Open Journal Systems

Síndrome de burnout y enfermería. Evidencia para la práctica

María Victoria Fernández-García, Rosa Amarilis Zárate-Grajales, Lorena Bautista-Paredes, Patricia Domínguez-Sánchez, Carolina Ortega-Vargas, Maricela Cruz-Corchado, Graciela Montesinos-Jiménez

Resumen

Introducción: es reconocido que el trabajo de enfermería en el contexto hospitalario, el estrés tiene diversas fuentes y repercusiones en la salud física y mental de las enfermeras. Los efectos del estrés laboral se han descrito como síndrome de burnout (sb), por lo que en este trabajo se analizan los elementos involucrados en el problema.

Desarrollo: se presenta la evidencia científica sobre los factores que originan el sb: situacionales (características del trabajo, ocupacionales y organizacionales); individuales: (características sociodemográficas, de personalidad y actitudes hacia el trabajo) y la violencia hacia las enfermeras como un factor emergente. Se presenta la evidencia sobre las consecuen- cias en las enfermeras y en las instituciones, así como las intervenciones que han mostrado efectividad a nivel individual (intervenciones educativas y psicosociales) y a nivel organizacional.

Conclusiones: para la práctica es crucial que las enfermeras administradoras y el personal conozcan todo lo relativo al sb para prevenirlo e intervenir oportunamente. En investigación es prioritario construir una línea que supere las diferencias metodológicas que limitan comparacio- nes de prevalencia, factores relacionados y consecuencias en el contexto nacional. Es prioritario incluir la evaluación de intervenciones.

Palabras clave

Agotamiento profesional; Satisfacción en el trabajo; Personal de enfermería

Texto completo:

PDF

Referencias

McGrath A, Reid N. Boore J. Occupational stress in nursing. Int J Nurs Stud. 1989;26(4):343-58.

Aiken LH, Clarke SP, Sloane DM, Sochalski JA, Busse R, Clarke H, et al. Nurses’ reports on hospital care in five countries. Health Affairs. 2001;20(3):43-53.

Ibáñez Martínez N, Vilaregut Puigdesens A, Abio Roig A. Preva- lencia del síndrome de burnout y el estado general de salud en un grupo de enfermeras de un hospital de Barcelona. Enferm Clín. 2004;14(3):142-151.

Cheung RB, Aiken LH, Clarke SP, Sloane DM. Nursing care and patient outcomes: international evidence. Enferm Clin. 2008;18(1):35-40.

Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002;288(16):1987-93.

Dugan J, Lauer E, Bouquot Z, Dutro BK, Smith M, Widmeyer G. Stressful nurses: the effect on patient outcomes. J Nurs Care Qual. 1996;10(3):46-58.

Lee JL, Chang BL, Pearson ML, Kahn KL, Rubenstein LV. Does what nurses do affect clinical outcomes for hospitalized patients? A review of the literature. Health Serv Res. 1999;34(5 Pt. 1):1011-32.

Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52:397-422.

Díaz-Muñoz MJ. Síndrome del quemado en profesionales de enfermería que trabajan en un hospital monográfico para pacien- tes cardíacos. Nure Investigación. 2005;(18). [En linea] http:/ /www.fuden.es/FICHEROS_ADMINISTRADOR/ORIGINAL/ Original18.pdf [Consultado 30/03/2010].

Solano Ruíz MC, Hernández Vidal P, Vizcaya Moreno ME, Reig Ferrer A. Síndrome de burnout en profesionales de enfermería de cuidados críticos. Enferm Intensiva. 2002;13(1):9-16.

Poncet MC, Toullic P, Papazian L, Kentish Barnes N, Timsit JF, Pochard F, et al. Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med. 2007;175(7):698-704.

Pera G, Serra Prat M. Prevalencia del síndrome del quemado y estudio de los factores asociados en los trabajadores de un hospital comarcal. Gac Sanit. 2002;16(6):480-6.

Tourangeau AE, Doran DM, McGillis Hall L, O’Brien Pallas L, Pringle D, Tu JV, et al. Impact of hospital nursing care on 30-day mortality for acute medical patients. J Adv Nurs. 2007;57(1):32-44.

Grau A, Suñer R, García MM. Desgaste profesional en el personal sanitario y su relación con los factores personales y ambientales. Gac Sanit. 2005;19(6):463-470.

De los Ríos-Castillo JL, Barrios-Santiago P, Ocampo-Mancilla M, Ávila-Rojas TL. Desgaste profesional en personal de enfermería. Aproximaciones para un debate. Rev Med Inst Mex Seguro Soc. 2007;45(5):493-502.

Palmer Morales Y, Prince Vélez R, Searcy Bernal R, Compean Saucedo R. Prevalencia del síndrome de «burnout» en el personal de enfermería de 2 hospitales mexicanos. Enferm Clin. 2007;17(5):256-260.

