Quantitative and Qualitative Research Critique Assignment

Vitorino MF, Rodrigues MSD, Evangelista CB et al. Burnout syndrome: knowledge of neonatal…

English/Portuguese

J Nurs UFPE online., Recife, 12(9):2308-14, Sept., 2018 2308

ISSN: 1981-8963 ISSN: 1981-8963 https://doi.org/10.5205/1981-8963-v12i9a234632p2308-2314-2018

BURNOUT SYNDROME: KNOWLEDGE OF NEONATAL NURSING TEAM SÍNDROME DE BURNOUT: CONHECIMENTO DA EQUIPE DE ENFERMAGEM NEONATAL

SÍNDROME DE BURNOUT: CONOCIMIENTO DEL EQUIPO DE ENFERMERÍA NEONATAL Manuela Fausto Vitorino1, Mariana de Sousa Dantas Rodrigues2, Carla Braz Evangelista3, Keyth Sulamitta de Lima Guimarães4, Jaqueline Brito Vidal Batista5, Ana Gláucia Santos da Fonsêca6, Ana Lúcia Belarmino de

Araújo7, Fabrícia Maria de Araújo Bustorff Melo8

ABSTRACT

Objective: to evaluate the knowledge of the neonatal nursing team about Burnout Syndrome. Method: qualitative and exploratory study carried out with 23 nursing professionals, who work in the neonatology units of a public maternity unit, located in the city of João Pessoa. For the collection of the empirical material, a questionnaire and a semi-structured interview script were applied, with Content Analysis and construction of thematic axes. Results: the empirical material indicated the profile of the nursing team that cares for neonates and the following thematic axes were observed: health professionals and burnout; work overload

and risk of burnout; physical exhaustion and stress; Burnout and the health consequences of workers. Conclusion: it is concluded that this work will serve as a support to help in the indispensability of dissemination of knowledge about Burnout Syndrome, with emphasis on nursing, since most health professionals do not know this pathology. Descriptors: Worker Health; Occupational stress; Professional Exhaustion; Nursing team; Neonatal Nursing; Knowledge. Descritores: Occupational Health; Occupational Stress; Burnout, Professional; Nursing Team; Neonatal Nursing; Knowledge.

RESUMO

Objetivo: avaliar o conhecimento da equipe de enfermagem neonatal acerca da Síndrome de Burnout. Método: estudo qualitativo e exploratório realizado com 23 profissionais de enfermagem, que atuam nas unidades de neonatologia de uma maternidade pública, localizada no município de João Pessoa. Para a coleta do material empírico foram aplicados um questionário e um roteiro de entrevista semiestruturada, com Análise de Conteúdo e construção de eixos temáticos. Resultados: o material empírico indicou o perfil da equipe de enfermagem que cuida de neonatos e os seguintes eixos temáticos foram observados: profissionais

de saúde e o acometimento por Burnout; sobrecarga de trabalho e o risco de Burnout; esgotamento físico e estresse; Burnout e as consequências para a saúde dos trabalhadores. Conclusão: conclui-se que este trabalho servirá de suporte para auxiliar na indispensabilidade de disseminação do conhecimento sobre a Síndrome de Burnout, com destaque para a enfermagem, já que grande parte dos profissionais de saúde não conhece essa patologia. Descritores: Saúde do Trabalhador; Estresse Ocupacional; Esgotamento Profissional; Equipe de Enfermagem; Enfermagem Neonatal; Conhecimento.

RESUMEN

Objetivo: evaluar el conocimiento del equipo de enfermería neonatal acerca del Síndrome de Burnout. Método: estudio cualitativo y exploratorio, realizado con 23 profesionales de enfermería que actúan en las unidades de neonatología de una maternidad pública, ubicada en el municipio de João Pessoa. Para la recolección del material empírico, se aplicaron un cuestionario y un guión de entrevista semiestructurada, con análisis mediante técnica de Análisis de Contenido, y construcción de ejes temáticos. Resultados: a partir del material empírico se apuntó el perfil del equipo de enfermería que cuida de neonatos y se formalizaron

