. Conclusion Vitiligo is a psychcutaneous disease that does not only affect the patient’s physical status, but also his mental and psychological status.

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