Burnout in Physicians _ _______________________________________________________________________
DISTINCTION BETWEEN BURNOUT AND CLINICAL ENTITIES WITH SIMILAR PRESENTATION Other Clinical Entity Burnout Stress Precipitated by isolated or situational instances Result of prolonged stress Prolonged fatigue Associated with health-related factors Associated with job-related factors Depression Related to factors within every domain Related to specific factors in the work setting Source: [6; 15; 16; 17; 18] Table 2
SYMPTOMS ASSOCIATED WITH STRESS AND BURNOUT
Dimension
Manifestation
Physical
Exhaustion, lack of energy Musculoskeletal symptoms Respiratory illness Gastrointestinal disorders Cardiovascular conditions
Headache Insomnia Changes in appetite
Psychological
Anger Depression Anxiety Frustration Guilt Cynicism Tension, irritability Mood swings, outbursts of temper Sadness Withdrawn, numb feeling Emotional detachment Decreased coping abilities
Inability to concentrate Lack of drive or initiative Loss of idealism Dissatisfaction with personal accomplishments Addictive behavior
Interpersonal/social
Inability to communicate with family, friends, and colleagues Cynicism, suspiciousness toward co-workers and others in work environment Neglect of family and social obligations Marital dysfunction Questioning of spiritual beliefs
Source: [1; 2; 8; 19; 20]
Table 3
SIGNS AND SYMPTOMS OF STRESS AND BURNOUT
history should be obtained in an effort to identify potential stress factors and possible social consequences [8]. An evalua- tion of the type, course, and frequency of symptoms can help distinguish them as signs of burnout, and a drug history can help to identify potential substance abuse problems. The signs and symptoms of burnout discussed here are similar across work settings. Burnout among physicians is associated with these characteristics as well as some unique features, which will be described later.
The signs and symptoms of stress and burnout are multi- dimensional, with physical, psychological/psychiatric, and interpersonal/social manifestations ( Table 3 ) [1; 2; 8; 19; 20]. As such, a multidisciplinary approach should be taken not only to confirm the presence of burnout but also to rule out other illnesses or conditions. In addition to the traditional medical history and physical examination, a social and occupational
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MDPA2126
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