Türkiye’de Anesteziyoloji Ve Reanimasyon Hekimlerinin Mesleki Stres İlişkili Sorunlarının Belirlenerek Zihinsel Ve Fiziksel Sağlıklarının İyileştirilmesine Yönelik Önerilerin Geliştirilmesi: Çok Merkezli Anket Çalışması

Year 2024, Volume: 3 Issue: 3, 103 - 109, 28.12.2024

Miraç Selcen Özkal Yalin , Elif Oral Ahıskalıoğlu

https://doi.org/10.61745/jsmsau.1590179

Abstract

maç: Anesteziyoloji ve reanimasyon, hekimlerin sürekli olarak stres uyaranlarına maruz kaldığı yüksek performans gerektiren bir uzmanlık alanıdır. Bu çalışmada, ilk olarak Türkiye’de anesteziyoloji ve reanimasyon alanında görev yapan hekimlerin fiziksel ve zihinsel sağlık düzeylerini farklı açılardan değerlendirmek ve ikincil olarak ise buna etki eden meslek ilişkili stres faktörlerini ortaya koymaktır.
Yöntemler: Çalışmamız 63 soruluk bir anketin internet üzerinden Türkiye’nin çeşitli kurumlarında anestezi alanında görev yapan 115 hekime ulaştırılması yoluyla yürütülmüştür. Bu anket, farklı kategorilerde katılımcıların soru öbeği ile fikir uyumunu değerlendiren 4 aşamalı Likert ölçeği ile oluşturulmuş çoktan seçmeli ve açık uçlu soruları da içermektedir. Bu kategoriler altında cevaplanan sorulara ait kümülatif Likert skorları istatistiksel olarak değerlendirmeye alınmış ve ileri analizler yapılmıştır.
Bulgular: Hekimlerin %57,4'ü yorgunluk nedeniyle meydana gelen ramak-kala vakaları bildirmiştir. Tükenmişlik seviyeleri en yüksek asistan hekimlerde, ardından uzmanlarda görülürken, öğretim üyelerinde en düşük düzeyde olduğu tespit edilmiştir. Çocuk sahibi olan hekimler daha düşük tükenmişlik bildirmiş, kadın anesteziyologlar ise daha fazla Imposter Sendromu semptomları yaşamıştır. Hekim sağlığını destekleyen fiziksel koşullar, eğitim ve araştırma hastanelerinde en kötü, üniversite hastanelerinde ise en iyi seviyede bulunmuş ve iki grup arasında anlamlı bir fark gözlenmiştir (P=.004).
Sonuç: Mesleki stresin anesteziyologlar üzerindeki olumsuz etkilerinin erken tanınması ve tedavi edilmesi, hasta güvenliğinin artırılması ve iş performansının iyileştirilmesi açısından büyük önem taşımaktadır. Bu alanda daha fazla araştırma ve hastane yönetimlerinde tükenmişlik farkındalığını artırmayı hedefleyen somut gelişmelere ihtiyaç bulunmaktadır.

Keywords

Anesteziyoloji ve Reanimasyon, Asistanlık, Tükenmişlik Sendromu, Yorgunluk, Imposter Sendromu, Zihin Sağlığı, Hasta Güvenliği

Healing the Healers: Adressing Occupational Stress and Promoting Well-Being Among Anaesthesiology and Reanimation Physicians in Türkiye

Abstract

Objective: Anesthesiology and reanimation is a high-performance specialty where physicians are constantly exposed to stressors. This study primarily aims to evaluate the physical and mental health status of physicians working in anesthesiology and reanimation in Turkey, and to further identify the major occupational stress factors that could be eliminated by fatigue-management strategies.
Methods: Our study was conducted through an online 63-item questionnaire. 115 anaesthesiologists working at various institutions in Türkiye were included. The questionnaire consists of multiple-choice and open-ended questions, designed with a 4-point Likert scale. The cumulative Likert scores for the responses were statistically evaluated, and further analyses were performed through comparisons among different groups of physicians with various descriptive characteristics.
Results: 57.4% of physicians reported near-miss incidents caused by fatigue. Burnout levels were highest among trainees, followed by specialists, with faculty members experiencing the least burnout; physicians with children reported lower burnout, while female anaesthesiologists experienced more Imposter Syndrome symptoms. Hospital conditions for physician health were poorest in training and research hospitals and best in university hospitals, with a significant difference between the two (P=.004).
Conclusion: Early recognition and treatment of the negative effects of occupational stress on anesthesiologists are crucial for improving patient safety and work performance. There is a need for more research in this field in Türkiye for raising awareness of burnout and fatigue amongst anaesthesiologists and hospital managements.