Martínez López C, López Solache G. Características del síndrome de Burnout en un grupo de enfermeras mexicanas. Arch Med Fam. 2005;7(1):6-9 [En linea] http://www.medigraphic.com/pdfs/ medfam/amf-2005/amf051c.pdf [Consultado 09/02/2010].

Cabrera-Gutiérrez LS, Lopez-Rojas P, Salinas-Tovar S, Ochoa- Tirado JG, Marín-Cotonieto IA, Haro-García L. Burnout syndrome among Mexican hospital nursery staff. Rev Med Inst Mex Seguro Soc. 2005;43(1):11-15.

Aiken LH, Clarke SP, Sloane, DM, Sochalski JA, Busse, R, Clarke H, Et al. Nurses’ Reports On Hospital Care In Five Countries. Health Aff. 2001;20(3):43-53. [En linea] http://content.healthaffairs.org/ content/20/3/43.full.pdf+html [Consultado 20/03/2010].

Sheward L, Hunt J, Hagen S, Macleod M, Ball J. The relationship between UK hospital nurse staffing and emotional exhaustion and job dissatisfaction. J Nurs Manag. 2005;13(1):51-60.

Piko BF. Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: a questionnaire survey. Int J Nurs Stud. 2006;43(3):311-8.

Spooner Lane R, Patton W. Determinants of burnout among public hospital nurses. Aust J Adv Nurs. 2007;25:8-16. [En linea] http://www.ajan.com.au/vol25/vol25.1-1.pdf [Consul- tado 30/03/2010].

AbuAlRub RF. Job stress, job performance, and social support among hospital nurses. J Nurs Scholarsh. 2004;36(1):73-8.

Sherring S, Knight D. An exploration of burnout among city mental health nurses. Br J Nurs. 2009;18(20):1234-40.

Embriaco N, Azoulay E, Barrau K, Kentish N, Pochard F, Loundou A, et al. High level of burnout in intensivists: prevalence and associated factors. Am J Respir Crit Care Med. 2007;175(7):686-92.

Barrett L, Yates P. Oncology/haematology nurses: a study of job satisfaction, burnout, and intention to leave the specialty. Aust Health Rev. 2002;25(3):109-21.

Gutiérrez-Alanis MT, Martínez-Alcántara S. Burnout en enferme- ras oncológicas mexicanas. Salud Trabajadores. 2006;14(1):19- 30. [En linea] http://www2.scielo.org.ve/pdf/st/v14n1/ art03.pdf [Consultado 30/03/2010].

Poncet MC, Toullic P, Papazian L, Kentish Barnes N, Timsit JF, Pochard F, Chevret S, et al. Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med. 2007;175(7):698-704.

Sharma A, Sharp DM, Walker LG, Monson JR. Stress and burnout among colorectal surgeons and colorectal nurse specialists working in the National Health Service. Colorectal Dis. 2008;10(4):397-406.

Stordeur S, D’Hoore W; NEXT-Study Group. Organizational configuration of hospitals succeeding in attracting and retaining nurses. J Adv Nurs. 2007;57(1):45-58.

Bakker AB, Killmer CH, Siegrist J, Schaufeli WB. Effort-reward imbalance and burnout among nurses. J Adv Nurs. 2000;31(4):884-91.

Bourbonnais R, Brisson C, Vinet A, Vézina M, Lower A. Development and implementation of a participative intervention to improve the psychosocial work environment and mental health in an acute care hospital. Occup Environ Med. 2006;63(5):326-34.

Spence Laschinger HK, Leiter MP. The impact of nursing work environments on patient safety outcomes: the mediating role of burnout/engagement. J Nurs Adm. 2006;36(5):259-67.

Laschinger HKS, Finegan J. Shamian J, Wilk P. Workplace empowerment as a predictor of nurse burnout in restructured healthcare settings. Healthcare Quarterly. 2003;6(4):2-11. [En linea] http://www.longwoods.com/product/download/code/ 17242 [Consultado 30/03/2010].

Hochwälder J. The psychosocial work environment and burnout among Swedish registered and assistant nurses: the main, mediating, and moderating role of empowerment. Nurs Health Sci. 2007;9(3):205-11.

Hasselhorn HM, Muller BH, Tackenberg P, University of Wuppertal, NEXT-Study Coordination (ed.) NEXT Scientific Report July 2005. [En linea] http://www.econbiz.de/archiv1/2008/ 53602_nurses_work_europe.pdf [Consultado 08/01/2010].

Aström S, Nilsson M, Norberg A, Winblad B. Empathy, experience of burnout and attitudes towards demented patients among nursing staff in geriatric care. J Adv Nurs. 1990;15(11):1236-44. 38. Hanrahan NP, Aiken LH. Psychiatric nurse reports on the quality of psychiatric care in general hospitals. Qual Manag Health Care. 2008;17(3):210-7.

