Health  Vol.5 No.6 B , June 2013
Preventive care for burnout: General practitioner pilot program in Barcelona

Background: Despite the prevalence of “professsional exhaustion syndrome” or “burnout”, very few intervention programs for healthcare professionals have been proposed, and even fewer have been evaluated. The Catalan Health Institute requested an intervention that would be preventive, integrated, and would differentiate between those affected by burnout and those with established psychopathologic disorders requiring specific treatment. Aims: To describe the experience and initial reflections from the first cohort of primary care physicians in the Barcelona public health system to participate in a program designed to prevent burnout. Methods: Descriptive analysis of the characteristics of this secondary prevention program: design, cost estimates, recruitment and screening, and activities (training, organization, and group techniques). Particular emphasis on the process of identifying potentially affected professionals, how they were offered the opportunity to participate, and the coordinated and confidential nature of the program. Results: Of a target population of 969 family doctors and pediatricians in public primary care services in Barcelona, 6 (0.61%) applied for full program participation. All of them, along with 2 non-medical professionals in primary care services who joined the program, met the clinical and psychometric criteria (Shirom-Melamed Burnout Measure, General Health Questionnaire, and the 16 Personality Factors Questionnaire) of the desired participant profile. Conclusions: The level of participation could suggest defects in program design or, alternatively, problems in the concept of burnout. This construct may be more useful for detecting stress attributed to occupational contexts than for facilitating participation in activities related to its prevention or treatment.

Cite this paper: Tizón, J. , Gràcia, P. , Larripa, A. , Artigue, J. and Casajuana, J. (2013) Preventive care for burnout: General practitioner pilot program in Barcelona. Health, 5, 24-31. doi: 10.4236/health.2013.56A2005.

[1]   Freudenberger, H.J. (1974) Staff burnout. Journal of Social Issues, 30, 159-165. doi:10.1111/j.1540-4560.1974.tb00706.x

[2]   Maslach, C., and Jackson, S.E. (1986) Maslach burnout inventory. Consulting Psychologist Press, Palo Alto.

[3]   Shirom, A. (1989) Burnout in work organizations. In: Cooper, C.L. and Robertson, I., Eds., International Review of Industrial and Organizational Psychology, Wiley, New York, 25-48.

[4]   Gil-Monte, P. and Moreno-Jiménez, B. (2007) El síndrome de quemarse por el trabajo (burnout). Grupos profesionales de riesgo. Pirámide, Madrid.

[5]   Shirom, A. (2005) Shirom-Mellamed Burnout Measure (SMBM).

[6]   Tizón, J.L. (2011) Shirom-mellamed burnout measure. Spanish and Catalan translation of the English original, in collaboration with A. Shirom.

[7]   Sobrequés, J., Cebriá, J., Segura, J., Rodríguez, C., García, M. and Juncosa, S. (2002) La satisfacción laboral y el desgaste profesional de los médicos de atención primaria. Atención Primaria, 31, 227-233.

[8]   Cathébras, P., Begon, A., Laporte, S., Bois, C. and Truchot, D. (2004) Burn out entre les genéralistes francaises. Presse Médicale, 33, 1569-1574. doi:10.1016/S0755-4982(04)98994-4

[9]   Esteva, M., Larraz, C., Soler, J.K. and Yaman, H. (2005) Desgaste profesional en los médicos de familia espanoles. Atención Primaria, 35, 108-118. doi:10.1157/13071919

[10]   Wu, S., Zhu, W., Wang, A., Wang, M. and Lan, Y. (2007) Relationship between burnout and occupational stress among nurses in China. Journal of Advanced Nursing, 59, 233-239. doi:10.1111/j.1365-2648.2007.04301.x

[11]   Imai, H., Nakao, H., Tsuchiya, M., Kuroda, Y. and Katoh, T. (2004) Burnout and work environment of public health nurses involved in mental health care. Occupational and Environmental Medicine, 61, 764-768. doi:10.1136/oem.2003.009134

[12]   Olivares, V.E. and Gil-Monte, P. (2007) Prevalencia del síndrome de quemarse por el trabajo (burnout) en trabajadores de servicios en Chile. Informació Psicològica, 91-92, 543-563.

[13]   Unda, S., Sandoval, J.I. and Gil-Monte, P. (2007) Prevalencia del síndrome de quemarse por el trabajo (SQT) (burnout) en maestros mexicanos. Informació Psicològica, 91-92, 53-64.

[14]   Boudreau, R. and Nakashima, J. (2002) A bibliography of burnout citations, 1990-2002. ASAC, Winnipeg.

[15]   Marmot, M.G. (2001) Inequalities in health. New England Journal of Medicine, 345, 134-136. doi:10.1056/NEJM200107123450210

[16]   Ahola, K., Gould, R., Virtanen, M., Honkonen, T., Aromaa, A. and Lonnqvist, J. (2009) Occupational burnout as a predictor of disability pension: A population-based cohort study. Occupational and Environmental Medicine, 66, 284-290. doi:10.1136/oem.2008.038935

[17]   Generalitat de Catalunya, Departament de Salut (2006) Pla director de salut mental i adiccions (2006-2010). Generalitat de Catalunya, Barcelona.

