1
|
Frajerman A, Deflesselle E, Colle R, Corruble E, Costemale-Lacoste JF. [Burnout, anxiety, insomnia and depressive symptoms among French outpatient physicians in the second wave of COVID-19: Comparison between general practitioners and specialists]. Encephale 2024; 50:192-199. [PMID: 37121809 PMCID: PMC10076503 DOI: 10.1016/j.encep.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 01/10/2023] [Accepted: 01/31/2023] [Indexed: 04/08/2023]
Abstract
INTRODUCTION The 2019 coronavirus (COVID-19) pandemic has caused a public health crisis worldwide. Concerns have been expressed about the rapid deterioration of mental health among primary care physicians among whom burnout already had a high prevalence prior to the pandemic. However, there is little data on private doctors during the pandemic. France experienced a second wave with a second lockdown. We aimed to assess and compare physicians' burnout, anxiety and depression symptoms and insomnia between general practitioners (GP) and all other private specialists during the second Covid-19 wave. METHODS We conducted an online survey of private practitioners registered on Doctolib® (n=32,655), the interface software most used by private practitioners for booking medical appointments in France. Doctors were invited by email to complete an online survey in November 2020. Inclusions were closed on 1st December. The 2nd lockdown lasted from 30th October to 15th December 2020. We used the Copenhagen Burnout Inventory (CBI) to assess burnout syndrome. A mean score of>50 in at least one subscale defined burnout. The Hospital Anxiety and Depression Scale assessed anxiety and depression symptoms. We used two cut-offs, 8 (>7) and 11 (>10), as both are validated in the ability to find cases. The Insomnia Severity Index (ISI) measures sleep-related complaints among physicians (cut-off >7). To link variations in the psychological scales to the COVID-19 pandemic, one of the items asked explicitly whether participants considered that "the COVID-19 epidemic we are currently experiencing is a source of excess stress, psychological suffering or burnout". Approval for this study was obtained from the local institutional review board of the University of Paris-Saclay, France. The questionnaires were collected anonymously. Statistical significance was tested using the chi-square test and student's t-test to compare the prevalence between GPs and other specialities. Subsequently, logistic regression models were run for statistically significant associations. RESULTS 1992 physicians replied, a response rate of 12.8% of those who received the invitation email. Among them, 79.4% suffered from psychological distress (symptoms of anxiety or depression or burnout), of which 71.3% suffered from burnout, 26.7% from depressive symptoms, 58.9% from anxiety symptoms and 45.8% from insomnia. There was no difference in gender between GPs and specialists, but there was an age difference (P<0.001). GPs had a higher prevalence of burnout (OR=1.33 CI95 [1.09;1.63]) and took more psychotropic drugs (1.38 CI95 [1.05;1.81]). They were also more likely to perceive their stress as work-related (OR=1.50 CI95 [1.23;1.81]) or COVID-19-related (OR=1.43 CI95 [1.16;1.77]). CONCLUSION Our study is the first to assess the mental health of private practitioners in the second wave in association with COVID-19 stress. Firstly, GPs who provide primary care have a significantly higher burnout rate than other doctors. Secondly, COVID-19 stress is associated with more significant psychological distress. Thirdly, almost 80% of the private doctors surveyed suffer from psychological pain, and 71% suffer from burnout. This study has strengths and limitations. Firstly, this study assesses mental health and stress related to its COVID-19 association. Second, this is the largest population of private physicians during the COVID-19 pandemic. The low response rate is the main limit of this study. The alarming rates of psychological distress among private doctors and, in particular, GPs should lead to intervention to help doctors reduce stress, burnout and other mental disorders. This study gives a picture of the situation during the second wave and the lock-in, and we need to be cautious with the next waves.
