Self-perceived health in psychiatrists and psychiatry trainees. The role of perfectionism and distress
##plugins.themes.bootstrap3.article.main##
Resumen
Objetivo. Comparar y determinar la asociación de variables demográficas, condiciones de salud, distrés y perfeccionismo con la APS.
Método. Se realizó un estudio transversal, retrospectivo y comparativo mediante una encuesta en línea. Se incluyeron psiquiatras y residentes de psiquiatría que participaron voluntariamente. Se registraron variables demográficas, enfermedades médicas y psiquiátricas (autorreporte). La APS se evaluó con una escala análogo-visual de 10 puntos y el perfeccionismo con la Escala Multidimensional de Perfeccionismo. Se realizaron análisis comparativos y modelos de regresión lineal múltiple.
Resultados. Se reclutaron 330 residentes y 355 psiquiatras. Los psiquiatras reportaron más enfermedades físicas (32.4% vs. 15%, p < .001), distrés (p < .001) y perfeccionismo (p < .001). Más del 50% de los participantes reportaron ansiedad y depresión. Una mayor APS se asoció con tener pareja y mayor distrés en los residentes, y con la ausencia de una enfermedad física, menor preocupación por errores y mayores estándares personales en los psiquiatras.
Discusión y conclusión. El perfeccionismo orientado hacía sí mismo puede tener un componente motivacional acentuado por la competitividad y el individualismo. Tener una pareja y presentar mayor distrés en los residentes pudiera crear una sensación de satisfacción por logros. La creación de estrategias para priorizar y alcanzar objetivos es necesaria para tener un equilibrio de vida sin afectar la satisfacción personal y la sensación de logro.
Referencias
Adler, A. (1956). The neurotic disposition. In The individual psychology of Alfred Adler (pp. 239-262). New York, NY: Basic Books.
Amoafo, E., Hanbali, N., Patel, A., & Singh, P. (2015). What are the significant factors associated with burnout in doctors? Occupational Medicine, 65(2), 117-121. doi: 10.1093/occmed/kqu144
Assari, S., & Bazargan, M. (2019). Marital Status and Physical Health: Racial Differences. International Journal of Epidemiologic Research, 6(3), 108-113. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/31572801
Besser, A., Flett, G. L., Hewitt, P. L., & Guez, J. (2008). Perfectionism, and cognitions, affect, self-esteem, and physiological reactions in a performance situation. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 26(3), 206-228. doi: 10.1007/s10942-007-0067-0
Cloninger, C. R. (2006). The science of well being: An integrated approach to mental health and its disorders. World Psychiatry, 5(2), 71-76.
Cloninger, C. R., & Zohar, A. H. (2011). Personality and the perception of health and happiness. Journal of Affective Disorders, 128(1-2), 24-32. doi: 10.1016/j.jad.2010.06.012
Curran, T., & Hill, A. P. (2019). Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016. Psychological Bulletin, 145(4), 410-429. doi: 10.1037/bul0000138
Daily, J. A. (2019). Divorce Among Physicians and Medical Trainees. Journal of the American College of Cardiology, 73(4). doi: 10.1016/j.jacc.2018.12.016