Keywords

Anaesthesiology and Reanimation, Residency, Burnout, Fatigue, Imposter Syndrome, Mental health, Patient safety

References

• Dhabhar FS. The short-term stress response: Mother nature's mechanism for enhancing protection and performance under conditions of threat, challenge, and opportunity. Front Neuroendocrinol. 2018;49:175-192. doi:10.1016/j.yfrne.2018.03.004
• Selye H. The general adaptation syndrome and the diseases of adaptation. J Clin Endocrinol Metab. 1946;6(2):117-230. doi:10.1210/jcem-6-2-117
• Büget Mİ, Aksoy Ö, Ali̇ A, et al. Tek merkezli anket çalışması: anestezi asistanları arasında mesleki değerlendirme. Journal of Istanbul Faculty of Medicine / İstanbul Tıp Fakültesi Dergisi. 2015;78(3):62.
• Abut YC, Kitapcioglu D, Erkalp K, et al. Job burnout in 159 anesthesiology trainees. Saudi J Anaesth. 2012;6(1):46-51.
• Official Gazette of Turkey on September 3, with issue number 31942
• Jackson SH. The role of stress in anaesthetists' health and well-being. Acta Anaesthesiol Scand. 1999;43(6):583-602. doi:10.1034/j.1399-6576.1999.430601.x
• van der Wal RAB, Bijleveld E, Herwaarden AEV, Bucx MJL, Prins JB, Scheffer G. Chronic stress indicated by hair cortisol concentration in anaesthesiologists and its relationship to work experience and emotional intelligence: A cross-sectional biomarker and survey study. Eur J Anaesthesiol. 2022;39(1):26-32.
• Libretti S, Puckett Y. Physiology, Homeostasis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 1, 2023.
• Kroll H, Monroe KS, Van Harn MG, Davies NA, Jesse MT. Burnout in Certified Anesthesiologist Assistants. J Allied Health. 2020;49(2):e73-e78.
• Torquati L, Mielke GI, Brown WJ, Kolbe-Alexander T. Shift work and the risk of cardiovascular disease. A systematic review and meta-analysis including dose-response relationship. Scand J Work Environ Health. 2018;44(3):229-238.
• Patterson PD, Mountz KA, Agostinelli MG, et al. Ambulatory blood pressure monitoring among emergency medical services night shift workers. Occup Environ Med. 2021;78(1):29-35. doi:10.1136/oemed-2020-106459
• Vetter C, Dashti HS, Lane JM, et al. Night Shift Work, Genetic Risk, and Type 2 Diabetes in the UK Biobank. Diabetes Care. 2018;41(4):762-769.
• Clance, P. R., & Imes, S. A. (1978). The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy: Theory, Research & Practice, 15(3), 241–247.
• Gisselbaek M, Hontoir S, Pesonen AE, et al. Impostor syndrome in anaesthesiology primarily affects female and junior physicians. Br J Anaesth. 2024;132(2):407-409. doi:10.1016/j.bja.2023.09.025
• McCrossan R, Stacey K, Redfern N. Time to extinguish burnout. Anaesthesia. 2019;74(10):1215-1218. doi:10.1111/anae.14808
• Tubbs AS, Fernandez FX, Perlis ML, et al. Suicidal ideation is associated with nighttime wakefulness in a community sample. Sleep. 2021;44(1):zsaa128.
• Farhud D, Aryan Z. Circadian Rhythm, Lifestyle and Health: A Narrative Review. Iran J Public Health. 2018;47(8):1068-1076.
• Gurubhagavatula I, Barger LK, Barnes CM, et al. Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society. J Clin Sleep Med. 2021;17(11):2283-2306.
• Lewis JM, Barnhart FD, Nace EP, Carson DI, Howard BL. Marital satisfaction in the lives of physicians. Bull Menninger Clin. 1993;57(4):458-46521. Sotile WM, Sotile MO. The medical marriage. New York: Birch Lane, 1996.
• Morais A, Maia P, Azevedo A, Amaral C, Tavares J. Stress and burnout among Portuguese anaesthesiologists. Eur J Anaesthesiol. 2006 May;23(5):433-9.
• Camilleri Podesta AM, Redfern N, Abramovich I, et al. Fatigue among anaesthesiologists in Europe: Findings from a joint EBA/NASC survey. Eur J Anaesthesiol. 2024;41(1):24-33.
• Reed GM, First MB, Kogan CS, et al. Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders. World Psychiatry. 2019;18(1):3-19.
• Gonzalez-Pizarro P, Brazzi L, Koch S, et al. European Society of Anaesthesiology and Intensive Care consensus document on sustainability: 4 scopes to achieve a more sustainable practice. Eur J Anaesthesiol. 2024;41(4):260-277.
• Rosta J, Rø KI. Changes in weekly working hours, proportion of doctors with hours above the limitations of European Working Time Directive (EWTD) and time spent on direct patient care for doctors in Norway from 2016 to 2019: a study based on repeated surveys. BMJ Open. 2023;13(6):e069331.