Collapse
Affiliation(s)
- Ariel Frajerman
- MOODS Team, Inserm, CESP, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France; Service hospitalo-universitaire de psychiatrie de Bicêtre, Mood Center Paris Saclay, hôpital de Bicêtre, Assistance publique-Hôpitaux de Paris, hôpitaux universitaires Paris-Saclay, 94275 Paris, France; Inserm U1266-GDR 3557, institut de psychiatrie et neurosciences de Paris, institut de Psychiatrie, Paris, France; Université Paris Cité, Paris, France.
| | - Eric Deflesselle
- MOODS Team, Inserm, CESP, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France; Département de médecine générale, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France
| | - Romain Colle
- MOODS Team, Inserm, CESP, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France; Service hospitalo-universitaire de psychiatrie de Bicêtre, Mood Center Paris Saclay, hôpital de Bicêtre, Assistance publique-Hôpitaux de Paris, hôpitaux universitaires Paris-Saclay, 94275 Paris, France
| | - Emmanuelle Corruble
- MOODS Team, Inserm, CESP, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France; Service hospitalo-universitaire de psychiatrie de Bicêtre, Mood Center Paris Saclay, hôpital de Bicêtre, Assistance publique-Hôpitaux de Paris, hôpitaux universitaires Paris-Saclay, 94275 Paris, France
| | - Jean-François Costemale-Lacoste
- MOODS Team, Inserm, CESP, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France; Centre hospitalier le Vinatier, Bron, France; Union régionale des professionnels de santé libéraux, Auvergne Rhône-Alpes, France
| |
Collapse
|
2
|
Akiki G, Richa S, Kazour F. Medical and recreational cannabis: A cross-sectional survey assessing a sample of physicians' attitudes, knowledge and experience in a university hospital in Lebanon. Encephale 2023; 49:130-137. [PMID: 35016798 DOI: 10.1016/j.encep.2021.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/03/2021] [Accepted: 10/11/2021] [Indexed: 11/23/2022]
Abstract
CONTEXT A law legalizing the farming of medical cannabis for the international market was passed in Lebanese parliament in April 2020. Thus, this makes Lebanon the first Arab country to legalize medical cannabis, a law which can hold potential public health consequences. The advocates of legalization of medical cannabis in society and in the media influence the public opinion. A community of Lebanese physicians was the first to be asked about this subject. OBJECTIVE This study aims to assess a sample of physicians' opinions, knowledge and experiences with medical and non-medical cannabis. METHOD All physicians of every speciality working at the Hôtel Dieu de France-Beirut hospital (450) received by email a 33-question-online survey in French between November 2020 and December 2020. The survey was designed based on similar studies published outside of Lebanon. RESULTS Eighty-five Lebanese physicians responded to the survey and 80% of them supported the decriminalization of medical cannabis in Lebanon. But only 16% reported knowing the indications of medical cannabis, and only 24% stated that they have adequate knowledge of its secondary effects. Eighty-eight percent of them felt that they might be more comfortable discussing the option of medical cannabis if they had formal education on the subject. CONCLUSION Even though the majority of the sample who participated in this study seemed to approve the use of medical cannabis, they lacked the knowledge and confidence to do it. Therefore, this study highlights the need of physician training in the subject of medical cannabis. Future well-conducted university studies will produce evidence-based-guidelines for medical cannabis indications and side effects.
Collapse
Affiliation(s)
- G Akiki
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon; Hôtel Dieu de France Hospital, Beirut, Lebanon
| | - S Richa
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon; Hôtel Dieu de France Hospital, Beirut, Lebanon
| | - F Kazour
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon; Hôtel Dieu de France Hospital, Beirut, Lebanon; CHRU de Tours, avenue de la République, 37170 Chambray-lès-Tours, France.
