Depression among physicians working in public healthcare in Belo Horizonte, Brazil

Impact of atypical working hours on sleep and mood among healthcare workers

BACKGROUND

Atypical working hours have raised serious concerns about health effects, such as sleep disorders and psychological repercussions. These schedules are frequent among health professionals having the obligation to ensure the permanence of health services.

OBJECTIVE

To assess the impact of atypical working hours on sleep, sleepiness, and mood among health personnel (HP).

METHODS

Comparative descriptive cross-sectional study was carried out among HP of a regional hospital in Southern Tunisia from December 2019 to May 2020. Two groups were defined according to their work schedule: group A had a fixed-day work and group B had atypical working hours. The assessment of sleep, sleepiness, and mood was based respectively on the Spiegel questionnaire, the Epworth Sleepiness Scale, and the Hospital Anxiety and Disorder scale.

RESULTS

A total of 101 HP in group A and 135 in group B were included. We found signs of pathological sleep in group B: greater delay in falling asleep (78.1% Vs 53.5%; p = 0.002), altered sleep quality (88.1% Vs 56.4%; p = 0.039), and more frequent occurrence of dreams (37% Vs 31.7%; p = 0.033). The quality of sleep was associated with the professional seniority (p = 0.01), the workplace (p = 0.02), and having dependent children (p = 0.04). The mean score of depression was higher in group B (p = 0.02). Depression was associated with the workplace (p = 0.04) and the quality of sleep (p = 0.01).

CONCLUSION

The results of this study indicate that atypical working hours generate both sleep and mood disorders in HP. It is vital to encourage the occupational physicians to estimate sleep and mood disorders in HP.

Relationship between job satisfaction, burnout syndrome and depressive symptoms in physicians: a cross-sectional study based on the employment demand-control model using structural equation modelling

OBJECTIVE

To evaluate the relationship between job satisfaction, burnout syndrome (BS) and depressive symptoms (DS) based on the job demand-control framework model on a nationally representative sample of physicians working in the Peruvian Health System.

SETTING

We carried out a secondary data analysis of the National Survey of Satisfaction of Users in Health 2016 in Peru.

PRIMARY AND SECONDARY OUTCOME MEASURES

Our study assessed the development of the predictive model and had two parts: (1) to evaluate the association among the variables based on the job demand-control framework, and (2) to assess the proposed model acceptability using the structural equation modelling approach to estimate goodness-of-fit indices (GOFIs).

PARTICIPANTS

We excluded physicians older than 65 years, who did not report income levels or who had missing data related to the workplace. Thus, we analysed 2100 participants.

RESULTS

The prevalence of DS was 3.3%. Physicians' work-related illnesses had more probability to result in DS (prevalence ratio=2.23). DS was moderately related to BS dimensions (r>0.50); nevertheless, the relationships between DS and the three job satisfaction scales were weak (r<0.30). The first predictive model based on the variables, DS, BS and job satisfaction, had low GOFIs (comparative fit index (CFI)=0.883; root mean square error of approximation (RMSEA)=0.125). In a second evaluation, we used models with correlated errors obtaining optimal GOFIs (CFI=0.974; RMSEA=0.060).

CONCLUSIONS

Our study identified a stable model to explain the relationship between job satisfaction, BS and DS among physicians. The results are consistent with the job demand-control framework. They could be applied to decision-making in occupational contexts in Latin American low/middle-income countries.

Disstressassoziierte Erkrankungen im Arztberuf – Wie wirksam sind resilienzfördernde Interventionen?

Hintergrund

Ärztliches Personal ist starkem beruflichem Disstress ausgesetzt. Im Vergleich zur Normalbevölkerung besteht eine erhöhte Prävalenz von disstressassoziierten Erkrankungen wie Depression, Burnout und Suchtverhalten.

Fragestellung

Können resilienzfördernde Interventionen ärztlichen Disstress reduzieren?

Material und Methoden

Systematische Literaturrecherche in den Datenbanken „The Cochrane Library“, „Medline“ (via „PubMed“) und „Embase“ im Zeitraum von 2011–2018. Vergleich von vier randomisiert kontrollierten Studien.

Ergebnisse

Resilienzfördernde Interventionen können ärztlichen Disstress reduzieren. Insbesondere Berufsanfänger/-innen und weibliches ärztliches Personal scheinen davon zu profitieren.

Diskussion

Da bereits Kurzinterventionen einen positiven Effekt zeigen, sollten resilienzfördernde Maßnahmen im beruflichen Alltag von Ärztinnen und Ärzten implementiert werden.

