Szilvia Ádám

Physician Burnout in Hungary A Potential Role for Work—Family Conflict

In a study among Hungarian physicians (N = 420), we tested the hypothesis that compared to men female physicians experience higher work—family conflict (WFC) and consequent burnout. As predicted, female physicians scored significantly higher on the emotional exhaustion subscale of the Maslach Burnout Inventory and significantly more female physicians experienced high levels of emotional exhaustion compared to male physicians. WFC emerged as a significant predictor of burnout (emotional exhaustion and depersonalization). These findings suggest a potential path from WFC to burnout in a scarcely researched population of physicians in a unique cultural setting and provide further data for cross-cultural burnout research.

Measures of stress in epidemiological research

A comprehensive assessment of psychosocial stress often poses significant challenges due to diversity in conceptualization of stress. Consequently, a number of instruments that measure psychosocial stress, its stressors, and its impact at the individual, organizational, and societal levels have been developed. This article aims to provide a brief review of such instruments, focusing on established questionnaire and interview measures in line with the environmentalist and psychological conceptualizations of stress. This includes measures of major life events; work, marital, and social stress; the individuals coping abilities; and psychological and somatic outcomes of stress. We provide a general description of selected instruments and discuss their administration, scoring, and psychometric properties. Appropriate application of these instruments in epidemiological and clinical research, as well as in inpatient care, can aid the detection of psychosocial stress, support thorough assessment and management of the individuals illness, and ensure accurate identification of individuals who would benefit from specific behavioral (psychotherapeutic) interventions.

Work-related stress factors and menstrual pain: a nation-wide representative survey

While imposing research has been conducted with respect to the biological determinants of painful menstruation, little is known about the psychosocial factors, including work-related stress that might influence menstrual pain. We conducted a study in which we aimed to determine besides the prevalence of dysmenorrhoea whether menstrual pain was associated with job control, co-worker social support, job security and dissatisfaction with the job. Data of 2772 working women aged 18–55 years, participants in the Hungarostudy 2002 nation-wide representative survey was analyzed. Binary logistic regression was used to determine the association between work stress factors and menstrual pain. Altogether 15.5% of women reported to experience menstrual pain that limits their daily activity. Low job control, low co-worker social support and low job security were found to be associated with a higher risk for menstrual pain even after controlling for the effect of age, educational attainment, parity status, smoking, body-mass index and treatment for gynecological problems. Job dissatisfaction was also related to dysmenorrhoea, albeit not significantly. The relationship between work-related psychosocial factors and painful menstruation deserves further investigation in order to determine the possible pathways of this association.

Gyakori a magas fokú kiégés a háziorvosok és háziorvosi rezidensek körében

UNLABELLED General practitioners (GPs) play a central role in patient care and are exposed to high levels of work strain and consequent burnout due to the large number of stressful patient-doctor relationships. Despite the high likelihood of burnout among GPs, limited information is available about this topic. AIMS To explore the prevalence of burnout among GPs and residents in Hungary. METHODS Exploratory/descriptive, cross-sectional study with self-administered questionnaires among 453 GPs and 43 residents. To assess burnout, the Maslach Burnout Inventory (MBI-GS) was used. To evaluate the level of burnout, mean (+/- SD) scores on the emotional exhaustion, cynicism/depersonalization, and personal accomplishment dimensions of the MBI were determined among male and female GPs and residents. Differences in the level or degree of burnout (high, intermediate and low) in all three burnout dimensions between male and female GPs and residents were examined by independent samples t -test and chi 2 -tests. Socio-demographic antecedents to burnout were assessed by linear regression analyses. RESULTS Residents reported significantly lower cynicism/depersonalization [ t (df): 2.8 (476); p < 0.01] and personal accomplishment [ t (df): 2.0 (485); p < 0.05] compared to GPs. No gender differences were identified in the level of burnout. Significantly more GPs then residents reported high [chi 2 (df) = 5.9 (1); p < 0.05] or intermediate [chi 2 (df) = 4.6 (1); p < 0.05] degree of depersonalization. Emotional exhaustion, depersonalization, and low personal accomplishment were reported by around 30%, 60%, and 100% of the physicians, respectively. Being a resident emerged as the strongest negative predictor of depersonalization (beta = -0.09, 95% CI -0.22 - -0.002). CONCLUSIONS The prevalence of burnout is high among GPs, and almost all GPs report low degree of personal accomplishment. Residency emerged as a significant protective correlate of depersonalization. These findings provide further data for cross-cultural burnout research.