Denman, M., Oyebode, F., & Greening, J. (2016). Reasons for choosing to specialise in psychiatry: differences between core psychiatry trainees and consultant psychiatrists. BJPsych Bulletin, 40(1), 19-23. doi: 10.1192/pb.bp.114.048678
Flett, G. L., Baricza, C., Gupta, A., Hewitt, P. L., & Endler, N. S. (2011). Perfectionism, psychosocial impact and coping with irritable bowel disease: A study of patients with Crohn’s disease and ulcerative colitis. Journal of Health Psychology, 16(4), 561-571. doi: 10.1177/1359105310383601
Fothergill, A., Edwards, D., & Burnard, P. (2004). Stress, burnout, coping and stress management in psychiatrists: Findings from a systematic review. International Journal of Social Psychiatry, 50(1), 54-65. doi: 10.1177/0020764004040953
Franco Paredes, K., Mancilla-Díaz, J. M., Álvarez Rayón, G., Vázquez Arévalo, R., & López Aguilar, X. (2010). Estructura factorial y consistencia interna de la Escala Multidimensional de Perfeccionismo. Revista Mexicana de Psicología, 27(2), 143-149. Retrieved from http://www.redalyc.org/articulo.oa?id=243016324003
Frost, R. O., Heimberg, R. G., Holt, C. S., Mattia, J. I., & Neubauer, A. L. (1993). A comparison of two measures of perfectionism. Personality and Individual Differences, 14(1), 119-126. doi: 10.1016/0191-8869(93)90181-2
Fry, P. S., & Debats, D. L. (2009). Perfectionism and the five-factor personality traits as predictors of mortality in older adults. Journal of Health Psychology, 14(4), 513-524. doi: 10.1177/1359105309103571
Hadjistavropoulos, H., Dash, H., Hadjistavropoulos, T., & Sullivan, T. L. (2007). Recurrent pain among university students: Contributions of self-efficacy and perfectionism to the pain experience. Personality and Individual Differences, 42(6), 1081-1091. doi: 10.1016/j.paid.2006.09.013
Heinze, G., Bernard-Fuentes, N., Carmona-Huerta, J., Chapa, G. C., & Guízar-Sánchez, D. P. (2019). Physicians specializing in psychiatry of Mexico: An update 2018. Salud Mental, 42(1), 13-23. doi: 10.17711/SM.0185-3325.2019.003
Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60(3), 456-470. doi: 10.1037/0022-3514.60.3.456
Jovanović, N., Podlesek, A., Volpe, U., Barrett, E., Ferrari, S., Rojnic Kuzman, M., … Beezhold, J. (2016). Burnout syndrome among psychiatric trainees in 22 countries: Risk increased by long working hours, lack of supervision, and psychiatry not being first career choice. European Psychiatry, 32, 34-41. doi: 10.1016/j.eurpsy.2015.10.007
Koreki, A., Nakagawa, A., Abe, A., Ikeuchi, H., Okubo, J., Oguri, A., … Mimura, M. (2015). Mental health of Japanese psychiatrists: the relationship among level of occupational stress, satisfaction and depressive symptoms. BMC Research Notes, 8(1), 1-9. doi: 10.1186/s13104-015-1054-7
Korkeila, J. A., Töyry, S., Kumpulainen, K., Toivola, J., Räsänen, K., & Kalimo, R. (2003). Burnout and self-perceived health among Finnish psychiatrists and child psychiatrists: a national survey. Scandinavian Journal of Public Health, 31(2), 85-91. doi: 10.1080/14034940210133880
Kuhn, C. M., & Flanagan, E. M. (2017). Self-care as a professional imperative: physician burnout, depression, and suicide. Canadian Journal of Anesthesia, 64(2), 158-168. doi: 10.1007/s12630-016-0781-0
Kumar, S. (2007). Burnout in psychiatrists. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 6(3), 186-189.
