BURNOUT SYNDROME AMONG MEDICAL STAFF OF NEONATAL DEPARTMENTS: A MYTH OR SAD REALITY?

Abstract

Introduction. According to the WHO «burnout syndrome» (BOS) is defined as physical, emotional and mental exhaustion characterized by disturbed efficiency at work, fatigue, insomnia, increased susceptibility to somatic diseases, alcohol or other psychoactive substances consumption with the aim to get temporary relief, having a tendency to the development of physiological addiction and (in many cases) suicidal behavior. This syndrome is usually assessed as stress-response to inhuman job-related and emotional requirements resulting from an excessive individual commitment to work associated with neglecting family life and/or rest. BOS formation among the medical staff of neonatal departments is associated with negative changes of its psycho-emotional state having a direct influence upon the level of giving medical aid to patients, especially neonates born with extremely low body weight, congenital developmental defects, with severe asphyxia being under end-of-life conditions. Objective: to study the rate of formation and potential risk factors promoting BOS of physicians who give medical aid to patients of neonatal age by means of focused risk assessment with the help of Maslach Burnout Inventory (MBI) test and NeoBurn questionnaire developed by the researchers. Materials and methods. In the course of the study from September 2019 to February 2020 a personalized survey of 50 neonatologists and children’s anesthesiologists who give medical aid to the patients of neonatal age (under 28 days of life) on the basis of 8 departments of 6 hospitals (Kyiv, Chernivtsi, Ukraine) was conducted. NeoBurn questionnaire was developed by the researchers considering the data of present-day scientific literature dealing with the most valuable BOS risk factors among the medical staff of neonatal departments. The questionnaire includes general questions; questions determining conditions of work; questions characterizing one’s own personal assessment etc. Maslach Burnout Inventory (MBI) test includes three blocks of questions, and the answers to them can help determine the signs of exhaustion or depressive anxiety syndrome (part A), depersonalization signs or loss of empathy (part B) and the signs of deteriorated personality achievements (part С). Results. 36 neonatologists (72 %) and 14 children’s anesthesiologists (28 %) were involved into the study including 80 % female respondents and approximately 1/3 of the neonatal community were over 50. At the time of the survey the majority of respondents (72 %) had a position of resident doctors of the departments, 8 (16 %) of them were heads of the departments, 6 (12%) – research workers of the core departments. In 70% of cases the main working places of physicians were neonatal resuscitation units, in 30% - neonatal care units. 21 people (42 %) had working experience as neonatologists more than 20 years. More than a half of respondents (54 %) worked more than one wage rate, 37 physicians (74 %) had night duties as well. The majority of physicians (94 %) indicated that their income is insufficient for a comfortable life in Ukraine. The survey by means of MBI test was indicative of the fact that depersonalization sphere appeared to be the most vulnerable. Its severe degree was found in 24 % of cases, moderate degree – in 40 % of cases. A marked decrease of significance of the personality achievements was found in 22 % of cases, a moderate degree was registered in 30 % of cases. Exhaustion option appeared to be the most «reserved», its severe degree was diagnosed only in 4 % of cases, moderate degree – in 24 % of cases. It should be noted that the survey did not find any physician with the lack of disorders of all the three characteristics of MBI test. Conclusion. Medical staff giving aid to the patients of neonatal age (in the first 28 days of life) constitutes a high risk group concerning BOS formation which is associated with considerable potential mortality and sickness rates of patients, high requirements to the professional level of physicians, necessity of continuous improvement in order to introduce new up-to-date perinatal technologies, night duties available, insufficient salary etc. MBI test in the survey of Ukrainian neonatologists and children’s anesthesiologists found the most marked disorders in the sphere of depersonalization and decrease of significance of the personality achievements which requires the programs of identification, prevention and correction of BOS involving multi-professional team of specialists and introduced into the practical work of medical institutions.