МЕДИЦИНСКОЙ СПЕЦИАЛЬНОСТИ
УДК: 614.253.52-616-009.614]-159.942.22
СИНДРОМ ЭМОЦИОНАЛЬНОГО ВЫГОРАНИЯ
У МЕДИЦИНСКИХ СЕСТЕР-АНЕСТЕЗИСТОВ
1
Ш.Х. Сайдалихужаева,
2
Х.Е.Рустамова
1
Кафедра общественного здоровья, управления здравоохранением и физической культуры. ТГСИ, Махтумкули 103, Ягинабадский
район, 100047 Ташкент, Y36eKucmaH,E-mailshoirasaydalikhujaeva(a)gmail.comORCID:
https://omd.Org/0000-0002-5982-7040
2
Кафедра общественного здоровья, управления здравоохранением и физической культуры. ТГСИ, Махтумкули 103, Ягинабадский
район, 100047 Ташкент, Узбекистан.Е-гпаП Hamidar&rambler.ruORCID:
. org/0000-0003-0000-0000
РЕЗЮМЕ
В настоящее время от медицинских сестер-а
нестезистов
ожидается
не
только
обладание
высокого
профессионализма,
но
и
проявлять
высокую
моральную
ответственность.
Высокая
психологическая нагрузка приводит само собой
к
эмоциональному
выгоранию.
Эмоциональная
выгорания
является
механизмом
психологиче
ской защиты в форме полного или частичного
исключения эмоций в ответ на психотравмирую
щие воздействия. Основными признаками эмо
ционального
выгорания
относятся
усталость,
переутомление,
приступы
агрессии,
ухудшение
общего
самочувствия,
снижение
социальной
активности, нарушение сна, скудность эмоций.
Естественно,
медицинские
сестры-анестезисты
в большей степени, чем сестринский персонал
других
отделений
подвержены
синдрому
эмо
ционального
выгорания.
Развитие
синдрома
выгорания
затрагивает
структуру
профессио
нальной
и
организационной
приверженности,
что
способствует
снижению
удовлетворенности
работой
и
эффективности
труда
медицинских
сестер-анестезистов.
При
развитии
«редукции
персональных
достижений»
снижается
аффек
тивная
профессиональная
приверженность;
при
развитии
«деперсонализации»
снижается
нор
мативная приверженность как показатель груп
повой
профессиональной
и
организационной
принадлежности
специалиста.
Высокая
аффек
тивная приверженность к организации ускоря
ет развитие «эмоционального истощения», при
эмоциональной привязанности к одному объек
ту (организации) отношение к другому (профес
сии) переходит в категорию долженствования.
Ключевые
слова:
Медицинская
сестра-ане
стезист,
синдром
эмоционального
выгорания,
стресс, рабочее поведение, достижение.
THE SYNDROME OF EMOTIONAL BURNOUT AMONG
ANESTHESIOLOGIST NURSES
1
Sh.Kh. Saydalikhujaeva,
2
Kh. E. Rustamova
1
Department of Public health, healthcare management and physical culture, TSDI, Yashnabad district, Makhtumkuli str., 103,
100047,Tashkent. E-mailshoirasaydalikhujaeva(a)
gmail.comORCID:https://orcid.org/0000-0002-5982-7040
department of Public health, healthcare management and physical culture, TSDI, Yashnabad district, Makhtumkuli str., 103, 100047,
Tashkent. E-mail Hamida r(a)ramblerru
ABSTRACT
Nowadays, anesthesiologist nurses are expected
not only to possess high professionalism, but also to
show high moral responsibility. High psychological
stress leads to emotional burnout. Emotional burnout
is a psychological defense mechanism in the form
of complete or partial exclusion of emotions in
response
to
psychotraumatic
effects.
The
main
signs of emotional burnout include fatigue, bouts
of aggression, deterioration of general well-being,
decreased social activity, sleep disorders, and lack of
emotions. Naturally, anesthesiologist nurses are more
susceptible to burnout syndrome than the nursing staff
of other departments. The development of burnout
affects the structure of professional and organizational
commitment, which contributes to a decrease in
job satisfaction and the effectiveness of the work
of anesthesiologist nurses. With the development
of "reduction of personal achievements'’, affective
professional
commitment
decreases;
with
the
development of "depersonalization”, the normative
commitment as an indicator of the group professional
and organizational affiliation of a specialist decreases.
High
affective
commitment
to
the
organization
accelerates
the
development
of
"emotional
exhaustion”, with emotional attachment to one object
(organization), the attitude to another (profession)
passes into the category of duty.
9
Key words:
Nurse-anesthetist, burnout syndrome,
stress, work behavior, achievement.
FOR CITATION:
Relevance of the study.