[18]   Frith-Cozens, J. and Payne, R. (1999) Stress in health professionals. John Wiley & Sons, Chichester.

[19]   Stanton, J. and Caan, W. (2003) How many doctors are sick? British Medical Journal Career Focus, 326, 97.

[20]   Fundació Galatea (2005) PAIME: Programa de atención integral al Médico enfermo. Fundació Galatea, Barcelona.

[21]   Ro, K.E., Gude, T., Tyssen, R. and Aasland, O.G. (2008) Counselling for burnout in Norwegian doctors: One year cohort study. British Medical Journal, 337, 2004. doi:10.1136/bmj.a2004

[22]   Rabin, S., Feldman, D. and Caplan, Z. (1999) Stress and intervention strategies in mental health professionals. British Journal of Medical Psychology, 72, 159-169. doi:10.1348/000711299159916

[23]   Shapiro, S.L., Shapiro, D.E. and Schwartz, G.E. (2000) Stress management in medical education: A review of the literature. Academic Medicine, 75, 748-759. doi:10.1097/00001888-200007000-00023

[24]   Mingote, J.C., Moreno, B. and Gálvez-Herero, M. (2004) Desgaste profesional y salud de los profesionales médicos: Revisión y propuestas de prevención. Medicina Clinica (Barc), 123, 265-270. doi:10.1157/13065203

[25]   Brandes, V., Terris, D.D., Fischer, C., Schuessler, M.N., Ottowitz, G., Titscher, G., Fisher, J.E. and Thayer, J.F. (2009) Music programs designed to remedy burnout symptoms show significant effects after five weeks. Annals of the New York Academy of Sciences, 1169, 422-425. doi:10.1111/j.1749-6632.2009.04790.x

[26]   Bragard, I., Etienne, A.M., Merckaert, I., Libert, Y. and Razavi, D. (2010) Efficacy of a communication and stress management training on medical residents’ self-efficacy, stress to communicate and burnout: A randomized controlled study. Journal of Health Psychology, 15, 1075- 1081. doi:10.1177/1359105310361992

[27]   Beckman, H.B., Wendland, M., Mooney, C., Krasner, M.S., Quill, T.E., Suchman, A.L. and Epstein, R.M. (2012) The impact of a program in mindful communication on primary care physicians. Academic Medicine, 87, 815- 819. doi:10.1097/ACM.0b013e318253d3b2

[28]   Goodman, M.J. and Schorling, J.B. (2012) A mindfulness course decreases burnout and improves well-being among healthcare providers. The International Journal of Psychiatry in Medicine, 43, 119-128. doi:10.2190/PM.43.2.b

[29]   Deneckere, S., Euwema, M., Lodewijckx, C., Panella, M., Mutsvari, T., Sermeus, W. and Vanhaecht, K. (2013) Better interprofessional teamwork, higher level of organized care, and lower risk of burnout in acute health care teams using care pathways: A cluster randomized controlled trial. Medical Care, 51, 99-107. doi:10.1097/MLR.0b013e3182763312

[30]   Awa, W.L., Plaumann, M. and Walter, U. (2010) Burnout prevention: A review of intervention programs. Patient Education and Counseling, 78, 184-190. doi:10.1016/j.pec.2009.04.008

[31]   Balch, C.M. and Shanafelt, T. (2010) Combating stress and burnout in surgical practice: A review. Advanced Surgery, 44, 29-47. doi:10.1016/j.yasu.2010.05.018

[32]   Arteman, A., Colom, J., Gabilondo, A. and Masachs, E. (2012) La salut i el benestar dels professionals sanitaris en l’entorn laboral. Guia de bones pràctiques per a institucions, equips i professionals. Generalitat de Catalunya, Agència de Salut Pública, Barcelona.

[33]   Krasner, M., Epstein, R.M., Beckman, H., Suchman, A.L., Chapman, B., Mooney, C.J. and Quill, T.E. (2009) Association of an educational program in mindful communication with burnout, empathy and attitudes among primary care physicians. Journal of the American Medical Association, 302, 1284-1293. doi:10.1001/jama.2009.1384

[34]   Moreno, B., Gálvez, M., Garrosa, E. and Mingote, J.C. (2006) Nuevos planteamientos en la evolución del burnout. La evaluación específica del desgaste profesional médico. Atención Primaria, 38, 544-549. doi:10.1157/13095925

[35]   Tizón, J.L. (2013) Pérdida, pena, duelo. Vivencias, investigación y asistencia. Herder, Barcelona.

[36]   Marucco, M., Gil-Monte, P. and Flamenco, E. (2007) Síndrome de quemarse por el trabajo (burnout) en pediatras de hospitales generales, estudio comparativo de la prevalencia medida con el MBI-HSS y el CESQ. Informació Psicològica, 91-92, 32-43.

[37]   Tizón, J.L., Daurella, N. and Cleries X. (2012) Bioingeniería o Medicina? El futuro de la medicina y la— formación de los médicos. Red-Ediciones, Barcelona.