los siguientes ejes temáticos fueron observados: profesionales de salud y el afecto por Burnout; sobrecarga de trabajo y el riesgo para Burnout; el agotamiento físico y el estrés; y Burnout y las consecuencias para la salud de los trabajadores. Conclusión: se concluye que este trabajo servirá de soporte para auxiliar en la indispensabilidad de diseminación del conocimiento sobre el Síndrome de Burnout, con destaque para la enfermería, ya que gran parte de los profesionales de salud no conoce esa patología. Descritores: Salud Laboral; Estrés Laboral; Agotamiento Profesional; Grupo de Enfermería; Enfermería Neonatal; Conocimiento. 1,6Nurses, University Center of João Pessoa / UNIPÊ. João Pessoa (PB), Brazil. E-mail: manuelav[email protected] ORCID iD: https://orcid.org/0000-0001-8187-8197; E-mail: [email protected] ORCID iD: https://orcid.org/0000-0003-0534-6871; 2,3,4Masters (PhD students), Doctorate, Postgraduate Program in Nursing, Federal University of Paraíba / PB. João Pessoa (PB), Brazil. E- mail: [email protected] ORCID iD: https://orcid.org/0000-0001-7296-0455; E-mail: [email protected] ORCID iD: https://orcid.org/0000-0001-7063-1439; E-mail: [email protected] ORCID iD: https://orcid.org/0000-0002-1315-6624; 5PhD, Federal University of Paraíba / UFPB. João Pessoa (PB), Brazil. E-mail: [email protected] ORCID iD: https://orcid.org/0000- 0002-8107-9763; 7Specialist, University of Vale do Acaraú / CE. João Pessoa (PB), Brazil. E-mail: [email protected] ORCID iD: https://orcid.org/0000-0003-3390-2118; 8Master’s student, Federal University of Paraíba/UFPB. João Pessoa (PB), Brazil. E-mail:

[email protected] ORCID iD: https://orcid.org/0000-0002-4846-1442

 

The information and data collected must be current and Evidence-based to support the topic

ORIGINAL ARTICLE

 

The information and data collected must be current and Evidence-based to support the topic

Vitorino MF, Rodrigues MSD, Evangelista CB et al. Burnout syndrome: knowledge of neonatal…

English/Portuguese

J Nurs UFPE online., Recife, 12(9):2308-14, Sept., 2018 2309

ISSN: 1981-8963 ISSN: 1981-8963 https://doi.org/10.5205/1981-8963-v12i9a234632p2308-2314-2018

 

Over the years, a process of physical and

mental changes is observed in the lives of the

population. The system of financial

globalization, technological innovations and

new management models demonstrated

involvement with the goals of work in the

community, highlighting the professional

subjectivity and the greater dissemination of

the subject of mental health of the worker in

the scientific community.1

It should be noted that the consequences

of the technological changes affect several

professionals and cause high levels of tension

and stress in the work environment. These

factors can lead to an increase in the

diagnosis of work-related mental illnesses,

such as Burnout Syndrome.2

It is stated that Burnout Syndrome is a

professional disease, due to physical and / or

mental overload and excessive stress in the

work environment. The main manifestations

of this syndrome are emotional exhaustion,

distancing and low personal fulfillment.3 It

reaches several professional categories with a

higher incidence in workers who have direct

contact with people, such as health

professionals, social workers, teachers and

police officers.3-5

The main causes of Burnout Syndrome in

health professionals are anguish, difficulty

coping with problems, work overload, lack of

incentive to good productivity, warnings about

poor performance in employment and death.5

In addition, the fact that health professionals

deal with the suffering of the other and

experience situations of extreme pressure and

stress, depending on the work that they do.6

From this perspective, the relationships

between working conditions and the quality of

life of pediatric professionals are impaired.

They are evidenced by workplace insecurity,

increased levels of stress, work-related

overload, low pay and change in the level of

sleep.7

However, the perception of health

professionals about Burnout Syndrome is still a

little discussed in the area of nursing,

especially among teams that work in

neonatology. In view of the above, this study

has as a guiding question: what is the

knowledge of the neonatal nursing team about

Burnout Syndrome?

It is reported that Burnout is a little

discussed topic in the nursing area and,

regarding the care of newborns, there is a

shortage of studies published in this regard.

Thus, it is important to carry out a survey,

which evaluates the knowledge of neonatal

nursing professionals about the higher

incidence of this syndrome, which also

addresses their relationship with the practice

of care.