Golbasi Z, Kelleci M, Dogan S. Relationships between coping strategies, individual characteristics and job satisfaction in a sample of hospital nurses: cross-sectional questionnaire survey. Int J Nurs Stud. 2008;45(12):1800-6.

Popp MS. Estudio preliminar sobre el síndrome de burnout y estrategias de afrontamiento en enfermeras de unidades de terapia intensiva (UTI). Interdisciplinaria.2008;25(1):5-27.[Enlinea]http://www.scielo.org.ar/ pdf/interd/v25n1/v25n1a01.pdf [Consultado 30/03/2010].

Shimizutani M, Odagiri Y, Ohya Y, Shimomitsu T, Kristensen TS, Maruta T, et al. Relationship of nurse burnout with personality characteristics and coping behaviors. Ind Health. 2008;46(4):326-35.

Langelaan S, Bakker AB, van Doornen LJP, Schaufeli WB. Burnout and work engagement: Do individual differences make a difference? Pers Individ Dif. 2006;40:521-532. [En linea] http:/ /www.fss.uu.nl/sop/Schaufeli/237.pdf [Consultado 12/04/ 2010].

Maben J, Latter S, Clark JM. The sustainability of ideals, values and the nursing mandate: evidence from a longitudinal qualitative study. Nurs Inq. 2007;14(2):99-113.

Registered Nurses’ Association of Ontario (Canadá). Position statement: Violence against nurses: “Zero tolerance” for violence against nurses and nursing students. [En linea] http:// www.rnao.org/Storage454013_Violence_in_the_ Workplace_Against_Nurses_and_Nursing_Students.pdf [Con- sultado 12/04/2010].

Nolan P, Smojkis M. The mental health of nurses in the UK. Adv Psychiatry Treat. 2003;9: 374-379. [En linea] http:// apt.rcpsych.org/content/9/5/374.full.pdf+html [Consultado 12/04/2010].

Estryn-Behar M, van der Heijden B, Camerino D, Fry C, Le Nezet O, Et al. Violence risks in nursing—results from the European ‘NEXT’ Study. Occup Med (Lond). 2008;58(2):107-14.

Gonge H, Jensen LD, Bonde JP. Are psychosocial factors associated with low-back pain among nursing personnel? Work Stress. 2002;16(1):79-87.

Kitaoka Higashiguchi K, Morikawa Y, Miura K, Sakurai M, Ishizaki M, Kido T, Et al. Burnout and risk factors for arteriosclerotic disease: follow-up study. J Occup Health. 2009;51(2):123-31.

Melamed S, Shirom A, Toker S, Shapira I. Burnout and risk of type 2 diabetes: a prospective study of apparently healthy employed persons. Psychosom Med. 2006;68(6):863-9. [En linea] http:// www.psychosomaticmedicine.org/content/68/6/863.full.pdf+html [Consultado 12/04/2010].

De Bacquer D, Pelfrene E, Clays E, Mak R, Moreau M, de Smet P, Et al. Perceived job stress and incidence of coronary events: 3- year follow-up of the Belgian Job Stress Project cohort. Am J Epidemiol. 2005;161(5):434-41. [En linea] http:// aje.oxfordjournals.org/content/161/5/434.full.pdf+html [Con- sultado 12/04/2010].

Rev Enferm Inst Mex Seguro Soc 2012; 20 (1): 45-53

Kanai Pak M, Aiken LH, Sloane DM, Poghosyan L. Poor work environments and nurse inexperience are associated with burnout, job dissatisfaction and quality deficits in Japanese hospitals. J Clin Nurs. 2008;17(24):3324-9.

Aiken LH, Clarke SP, Sloane DM, Lake ET, Cheney T. Effects of hospital care environment on patient mortality and nurse outcomes. J Nurs Adm. 2008;38(5):223-9.

Palfi I, Nemeth K, Kerekes Z, Kallai J, Betlehem J. The role of burnout among Hungarian nurses. Int J Nurs Pract. 2008;14(1):19-25.

Vahey DC, Aiken LH, Sloane DM, Clarke SP, Vargas D. Nurse burnout and patient satisfaction. Med Care. 2004;42(2 Suppl):II57-66. [En linea] http:/www.protectmasspatients. org/docs/Nurse%20Burnout%20and%20Pt%20Satisfaction %20pdf.pdf [Consultado 08/04/2009].

Jones CB, Gates M. The costs and benefits of nurse turnover: A business case for nurse retention. Online J Issues Nurs. 2007; 12(3):1-11. [En linea] http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/ NurseRetention.aspx [Consultado 20/03/2010].