The problem of studying
the work of medical personnel is relevant in modem
conditions. The work activity of nurses is associated
with conditions in which there is a huge number of
negative impacts, such as interaction with drags,
high physical activity, psychoemotional stress, and
others [2, 10]. Constant interaction with risk factors
in the workplace leads to an increase in occupational
morbidity, premature mortality, and a decrease in
working capacity. In this regard, an important task
of medical psychology is the theoretical analysis
of the problem of professional stress, as well as
the development of methodological approaches to
the diagnosis, correction and prevention of mental
maladjustment
of
medical
workers
working
in
conditions of prolonged and intense professional
stress. In the literature, the professional burnout
syndrome is considered as an indicator of mental
maladaptation of a professional in the workplace [4,6].
The relevance of the professional burnout syndrome is
due to its wide prevalence and its impact on the well
being and efficiency of employees, the stability of the
business life of the organization, and the prevention
of
iatrogenic
complications
in
medicine.
Early
detection and prevention of burnout contributes to
the optimization of work behavior, better tolerance of
workloads and improved quality of qualified treatment
of patients in critical condition [1,3].
However, among the specialists of the medical
profile, a group of nurses working in extreme
conditions, which include anesthesiologist nurses,
stands out. The work of anesthesiologist nurses is
characterized by the presence of factors of professional
harm, violations of sleep and rest, increased moral
and legal responsibility, constant interaction with
people, their problems and sufferings and serious
diseases [1]. For anesthesiologist nurses, the problem
of
burnout
syndrome
is
particularly
significant,
since any disease that requires intensive therapy,
resuscitation or anesthesia is a stressful situation,
contains the possibility of provoking the development
of a situational crisis. The staff is characterized by
secondary psychological trauma, because they work
with psychologically traumatized patients and their
relatives [9, 11].
The field of Anesthesiologists and intensivistsrefers
to professional areas that are maximally saturated with
stress factors, the effect of which is potentiated by an
increase in the functional load of these specialists,
which is associated with an increase in surgical activity
and an increase in the number of operated patients with
severe concomitant pathology. This naturally leads
to a high level of mental stress of anesthesiologist
nurses and determines an increased risk of developing
professional personality maladaptation (one of the
manifestations of which is the emotional burnout
syndrome) and other negative conditions up to
violations of social adaptation, neuropsychic or somatic
health [3,5,6]. The main scientific contradiction on
the problem is that researchers distinguish different
personal characteristics of anesthesiologist nurses, but
no systematic studies have been conducted to assess
the manifestations of burnout syndrome and develop
recommendations for this professional group. In
addition, it is important to establish the relationship
between the complex of psychological characteristics
of anesthesiologist nurses and the duration of work
in this field, since there are reasons to assume the
transformation of personality characteristics as the
duration of work increases in the stressful conditions
of professional activity [8, 10].
Purpose of the study.To
identify the psychological
features of the development of burnout syndrome in
anesthesiologist nurses and to justify recommendations
for prevention and psychological correction.
Objectives of the study.
-
identify the presence and severity of occupational
burnout syndrome in anesthesiologist nurses;
-
to determine the indicators of professional and
organizational commitment in anesthesiologist nurses
and their relationship with the parameters of burnout
syndrome;
-
develop practical recommendations for the early
diagnosis, prevention and psychological correction of
burnout syndrome in anesthesiologist nurses.
Materials and methods.Specialists with secondary
medical education, working in the specialty "nurse
anesthetist'’ in multidisciplinary medical institutions.
We used a questionnaire, a conversation, a set of
psychodiagnostic tests as part of the methods of
Maslach S. (Vodopyanova N. E., Starchenkova E.
S., 2005), the level of subjective control J. V. Rotter
(Eliseev О. P., 2001), mathematical and statistical
processing of empirical data.
The total volume of the study included 32 people
aged 19 to 65 years, of which 7% were men and
93% were women. All respondents have a secondary
medical education and work in the position of
"anesthesiologist nurses”. The respondents ‘ work
experience in the specialty is from 1 to 45 years.
Results.
A comprehensive study was carried out,
which included the study of the level of severity of
the burnout syndrome, working behavior strategies,
personal characteristics of anesthesiologist nurses, the
semantic sphere and professional needs of nurses, as
well as indicators of professional and organizational
commitment.
The
collection
of
initial
sociological
and
psychological data, their study and analysis were
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МЕДИЦИНСКОЙ СПЕЦИАЛЬНОСТИ
carried out in 2017-2020 on the basis of the Department
of
"Anesthesiology’’
of
Vakhidov
Republican
specialized center of surgery.