It is considered that, because it is not very

noticeable to some health professionals, it is

indispensable to have a greater dissemination

on the involvement of the phenomenon of

Burnout Syndrome. When professionals are

aware of the manifestations and causes of this

pathology, they seek the appropriate forms of

prevention or intervention.

 

● To evaluate the knowledge of the

neonatal nursing team about Burnout

Syndrome.

 

This is a qualitative and exploratory study

carried out with the nursing team, which

provides care to the neonates in the sectors of

the Neonatal Intensive Care Unit (NICU), the

Neonatal Intermediate Care Unit (NIMCU) and

the Kangaroo Nursing. The place chosen for

the research was a reference maternity

hospital, located in the municipality of João

Pessoa, in the state of Paraíba, Brazil.

It is emphasized that the universe of the

study included 52 nursing workers, who care

for neonates. The sample was obtained for

convenience and totaled 23 professionals of

the neonatal nursing team, being 15 nurses

and eight nursing technicians.

In the research, inclusion criteria were

considered workers with work time greater

than six months and work activity, at the time

the research was taking place. Thus, workers

with a professional activity of less than six

months, on leave, on medical leave and who

were not in work at the time of the study

were excluded.

Data collection took place in April 2017. A

questionnaire and a semi-structured interview

itinerary were used to obtain information

about the participant and his / her work in

order to achieve the proposed research

objectives.

It should be emphasized that the empirical

material obtained from the semi-structured

interview had the answers transcribed by the

researcher. After this step, the data was

archived in Word format documents. In order

to analyze the participants’ discourses, the

content analysis technique proposed by Bardin

was used through the steps of pre-analysis,

coding, inference and interpretation of data.8

The evaluation of the empirical material

INTRODUCTION

The information and data collected must be current and Evidence-based to support the topic

OBJECTIVE

The information and data collected must be current and Evidence-based to support the topic

METHOD

The information and data collected must be current and Evidence-based to support the topic

Vitorino MF, Rodrigues MSD, Evangelista CB et al. Burnout syndrome: knowledge of neonatal…

English/Portuguese

J Nurs UFPE online., Recife, 12(9):2308-14, Sept., 2018 2310

ISSN: 1981-8963 ISSN: 1981-8963 https://doi.org/10.5205/1981-8963-v12i9a234632p2308-2314-2018

 

allowed the construction of central thematic

axes and their respective subtopics.

It is noteworthy that this research obeyed

the requirements of Resolution 466 of 2012, of

the National Health Council (NHC) 9, which

deals with research involving human beings.

Therefore, we sought to ensure the well-being

of all the interviewees involved in the

research and respect their autonomy. It was

also made a free and clear statement to all

who participated in the study. This research

was approved by the Research and Ethics

Committee (REC) of the University Center of

João Pessoa – UNIPÊ and was registered under

the number CAAE 65770917.7.0000.5176.

 

Twenty-three workers of the neonatal

nursing team of a hospital located in the

municipality of João Pessoa, state of Paraíba

were interviewed. Regarding the data

characterizing the research, it was observed

that the majority of respondents were female,

with 95.6% (n = 22). 56.5% of the participants

were married (n = 13), followed by singles,

with 34.8% (n = 8) and divorced, with 8.7% (n

= 2). As for ethnic groups, 60.9% were brown

(n = 14), followed by whites, with 39.1% (n =

9). Among the participants’ demographic

profile, 56.5% (n = 13) were aged between 21

and 40 years, 56.5% (n = 13) with children and

65.2% with a family income of one to two

minimum wages (n = 15).

Concerning the permanence in the

institution, it was observed the predominance

of employees with seven to nine years of

work, with a percentage of 34.8% (n = 8),

followed by 30.4% (n = 7) of professionals with

hiring time greater than nine years. According

to the work hours per week, the majority of

the professionals worked for 40 hours, with

47.8% of cases (n = 11), followed by 43.4% (n =

10) with 30 hours.

It is noteworthy that 65.2% (n = 15) of the

interviewees never heard of or did not know

about Burnout Syndrome, which made it

impossible to use these testimonies

throughout the research. On the other hand,

it was possible to explore the speeches of

34.8% (n = 8) participants, based on the

identification of central thematic axes and

subtopics, developed through the Bardin

content analysis and expressed in Figure 1.