| |
Collapse
|
3
|
Davin-Casalena B, Jardin M, Guerrera H, Mabille J, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V. The impact of the COVID-19 epidemic on primary care in South-eastern France: implementation of a real-time monitoring system based on regional health insurance system data. Rev Epidemiol Sante Publique 2021; 69:255-264. [PMID: 34454792 PMCID: PMC8818324 DOI: 10.1016/j.respe.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/19/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The spring 2020 COVID-19 epidemic severely impacted France's healthcare system. The associated lockdown (17 March- 11 May 2020) and the risk of exposure to SARS-CoV-2 led patients to change their use of healthcare. This article presents the development and implementation of a real-time system to monitor i) private doctors' activity in South-eastern France, and ii) changes in prescription of drugs for people with diabetes, mental health disorders and for certain vaccines from Mars 2020 to October 2020. METHODS Data extracted from the regional healthcare insurance databases for 2019 and 2020 were used to construct indicators of healthcare use. They were calculated on a weekly basis, starting from week 2 2020 and compared for the same period between 2019 and 2020. RESULTS Private doctors' activity decreased during the spring 2020 lockdown (by 23 % for general practitioners and 46 % for specialists), followed by an almost complete return to normal after it ended until week 41. Over the same period, a huge increase in teleconsultations was observed, accounting for 30 % of private doctors' consultations at the height of the crisis. The start of the lockdown was marked by a peak in drug prescriptions, while vaccinations declined sharply (by 39 % for the measles, mumps and rubella (MMR) vaccine in children under 5 years old, and by 54 % for human papillomavirus vaccine in girls aged 10-14 years old). CONCLUSION The ongoing COVID-19 epidemic may lead to health consequences other than those directly attributable to the disease itself. Specifically, lockdowns and foregoing healthcare could be very harmful at the individual and population levels. The latter issue is a concern for French public authorities, which have implemented actions aimed at encouraging patients to immediately seek treatment. However, the COVID-19 crisis has also created opportunities, such as the roll-out of teleconsultation and tele-expertise. The indicators described here as part of the monitoring system can help public decision-makers to become more responsive and to implement tailored actions to better meet the general population's healthcare needs.
Collapse
Affiliation(s)
- B Davin-Casalena
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille.
| | - M Jardin
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - H Guerrera
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - J Mabille
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - H Tréhard
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - D Lapalus
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - C Ménager
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - S Nauleau
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - V Cassaro
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - P Verger
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - V Guagliardo
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| |
Collapse
|
4
|
Mhiri A, Khemakhem M, Kalboussi N, Kacem B. [Knowledge and perceptions of biosimilar medicines by health professionals in Tunisia]. Ann Pharm Fr 2021; 80:327-339. [PMID: 34428456 DOI: 10.1016/j.pharma.2021.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/09/2021] [Accepted: 08/17/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Biosimilar drugs occupy a strategic place in the global pharmaceutical market. However, there are brakes on their use. The objective of our study is to assess the knowledge and perceptions of healthcare professionals on biosimilar drugs in a developing country. MATERIAL AND METHODS This is a prospective survey via an anonymous 18-question multiple-choice questionnaire developed and published online through the "Google Forms" application over a period of one month. This questionnaire is intended for Tunisian pharmacists and doctors of all ranks. RESULTS A total of 240 health professionals responded to this questionnaire, including 158 pharmacists and 82 physicians. Among them, 73 are not informed about the biosimilar drugs and were excluded from the rest of the questionnaire. Questions regarding the definition of biosimilar drugs and their differences from generic drugs obtained the best rate of 76 % of correct answers. In contrast, the questions that generated the most errors mainly concerned the regulation of biosimilar drugs. Participants felt that they were under-informed about biosimilar drugs in 65 % of the cases. In addition, 92 % were in favor of the development of this class of drugs and 85 % estimated significant to very significant savings related to their use. CONCLUSION Our study confirms the lack of information of pharmacists and physicians on biosimilar drugs. Sensitization of healthcare professionals on the safety and effectiveness of the use of these drugs seems to be necessary in order to allow their development.