High prevalence of job dissatisfaction among female physicians: work-family conflict as a potential stressor

UNLABELLED Due to the family-centric nature of Hungarian society and to the high proportion of women in the medical profession, more female than male physicians may experience work-family conflict. The authors hypothesized that work-family conflict may reduce job satisfaction among female physicians. However, there is limited information about the prevalence of work-family conflict and job dissatisfaction as well as their associations among female physicians. AIMS To explore the prevalence of work-family conflict and its relations to job dissatisfaction among Hungarian physicians. METHODS Cross-sectional study with 219 female and 201 male physicians using self-report questionnaires. RESULTS As hypothesized, female physicians reported significantly higher level of work-family conflict compared to male physicians (3.0 (SD 0.9) vs. 2.6 (SD 0.9); t (df): -3.8 (418); p < 0.001). Furthermore, more female than male physicians experienced work-family conflict often or extremely often [56% vs. 41%, respectively; chi 2 (df) = 9.3 (1); p < 0.01]. Significantly fewer women (55%) than men (66%) reported high levels of job satisfaction [chi 2 (df) = 4.8 (1), p < 0.05]. Similarly, significantly more female physicians (13%) experienced high level of job dissatisfaction compared to men (6%) [chi 2 (df) = 4.7 (1), p < 0.05]. Linear regression analyses showed that work-family conflict predicts job dissatisfaction among female and all physicians (beta = -0.17, 95% CI -0.31 - -0.04 and beta = -0.14, 95% CI -0.22 - -0.04, respectively). CONCLUSIONS These results show that the level and prevalence of work-family conflict experienced by female physicians in Hungary is significantly higher than that among male physicians. Furthermore, these findings suggest that work-family conflict as a stressor may contribute to the development of job dissatisfaction and hence may adversely impact the well-being of female and male physicians and consequently the quality of patient care.

Gender Differences in Deliberate Self-Poisoning in Hungary

BACKGROUND The suicide rate in Hungary is one of the highest in the European Union, with a male-female ratio of 3.55:1. Suicide rates correlate positively with suicide attempts, for which depression is the most frequent underlying disorder. AIMS The aim of this qualitative study was to examine gender differences in suicide attempts, with a focus on the effect of precipitating factors on depression. METHOD Semistructured interviews were conducted among 150 suicide attempters. Data on circumstances, reason, and method of attempt were recorded. Patients completed the Shortened Beck Depression Inventory, the Beck Hopelessness Scale, the Sense of Coherence Scale, and the Social Support Questionnaire. RESULTS Interpersonal conflict was found to be the most frequent precipitating factor. There were significant gender differences in depressive symptoms among patients with interpersonal conflicts. We found differences in depressive symptoms according to presence or absence of interpersonal conflicts among men, but not among women. Male suicide attempters who indicated interpersonal conflicts had lower levels of depression. CONCLUSION Depressive symptoms are frequent among suicide attempters. However, a subgroup of male attempters reporting interpersonal conflicts are characterized by a lower level of depression. This subgroup of attempters would probably not be detected with depression screening programs and may have an unmet need for other forms of screening and prevention.

[Frequent high-level burnout among general practitioners and residents].

UNLABELLED General practitioners (GPs) play a central role in patient care and are exposed to high levels of work strain and consequent burnout due to the large number of stressful patient-doctor relationships. Despite the high likelihood of burnout among GPs, limited information is available about this topic. AIMS To explore the prevalence of burnout among GPs and residents in Hungary. METHODS Exploratory/descriptive, cross-sectional study with self-administered questionnaires among 453 GPs and 43 residents. To assess burnout, the Maslach Burnout Inventory (MBI-GS) was used. To evaluate the level of burnout, mean (+/- SD) scores on the emotional exhaustion, cynicism/depersonalization, and personal accomplishment dimensions of the MBI were determined among male and female GPs and residents. Differences in the level or degree of burnout (high, intermediate and low) in all three burnout dimensions between male and female GPs and residents were examined by independent samples t -test and chi 2 -tests. Socio-demographic antecedents to burnout were assessed by linear regression analyses. RESULTS Residents reported significantly lower cynicism/depersonalization [ t (df): 2.8 (476); p < 0.01] and personal accomplishment [ t (df): 2.0 (485); p < 0.05] compared to GPs. No gender differences were identified in the level of burnout. Significantly more GPs then residents reported high [chi 2 (df) = 5.9 (1); p < 0.05] or intermediate [chi 2 (df) = 4.6 (1); p < 0.05] degree of depersonalization. Emotional exhaustion, depersonalization, and low personal accomplishment were reported by around 30%, 60%, and 100% of the physicians, respectively. Being a resident emerged as the strongest negative predictor of depersonalization (beta = -0.09, 95% CI -0.22 - -0.002). CONCLUSIONS The prevalence of burnout is high among GPs, and almost all GPs report low degree of personal accomplishment. Residency emerged as a significant protective correlate of depersonalization. These findings provide further data for cross-cultural burnout research.