Kumar, S., Hatcher, S., & Huggard, P. (2005). Burnout in psychiatrists: An etiological model. International Journal of Psychiatry in Medicine, 35(4), 405-416. doi: 10.2190/8XWB-AJF4-KPRR-LWMF
Lindström, M. (2009). Marital status, social capital, material conditions and self-rated health: A population-based study. Health Policy, 93(2-3), 172-179. doi: 10.1016/j.healthpol.2009.05.010
McCann, C. M., Beddoe, E., McCormick, K., Huggard, P., Kedge, S., Adamson, C., & Huggard, J. (2013). Resilience in the Health Professions: A review of recent literature. International Journal of Wellbeing, 3(1), 60-81. doi: 10.5502/ijw.v3i1.4
McFarland, D. C., Hlubocky, F., & Riba, M. (2019). Update on Addressing Mental Health and Burnout in Physicians: What Is the Role for Psychiatry? Current Psychiatry Reports, 21(11), 108. doi: 10.1007/s11920-019-1100-6
Molnar, D. S., Sadava, S. W., Flett, G. L., & Colautti, J. (2012). Perfectionism and health: A mediational analysis of the roles of stress, social support and health-related behaviours. Psychology & Health, 27(7), 846-864. doi: 10.1080/08870446.2011.630466
Moriarty, D. G., Zack, M. M., & Kobau, R. (2003). The Centers for Disease Control and Prevention's Healthy Days Measures – Population tracking of perceived physical and mental health over time. Health Qual Life Outcomes, 1(1), 37. doi: 10.1186/1477-7525-1-37
Mundia, L. (2019). Satisfaction with work-related achievements in Brunei public and private sector employees. Cogent Business & Management, 6(1), 1664191. doi: 10.1080/23311975.2019.1664191
O’Connor, K., Neff, D. M., & Pitman, S. (2018). Burnout in mental health professionals: A systematic review and meta-analysis of prevalence and determinants. European Psychiatry, 53, 74-99. doi: 10.1016/j.eurpsy.2018.06.003
Pisinger, C., Toft, U., Aadahl, M., Glümer, C., & Jørgensen, T. (2009). The relationship between lifestyle and self-reported health in a general population. The Inter99 study. Preventive Medicine, 49(5), 418-423. doi: 10.1016/j.ypmed.2009.08.011
Pritchard, M. E., Wilson, G. S., & Yamnitz, B. (2007). What predicts adjustment among college students? A longitudinal panel study. Journal of American College Health, 56(1), 15-22. doi: 10.3200/JACH.56.1.15-22
Rathod, S., Roy, L., Ramsay, M., Das, M., Birtwistle, J., & Kingdon, D. (2000). A survey of stress in psychiatrists working in the Wessex Region. Psychiatric Bulletin, 24(4), 133-136. doi: 10.1192/pb.24.4.133
Rotenstein, L. S., Torre, M., Ramos, M. A., Rosales, R. C., Guille, C., Sen, S., & Mata, D. A. (2018). Prevalence of burnout among physicians: A systematic review. JAMA, 320(11), 1131-1150. doi: 10.1001/jama.2018.12777
Rotstein, S., Hudaib, A. R., Facey, A., & Kulkarni, J. (2019). Psychiatrist burnout: a meta-analysis of Maslach Burnout Inventory means. Australasian Psychiatry, 27(3), 249-254. doi: 10.1177/1039856219833800
Saboonchi, F., & Lundh, L. G. (2003). Perfectionism, anger, somatic health, and positive affect. Personality and Individual Differences, 35(7), 1585-1599. doi: 10.1016/S0191-8869(02)00382-3
Siegrist, J., & Li, J. (2016). Associations of extrinsic and intrinsic components of work stress with health: A systematic review of evidence on the effort-reward imbalance model. International Journal of Environmental Research and Public Health, 13(4), 432. doi: 10.3390/ijerph13040432
Tyssen, R. (2019). Work and mental health in doctors: A short review of Norwegian studies. Porto Biomedical Journal, 4(5), e50. doi: 10.1097/j.pbj.0000000000000050
Umene-Nakano, W., Kato, T. A., Kikuchi, S., Tateno, M., Fujisawa, D., Hoshuyama, T., & Nakamura, J. (2013). Nationwide Survey of Work Environment, Work-Life Balance and Burnout among Psychiatrists in Japan. PLoS ONE, 8(2), e55189. doi: 10.1371/journal.pone.0055189
Weerdesteijn, K. H. N., Schaafsma, F. G., Louwerse, I., Huysmans, M. A., Van der Beek, A. J., & Anema, J. R. (2019). Does self-perceived health correlate with physician-assessed functional limitations in medical work disability assessments? Journal of Psychosom Research, 125, 109792. doi: 10.1016/j.jpsychores.2019.109792
Yester, M. (2019). Work-Life Balance, Burnout, and Physician Wellness. Health Care Manager, 38(3), 239-246. doi: 10.1097/HCM.0000000000000277