Collapse
Affiliation(s)
- A Mhiri
- Service de pharmacie, hôpital Sahloul de Sousse, Sousse, Tunisie; Faculté de pharmacie de Monastir, Monastir, Tunisie.
| | - M Khemakhem
- Faculté de pharmacie de Monastir, Monastir, Tunisie.
| | - N Kalboussi
- Service de pharmacie, hôpital Sahloul de Sousse, Sousse, Tunisie; Faculté de pharmacie de Monastir, Monastir, Tunisie.
| | - B Kacem
- Service de pharmacie, hôpital Sahloul de Sousse, Sousse, Tunisie; Faculté de pharmacie de Monastir, Monastir, Tunisie.
| |
Collapse
|
5
|
Davin-Casalena B, Jardin M, Guerrera H, J Mabille, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V. [The impact of the COVID-19 pandemic on first-line primary care in southeastern France: Feedback on the implementation of a real-time monitoring system based on regional health insurance data]. Rev Epidemiol Sante Publique 2021; 69:105-115. [PMID: 33992499 PMCID: PMC8075812 DOI: 10.1016/j.respe.2021.04.135] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/02/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022] Open
Abstract
Position du problème L’épidémie de COVID-19 du printemps 2020 a fortement affecté le système de soins. Le confinement et les risques d’exposition au coronavirus ont incité les patients à modifier leur recours aux soins. L’objectif était de partager un retour d’expérience sur la mise en place d’un dispositif de surveillance en temps réel de l’activité des médecins libéraux de la région Provence-Alpes-Côte d’Azur, et de l’évolution des remboursements de médicaments prescrits aux assurés du régime général pour le diabète, pour des troubles de la santé mentale et pour certains vaccins. Méthodes Les données ont été extraites à partir des bases régionales de l’Assurance maladie pour les années 2019 et 2020. Elles ont permis de construire des indicateurs en date de soins pour le régime général stricto sensu, calculés de façon hebdomadaire, à partir de la semaine 2. Résultats On constate une chute d’activité des médecins libéraux lors du confinement (−23 % pour les médecins généralistes ; −46 % pour les spécialistes), suivie d’un quasi retour à la normale par la suite. Dans le même temps, les téléconsultations ont connu un véritable essor : elles ont constitué 30 % des actes des médecins libéraux au plus fort de la crise. Le début du confinement a été marqué par un pic d’approvisionnement en médicaments, tandis que la vaccination a fortement diminué (−39 % concernant le vaccin contre la rougeole, les oreillons et la rubéole chez les enfants âgés de moins de 5 ans ; −54 % pour le vaccin contre les papillomavirus humains chez les filles âgées de 10–14 ans). Conclusion L’épidémie de COVID-19 risque d’entraîner d’autres conséquences sanitaires que celles directement imputables à la COVID-19 elle-même. Le renoncement aux soins pourrait causer des retards de soins fortement préjudiciables aux individus et à la collectivité. Ces questions inquiètent les autorités publiques, qui mettent en place des actions visant à inciter les patients à se soigner sans tarder. Mais la crise liée à la COVID-19 a aussi créé des opportunités, telles que le déploiement de la téléconsultation et de la télé-expertise. Bien que partiels, les indicateurs mis en œuvre peuvent permettre aux décideurs publics d’être réactifs et de mettre en place certaines actions afin de répondre aux besoins de santé des populations.
Collapse
Affiliation(s)
- B Davin-Casalena
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France.