High prevalence of work-family conflict among female physicians: lack of social support as a potential antecedent

UNLABELLED According to stress theory, social support from work and non-work-related sources may influence the level of perceived work-family conflict. Despite the high prevalence of work-family conflict as a source of distress among female physicians, no information is available on the associations between work-family conflict and social support in a traditional, family-centric cultural setting, where female role expectations are demanding. The author hypothesized that high prevalence of work-family conflict could be attributed to the lack of social support among female physicians. AIMS To investigate the prevalence and psychosocial characteristics of social support and its relations to work-family conflict among female physicians. METHODS Quantitative and qualitative study using questionnaires ( n = 420) and in-depth interviews ( n = 123) among female and male physicians. RESULTS Female physicians reported significantly higher mean level and prevalence of work-family conflict compared to men. The predominant form of work-family was work-to-family conflict among physicians; however, significantly more female physicians experienced family-to-work conflict and strain-based work-family conflict compared to men (39% vs. 18% and 68% vs. 20%, respectively). Significantly more male physicians experienced time-based work-family conflict compared to women. Content analyses of interview data revealed that provision of support to physicians manifested itself in parental support in career selection, spousal support with household duties, peer support with enabling access to professional role models-mentors, peer support to ensure gender equity, and organizational support with family-centric policies. Female physicians reported significantly less parental, spousal, and peer support compared to men. Female physicians lacking parental, peer, or organizational support experienced significantly higher level of work-family conflict compared to appropriate control. In regression analyses, high job demands, job strain, high workload and number of children, younger age, and lack of support in the workplace predicted work-family conflict best (adjusted R 2 0.59). CONCLUSIONS Lack of social - particularly parental, peer, and organizational - support may play an important role in the pathogenesis of work-family conflict experienced by female physicians.

Coping with work-related stress in health care professionals – strategies for prevention of burnout and depression

BACKGROUND The prevalence of depression and burnout among health care professionals is high in Hungary. However, there is limited empirical data on disease prevention among these populations. AIMS This study aims at evaluating the mediating role of coping mechanisms in preventing depression and burnout. METHODS Cross-sectional survey among 1333 health care professionals. Participants completed self-administered questionnaires about their perception of work stress, burnout and depressive symptoms, as well as their preferred coping strategies. Analyses were performed using structural equation modelling. RESULTS The prevalence of severe depression and lack of personal accomplishment was 5.6% and nearly 50%, respectively. Work stress predicted symptoms of burnout and depression both directly and indirectly through the mediation by coping strategies. Of the coping strategies, cognitive restructuring, which accentuates the realistic assessment of challenging situations, was found to reduce the probability of the development of burnout and depression symptoms. CONCLUSIONS This study provides further data for the development of cognitive interventional strategies and highlights the significance of these strategies in the prevention of depression and burnout among Hungarian health care professionals.

A kiégés és a depresszió diagnosztizálásának elősegítése demográfiai és munkahelyi védő- és kockázati tényezőik feltárásával egészségügyi szakdolgozók körében

INTRODUCTION Depression and burnout are frequent comorbidities among nurses. Despite similar symptoms, their management differ. Therefore, their timely diagnosis is essential. AIM To identify demographic and work-related risk and protective factors of burnout and depression, and facilitate their diagnosis. METHOD A cross-sectional study among 1,713 nurses was carried out. Depression and burnout were assessed by the shortened Beck Depression Questionnaire and Maclach Burnout Inventory, respectively. Risk and protective factors were explored using t-tests and analysis of variance. RESULTS The prevalence of depression and moderate-to-high burnout was 35.1% and 34-74%, respectively. Having a partner/child and longer employment in the outpatient setting protected from burnout. Lack of a partner and male sex emerged as risk factors of depression and depersonalisation, respectively. CONCLUSIONS High prevalence of depression and burnout among nurses poses a significant public health issue. Familiarity with the disease-specific risk and protective factors identified in this research may facilitate timely diagnosis and effective disease management.Absztrakt Bevezetes: A depresszio es a kieges gyakran lep fel egyutt egeszsegugyi szakdolgozok koreben. Bar tuneteik hasonloak, kezelesuk elterő, igy mihamarabbi felismeresuk rendkivul fontos. Celkitűzes: A kieges es a depresszio demografiai es munkahelyi riziko-, valamint vedőtenyezőinek feltarasa es diagnosztizalasuk elősegitese. Modszer: A depressziot a roviditett Beck Depresszio Kerdőivvel, a kiegest a Maslach Kieges Leltarral mertuk 1713 egeszsegugyi szakdolgozo koreben keresztmetszeti adatfelvetellel. A kockazati es vedőtenyezőket t-probaval es varianciaanalizissel tartuk fel. Eredmenyek: A depresszio es a legalabb kozepes szintű kieges prevalenciaja egyenkent 35,1% es 34–74% volt. A partner/gyermek meglete, a hosszabb, valamint a jarobeteg-ellatasban valo munkaviszony a kieges vedőtenyezőjenek bizonyult. A partner hianya es a ferfi nem egyenkent a depresszio es a deperszonalizacio kockazati tenyezőjekent jelent meg. Kovetkeztetesek: A depresszio es a kieges magas prevalenciaja egeszsegugyi szakdolg...