Simultaneity of leisure behaviors and common mental disorders among healthcare workers

The objective of this study was to investigate the aggregation of four leisure behaviors and the association between the number of leisure behaviors and common mental disorders (CMD). A cross-sectional study was carried out with a representative sample of healthcare workers of Brazil. The aggregation of the types of leisure activities was assessed by comparing the observed prevalence with the expected prevalence. The logistic regression analysis evaluated the association between the number of leisure behaviors and CMD. Leisure behaviors tended to show aggregation (<0.05). The multivariate analysis showed a negative association between the number of leisure behaviors and the CMD, only among women. The results indicate that the association between the number of leisure behaviors and the CMD is different depending on sex.

[Mental disorders and participation in the labor market: a multicenter national study in Brazil]

The objective was to explore the relationship between labor market participation and patient characteristics in a representative sample of 2,475 adults admitted to 26 Brazilian mental health institutions (15 Centers for Psychosocial Care and 11 hospitals). Socio-demographic, clinical, and behavioral characteristics were obtained with structured interviews. Multinomial regression was used. Increased likelihood of temporary absence from the work market was associated with female gender, single, divorced, or widowed conjugal status, lack of stable housing, and history of first admission or treatment before the age of 18. Increased likelihood of permanent absence from the labor market was associated with older age. Temporary or permanent leave from work was directly associated with low schooling, lifetime hospitalizations, and diagnosis of severe mental disorder and inversely associated with alcohol and drug use. The occupational vulnerabilities identified in the study raise the debate on specific policies for the mental health sector.

Work-Related Depression in Primary Care Teams in Brazil

OBJECTIVES

To identify work-related factors associated with depressive symptoms and probable major depression in primary care teams.

METHODS

Cross-sectional study among primary care teams (community health workers, nursing assistants, nurses, and physicians) in the city of São Paulo, Brazil (2011-2012; n = 2940), to assess depressive symptoms and probable major depression and their associations with job strain and other work-related conditions.

RESULTS

Community health workers presented higher prevalence of probable major depression (18%) than other primary care workers. Higher odds ratios for depressive symptoms or probable major depression were associated with longer duration of employment in primary care; having a passive, active, or high-strain job; lack of supervisor feedback regarding performance; and low social support from colleagues and supervisors.

CONCLUSIONS

Observed levels of job-related depression can endanger the sustainability of primary care programs. Public Health implications. Strategies are needed to deliver care to primary care workers with depression, facilitating diagnosis and access to treatment, particularly in low- and middle-income countries. Preventive interventions can include training managers to provide feedback and creating strategies to increase job autonomy and social support at work.

AME survey-003 A1-part 2: the motivation factors of medical doctors in China

BACKGROUND

The professional moral and job satisfaction of medical profession remain highly disputed in media in China. On the other hand, there is wide disaffection of patients toward doctors in China. This survey aims to obtain a better understanding of the motivation of Chinese medical professionals.

METHODS

An anonymous online cross-sectional survey, AME survey III, was conducted using the platform provided by DXY (www.dxy.cn) during the period of September 10-23, 2015. In total 2,356 DXY users completed the survey, including 1,740 males and 617 females, with a mean age of 31.96±7.03 yrs.

RESULTS

The reasons (multiple choices) for career disaffection included poor patient/doctor relationship (88.6%), imbalance between workload and pay (79.5%), could not enter the preferred specialty (14.14%), and working in small clinics with no career progress (11.17%). If given the choice to enter the specialty as well as the hospital grade of their choice, 73.8% dissatisfied respondents replied they would like to be a doctor. For the dis-satisfied respondents, university teacher appeared to be the most popular career choice. The cited high workload was considered to be due to (I) imbalance in geographical allocation of doctors and insufficient training of doctors; (II) many red-tapism formalities; (III) Chinese patients often have unreasonable requests; (IV) over-examination and over-treatment; (V) high pressure to publish papers. One hundred and twelve respondents have their child/children attending university or graduated from university, 25.0% of them are pursuing a career in medicine. Nine hundred and ninety respondents have child/children while did not reach university age yet, among them 23.62% would like their child/children to study medicine. 64.87% of the 2,356 participants favor China to open up medical market to qualified foreign medical organizations to take part in fair competition, and 57.91% favor the government supporting regulated private hospitals.

CONCLUSIONS

The moral and motivation of medical doctors in China are likely to be similar to other continuously evolving societies. Cost-effective use of existing resources should be explored as the first priority.