| | - M Jardin
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - H Guerrera
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - J Mabille
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - H Tréhard
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - D Lapalus
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - C Ménager
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - S Nauleau
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - V Cassaro
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - P Verger
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - V Guagliardo
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| |
Collapse
|
6
|
Firn S, Galland J, Rousseau H, Andres E, Salles N, Disdier P, Azzi J, Baumann C, de Korwin JD. [The practice of telemedicine by French internal medicine physicians in 2019]. Rev Med Interne 2021; 42:523-34. [PMID: 33715889 DOI: 10.1016/j.revmed.2021.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 01/28/2021] [Accepted: 02/14/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Telemedicine has been developing in France since 2018. The objective of this survey was to assess the knowledge, attitudes, practices and training of internal physicians regarding telemedicine. MATERIAL AND METHODS A national descriptive observational study carried out between July and October 2019, via an online self-questionnaire with members of the National Society of Internal Medicine and the Association of Young Internists, included a descriptive and comparative analysis by subgroups of age. RESULTS Analysis of 309 responses from physicians qualified in internal medicine or practicing in an internal medicine service (61,8%) and residents in internal medicine (38%) showed that 34.6% had notions or a good knowledge of regulation of telemedicine. For 62,1%, 72.5% and 74.1% respectively, it could improve patient care, access to care and exchanges between internists and other doctors. The main obstacles to this practice were the absence of face-to-face with the patient (57.3%) and computer dysfunctions (55%). Only 23.3% practiced it, including 88.9% tele-expertise. Telemedicine was performed informally (telephone and email) in 70.8% of the cases. Doctors over the age of 50 were better acquainted with the regulations and more practiced official telemedicine. In total, 54% wanted to practice telemedicine and 72.8% wanted to train there. CONCLUSION Attitudes towards telemedicine were positive, but few internists knew about it and practiced it formally, warranting appropriate training.
Collapse
|
7
|
Raynard B, Hébuterne X, Goldwasser F, Ait Hssain A, Dubray Longeras P, Barthélémy P, Rosso E, Phoutthasang V, Bories C, Digue L, Laharie D, Desport JC, Falkowski S, Lacau Saint Guily J, Gyan E. [Crossed perceptions about malnutrition in patients and their doctors in oncology]. Bull Cancer 2017; 104:921-928. [PMID: 29128080 DOI: 10.1016/j.bulcan.2017.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 09/08/2017] [Accepted: 09/14/2017] [Indexed: 10/18/2022]
Abstract
Malnutrition is common in oncology. However, it is often detected too late and nutritional support is sub-optimal. The patient's opinion, although often sought in therapeutic decisions in oncology, does not appear to be frequently taken into account in dietetic management. In NutriCancer2012 study, we interviewed patients, relatives and doctors about their perceptions of the impact of malnutrition and its quality of care. Of the 2209 patients questioned, majority said they were concerned about nutrition with 75% considering it essential to take appropriate nutritional care but only 19% self-reported link between malnutrition and fatigue. Physicians underestimated impact of malnutrition on patient's "quality of life". Doctors referred to the lack of human resources and knowledge in nutrition, and more than 80% wished the creation of nutrition teams. Sensitization of the general public and patients (and relatives) as soon as the cancer diagnosis could lead to better malnutrition's screening. Better nutrition training for physicians and creation of nutrition team could optimize management and improve efficacy during cancer treatments.
Collapse
Affiliation(s)
- Bruno Raynard
- Centre Gustave-Roussy, unité transversale de diététique et de nutrition, département des soins de support, 114, rue Edouard-Vaillant, 94805 Villejuif, France.