In the course of the study, the features of the
structure and development of the burnout syndrome
characteristic of the group of anesthesiologist nurses
were reveal. The development of the burnout syndrome
begins and manifests itself more often with the
subfactor depersonalization. This is the interpersonal
aspect of burnout syndrome, which develops in
nurses as a psychologically protective mechanism for
psychotraumatic work situations. For anesthesiologist
nurses, indicators of depersonalization of a high
level of severity are characteristic according to the
analysis of average values. In 52% of the subjects, the
development of depersonalization corresponds to a
high level. Respondents were more evenly distributed
according to the reduction of personal achievements
(the self-assessment aspect of burnout) - at a low,
medium and high level of severity for about a third of
nurses. Emotional exhaustion in the representatives of
this professional group, according to the analysis of
average values, corresponds to the border of low and
medium levels of severity, but 10% of the examined
patients have a high level of emotional exhaustion.
During the factor analysis, 6 most significant factors
of psychological stability were identified: emotional
stenicity,
stability;
the
factor
of
interpersonal
communication, goodwill towards people and positive
self-esteem; age-status characteristics ofthe individual,
achievement of a certain status and professional
success; balance (balance) of nervous processes,
energy cost in achieving professional success; self
confidence, assertive behavior; understanding of the
relationship of events and a positive attitude to life.
The dynamics of burnout syndrome depending on
the length of professional activity is revealed to a
greater extent than on the age of the respondents, which
indicates that the development of burnout syndrome
in anesthesiologist nurses were conditioned by the
specifics of the work and has its own characteristic
differences in this professional group.
The group of specialists with 5-10 years of
experience are the most vulnerable to the development
of burnout syndrome: in this interval, the highest
rates of depersonalization, an increase in the value of
emotional exhaustion, and a decrease in the reduction
of personal achievements were note.
If we consider the burnout syndrome as a dynamic
process that takes place over time, then we can
describe the dynamics of changes that occur with
the nurse in this way. A nurse-anesthetist who has
entered the profession initially has a high desire to
help people, combined with a strong sense of duty and
interest in the content of professional activities. With
the growth of professional burnout, the meaning of the
profession as "helping people” is lost, but the interest
in its content increases, the need for self-actualization
remains, and material interest as the meaning of work
is manifested. In the future, there is a decrease in the
components of the meaning of the profession as a
"duty” and interest in professional activity.
The development of burnout affects the structure
of
professional
and
organizational
commitment,
which can contribute to a decrease in job satisfaction
and work efficiency. Thus, with the development of
the reduction of personal achievements, affective
professional
commitment
decreases;
with
the
development
of
depersonalization,
normative
commitment decreases as an indicator of the group
professional
and
organizational
competence
of
a specialist. High affective commitment to the
organization accelerates the development of emotional
exhaustion (with emotional attachment to one object
(organization), the attitude to another (profession)
passes into the category of duty.
The conducted studies of anesthesiologist nurses
confirm the presence of the risk of emotional burnout
syndrome in nurses of this specialty and the need
for prevention and psychological correction of the
emotional state. Methods of diagnosis, prevention
and psychological correction of burnout syndrome are
proposed, which include the study of the severity of
emotional burnout, psychological counseling, lectures
on professional stress and training.
Conclusion s.
According to the results of the survey,
30% of anesthesiologist nursess have psychological
determinants ofthe development of burnout syndrome.
The level of development of burnout syndrome is
average in 15% and high in 10% of the examined
nurses. The leading role in its development is played
by the symptom of "depersonalization”.
With the help of factor analysis, 6 most significant
factors of psychological stability were identified:
emotional stenicity, stability; the factor of interpersonal
communication, goodwill towards people and positive
self-esteem; age-status characteristics ofthe individual,
achievement of a certain status and professional
success; balance (balance) of nervous processes,
energy cost in achieving professional success; self
confidence, assertive behavior; understanding of the
relationship of events and a positive attitude to life.
The dynamics of burnout syndrome depending
on the length of professional experience is revealed
to a greater extent than on age, which indicates that
the development of burnout syndrome is conditioned
by the specifics of the work and has its own
characteristic differences in anesthesiologist nurses.
The group of nurses with 5-10 years of experience is
the most vulnerable to the development of burnout:
in this interval, the highest indicators on the scale
of "depersonalization”, an increase in the value of
"emotional exhaustion” and "reduction of personal
achievements” are noted.
11
Nurses initially have a high desire to "help people’’
combined with a strong sense of duty and interest
in the content of professional activities. With the
growth of the parameters of professional burnout, the
meaning of the profession as "helping people” is lost,
but the interest in its content increases, the need for
self-actualization remains, and material interest as the
meaning of work is manifested. In the future, there is
a decrease in the components of the meaning of the
profession as a "duty” and interest in professional
activity.
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