Scanlon WJ. Nursing Workforce: Recruitment and Retention of Nurses and Nurses Aides is a Growing Concern,U.S. General Accountability Office (GAO), testimony, May 17, 2001. [En linea] http://www.gao.gov/new.items/d01750t.pdf [Consul- tado 04/03/2010].

Finlayson B, Dixon J, Meadows S, Blair G. Mind the gap: the extent of the NHS nursing shortage. BMJ. 2002;325(7363):538-41.

Aiken LH, Clarke SP, Cheung RB, Sloane DM, Silber JH. Educational levels of hospital nurses and surgical patient mortality. JAMA. 2003;290(12):1617-23. [En linea] http://jama.ama-assn.org/ content/290/12/1617.full.pdf+html [Consultado 15/09/2008].

Aiken LH, Clarke SP, Sloane DM; International Hospital Outcomes Research Consortium. Hospital staffing, organization, and quality of care: cross-national findings. Int J Qual Health Care. 2002;14(1):5-13. [En linea] http://intqhc.oxfordjournals.org/ content/14/1/5.full.pdf+html [Consultado 07/09/2008].

Bakker AB, Le Blanc PM, Schaufeli WB. Burnout contagion among intensive care nurses. J Adv Nurs. 2005;51(3):276-87.

Awa WL, Plaumann M, Walter U. Burnout prevention: a review of intervention programs. Patient Educ Couns. 2010;78(2):184-90.

Fernández García V, Zarate Grajales RA, Lartigue Becerra T. ¿Para qué estudiar el síndrome de burnout en el personal de enfermería en México? Precisiones metodológicas para el desa- rrollo de una línea de investigación. Enferm Univ. 2010;7(7):23- 35. [En linea] http://www.journals.unam.mx/index.php/reu/article/download/26922/25098 [Consultado 08/08/2011].

Turner J, Clavarino A, Butow P, Yates P, Hargraves M, Connors V, Et al. Enhancing the capacity of oncology nurses to provide supportive care for parents with advanced cancer: evaluation of an educational intervention. Eur J Cancer. 2009;45(10):1798-806.

Gilbody S, Cahill J, Barkham M, Richards D, Bee P, Glanville J. Can we improve the morale of staff working in psychiatric units? A systematic review. J Ment Health. 2006;15(1):7-17.

Kravits K, McAllister Black R, Grant M, Kirk C. Self-care strategies for nurses: A psycho-educational intervention for stress reduction and the prevention of burnout. Appl Nurs Res. 2010;23(3):130-8. 66. Van der Klink JJ, Blonk RW, Schene AH, van Dijk FJ. The benefits of interventions for work-related stress. Am J Public Health. 2001;91(2):270-6. [En linea] http://www.ncbi.nlm.nih.gov/ pmc/articles/PMC1446543/pdf/11211637.pdf [Consultado 03/08/2008].

Marine A, Ruotsalainen J, Serra C, Verbeek J. Preventing occupational stress in healthcare workers. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD002892

Cohen-Katz J, Wiley SD, Capuano T, Baker DM, Kimmel S, ShapiroS. The effects of mindfulness-based stress reduction on nurse stress and burnout, Part II: A quantitative and qualitative study. Holist Nurs Pract. 2005;19(1):26-35.

Cohen-Katz J, Wiley S, Capuano T, Baker DM, Deitrick L, Shapiro S. The effects of mindfulness-based stress reduction on nurse stress and burnout: a qualitative and quantitative study, part III. Holist Nurs Pract. 2005;19(2):78-86.

Menzel NN, Robinson ME. Back pain in direct patient care providers: early intervention with cognitive behavioral therapy. Pain Manag Nurs. 2006;7(2):53-63

Mackenzie CS, Poulin PA, Seidman Carlson R. A brief mindfulness- based stress reduction intervention for nurses and nurse aides. Appl Nurs Res. 2006;19(2):105-9.

Mimura C, Griffiths P. The effectiveness of current approaches to workplace stress management in the nursing profession: an evidence based literature review. Occup Environ Med. 2003;60(1):10-5.

Pryce J, Albertsen K, Nielsen K. Evaluation of an open-rota system in a Danish psychiatric hospital: a mechanism for improving job satisfaction and work-life balance. J Nurs Manag. 2006;14(4):282-8.

Ewers P, Bradshaw T, McGovern J, Ewers B. Does training in psychosocial interventions reduce burnout rates in forensic nurses? J Adv Nurs. 2002;37(5):470-6.

Michie S, Williams S. Reducing work related psychological ill health and sickness absence: a systematic literature review. Occup Environ Med. 2003;60(1):3-9.

Teasdale K, Brocklehurst N, Thom N. Clinical supervision and support for nurses: an evaluation study. J Adv Nur. 2001;33(2):216-224