| | - Xavier Hébuterne
- Hôpital de l'Archet, service de gastro-entérologie et nutrition, fédération d'hépato-gastro-entérologie et de nutrition clinique, 151, route Saint-Antoine-de-Ginestière, 06202 Nice, France
| | - François Goldwasser
- AP-HP, hôpital Cochin, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France
| | - Ali Ait Hssain
- Centre hospitalier universitaire Gabriel-Montpied, service d'anesthésie-réanimation, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - Pascale Dubray Longeras
- Centre Jean-Perrin, service d'oncologie médicale, 58, rue Montalembert, 63011 Clermont-Ferrand, France
| | - Philippe Barthélémy
- Hôpitaux universitaires de Strasbourg, pôle d'hématologie et d'oncologie médicale, 1, avenue Molière, 67200 Strasbourg, France
| | - Edoardo Rosso
- Hôpitaux universitaires de Strasbourg, chirurgie générale, hépatique et endocrinienne, 1, avenue Molière, 67200 Strasbourg, France
| | - Valérie Phoutthasang
- Hôpital Carémeau, service d'hépato-gastro-entérologie, unité transversale de nutrition clinique, place du Pr R.-Debré, 30029 Nîmes, France
| | - Camille Bories
- Hôpital Carémeau, service d'hépato-gastro-entérologie, unité transversale de nutrition clinique, place du Pr R.-Debré, 30029 Nîmes, France
| | - Laurence Digue
- CHU Saint-André, service d'oncologie médicale, 1, rue Jean-Burguet, 33000 Bordeaux, France
| | - David Laharie
- CHU de Bordeaux, GH Sud, hôpital Haut-Lévêque, service d'hépato-gastro-entérologie et oncologie digestive, avenue de Magellan, 33604 Pessac, France
| | - Jean-Claude Desport
- CHU Limoges, hôpital Dupuytren, unité de nutrition, centre de spécialité de l'obésité, centre expert de nutrition parentérale à domicile, 2, avenue Martin-Luther-King, 87042 Limoges, France
| | - Sabrina Falkowski
- CHU de Limoges, hôpital Dupuytren, service d'oncologie médicale, 2, avenue Martin-Luther-King, 87042 Limoges, France
| | - Jean Lacau Saint Guily
- AP-HP, hôpital Tenon, service d'ORL et chirurgie cervico-faciale, 4, rue de la Chine, 75020 Paris, France
| | - Emmanuel Gyan
- CHRU de Tours, hôpital Bretonneau, service de cancérologie, 2, boulevard Tonnellé, 37044 Tours, France
| |
Collapse
|
8
|
Ben Zid A, Homri W, Ben Romdhane I, Bram N, Labbane R. [Burnout in Tunisian medical residents: About 149 cases]. Encephale 2017; 44:337-342. [PMID: 28870691 DOI: 10.1016/j.encep.2017.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 06/20/2017] [Accepted: 06/24/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Burnout is a professional psychological chronic stress-induced syndrome defined by three dimensions: emotional exhaustion, depersonalization, and low personal accomplishment. This syndrome concerns all professions but especially healthcare staff. Numerous studies have attempted to document the impact of work activities on the doctor's mental health. According to the literature, junior doctors are more vulnerable to develop this syndrome. AIMS Are to determine the prevalence of severe burnout among residents of different specialties: anesthesiology, general surgery, emergency medicine, psychiatry, basic sciences. The secondary end points are to analyze risk factors, causes and consequences associated with burnout. METHODS A cross-sectional study conducted among medical residents working in hospitals located in the governorates of Tunis. Three instruments were used: an anonymous self-administered questionnaire, Maslach Burnout Inventory (MBI) to assess burnout, and Abstract Beck Depression Inventory to evaluate the intensity of depression. Severe burnout was defined as a severely high level of both emotional exhaustion and depersonalization associated with a severely low level of personal accomplishment. RESULTS A total of 149 participants (response rate=76.8%) participated in the survey. Among participants, 17.14% (n=26) had a severe burnout. The emergency medicine residents had the highest rate of emotional exhaustion and depersonalization and severe depression. Overall, resident respondents, 31% (n=46), had moderate to severe depression. Among stress factors, those significantly correlated to burnout were: lack of hobbies (P<0.001), bad job conditions (P=0.031), poor conditions of the workplace (P=0.046), relationship problems in workplace (P=0.01), work-family conflicts (P<0.001). The consequences of occupational stress associated with burnout were: Antecedents of specialty change (P=0.017) and desire for a specialty change (P<0.001). A significant correlation between depression and severe burnout was not found. CONCLUSION Medical residents in all specialties are at risk of burnout. Nevertheless, this study revealed that some specialties are more exhausting, which is consistent with the results reported in the literature. Moreover, it is shown that several stress factors as well as many consequences are related to severe burnout, which is in agreement with numerous studies. However, results between different studies are disparate.
Collapse
Affiliation(s)
- A Ben Zid
- Service de psychiatrie C, hôpital Razi, cité des Orangers, 2010 La Manouba, Tunisie.
| | - W Homri
- Service de psychiatrie C, hôpital Razi, cité des Orangers, 2010 La Manouba, Tunisie
| | - I Ben Romdhane
- Service de psychiatrie C, hôpital Razi, cité des Orangers, 2010 La Manouba, Tunisie
| | - N Bram
- Service de psychiatrie C, hôpital Razi, cité des Orangers, 2010 La Manouba, Tunisie
| | - R Labbane
- Service de psychiatrie C, hôpital Razi, cité des Orangers, 2010 La Manouba, Tunisie
| |
Collapse
|
9
|
Legleye S, Bohet A, Razafindratsima N, Bajos N, Moreau C. A randomized trial of survey participation in a national random sample of general practitioners and gynecologists in France. Rev Epidemiol Sante Publique 2014; 62:249-55. [PMID: 25026884 DOI: 10.1016/j.respe.2014.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 03/31/2014] [Accepted: 04/28/2014] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Healthcare professionals play a critical role in women's choice of contraceptive methods. However, national surveys on sexual and reproductive health (SRH) among physicians are rare and present low participation rates. We conducted a randomized trial to test for the effectiveness of three interventions to improve survey participation of private physicians delivering reproductive health services in France. METHODS The study comprised a national random sample of 500 general practitioners and 500 gynecologists working in private offices. All received a postal invitation to participate either by completing a paper, phone or online questionnaire. Physicians were randomly assigned to six groups to test for the effect of three interventions: a non-monetary incentive in the form of a scientific book, telephone contact, and the possibility of completing the questionnaire by phone. RESULTS Overall, 362 questionnaires were collected (26 online, 2 by phone) and 58 physicians were ineligible. The completion rate increased from 26.7% in physicians who received no intervention to 42.7% in those who received the book and a phone call. The phone call increased the completion rate by 11% percentage points (P=0.01), while the book had no significant effect. Results from multivariate logistic regressions also indicate that gynecologists (OR=1.6) and female physicians (OR=1.5) were more likely to participate than others. CONCLUSION The results suggest that phone calls substantially increase participation of physicians in sexual and reproductive health surveys but have little impact on sampling distortion. Differentials in response rates by physicians' characteristics should be considered in future SRH studies among physicians.
Collapse
Affiliation(s)
- S Legleye
- Institut national des études démographiques (INED), 133, boulevard Davout, Paris, France; INSERM, U669, 75014 Paris, France; Université Paris-Sud and université Paris Descartes, UMRS 0669, 75014 Paris, France.
| | - A Bohet
- Gender, Sexual and Reproductive Health, CESP Centre for Research in Epidemiology and Population Health, U1018, INSERM, 94807 Le Kremlin-Bicêtre, France
| | - N Razafindratsima
- Institut national des études démographiques (INED), 133, boulevard Davout, Paris, France
| | - N Bajos
- Institut national des études démographiques (INED), 133, boulevard Davout, Paris, France; Gender, Sexual and Reproductive Health, CESP Centre for Research in Epidemiology and Population Health, U1018, INSERM, 94807 Le Kremlin-Bicêtre, France; Université Paris-Sud 11, UMRS 1018, 94807 Le Kremlin-Bicêtre, France
| | | | - C Moreau
- Institut national des études démographiques (INED), 133, boulevard Davout, Paris, France; Gender, Sexual and Reproductive Health, CESP Centre for Research in Epidemiology and Population Health, U1018, INSERM, 94807 Le Kremlin-Bicêtre, France; Université Paris-Sud 11, UMRS 1018, 94807 Le Kremlin-Bicêtre, France; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615, North Wolfe Street, Baltimore, MD 21205, USA
| |
Collapse
|