 

Central Thematic Axes Associated Thematic Axes (subtopics)

Risk of Burnout Health professionals and sickness due to Burnout Work overload and risk of Burnout

Characteristics of Burnout

Physical exhaustion Stress

Burnout and the consequences for the health of workers

Hindered social interaction

Depression

Figure 1. Distribution of the central thematic axes and

associated thematic axes. Paraíba (PB), Brazil, 2018.

 

 Health professionals and sickness due

to Burnout

It is reported that the reports of the

neonatal nursing team showed, for the most

part, that health professionals constitute the

group most vulnerable to the development of

Burnout, especially nursing professionals. This

perception about occupational vulnerability

can be observed in the following reports.

Health professionals, nurses, nursing

technicians, etc. (P9)

Nursing workers, professionals in general

working in the hospital area. (P22)

It should be noted that professionals

working under pressure, such as those working

in an intensive care unit and the night shift,

may also be prone to acquiring the complaint,

as follows.

(…)professionals who work in intensive care

units, etc.. (P5)

It is a physical or mental exhaustion closely

related to the professional aspect,

especially professionals working at night

and health professionals. (P2)

The high degree of exposure of teachers in

the area of health and nursing to this

occupational disorder were highlighted. Such

reference was cited by only two interviewees,

as explicitly stated in the discourse.

Teachers, in the area of health, nursing,

etc. (P5)

Health professionals, teachers. (P13)

It is inferred that the statements of the

interviewees highlight only health

professionals as being affected by Burnout

Syndrome.

 Work overload and risk of Burnout

It is presented that the deponents of this

investigation mention that the Burnout

Syndrome occurs due to the working

RESULTS

 

Vitorino MF, Rodrigues MSD, Evangelista CB et al. Burnout syndrome: knowledge of neonatal…

English/Portuguese

J Nurs UFPE online., Recife, 12(9):2308-14, Sept., 2018 2311

ISSN: 1981-8963 ISSN: 1981-8963 https://doi.org/10.5205/1981-8963-v12i9a234632p2308-2314-2018

 

conditions and the activity exerted under

pressure.

It consists of a syndrome that affects health

professionals due to overwork and the stress

of the hospital environment. (P14)

It is pointed out that, although stress has

been referenced as a consequence of Burnout

Syndrome, some testimonials understand it as

a cause of the illness, which is closely

associated with the high workload.

The syndrome is caused by everyday stress,

due to the professional deficit, many

accumulated tasks. (P22)

It is a syndrome related to the performance

of the health professional, regarding stress,

workload (…). (P19)

It is something related to work overload,

those more exposed to stressors. (P20)

In this context, it can be seen that working

conditions can be considered as risk factors

for the development of burnout. Generally,

these circumstances lead to overload in the

work environment, with high workload,

professional deficit and task accumulation.

Characteristics of Burnout: physical and

mental exhaustion

It is shown in the reports of the

professionals inserted in this study, physical

and mental exhaustion was mentioned with

emphasis, according to the following records.

It is a physical or mental exhaustion, closely

related to the professional aspect. (P2)It is

a psychic disorder of depressive character,

proceeding from mental and physical

exhaustion, stress. (P5)

In view of the above, it is verified that

burnout is a psychic disorder, related to the

work performed, caused by stressors, which

can have physical and mental implications.

Burnout and the health consequences of

workers

In addition to physical and mental

damages, it is pointed out that the onset of

Burnout is capable of producing serious

manifestations in the health of the worker and

affect their quality of life, as seen in the

speeches below.

Interferes in the social life of the worker,

disinterest in work, irritability. (P14)

The professional begins to get sick,

jeopardize their income at work. (P9)

Malaise with colleagues, meaningless

discussions (…) discussions at work, loss of

ethical structure (…). (P22)

In the face of the reports, it is evident that

the professional affected by Burnout becomes

ill, becomes disinterested in the work to be

performed, irritated with himself and with his

colleagues, with a consequent compromise of

income.

 

It is noteworthy that, with regard to the

most vulnerable workers to develop the

phenomenon, it was identified through the

reports of the interviewees that among the

group that operates in the hospital area,

nurses and nursing technicians present a high

prevalence of the syndrome. These data

corroborate studies with nursing professionals,

developed by national researchers.4,10.

It is asserted that health professionals

establish a constant bond with the patient and

their families during the period of hospital

stay. With this, they fit into a more vulnerable

category, constantly exposed to periods of

tension and stress, predisposed to the

appearance of Burnout Syndrome.11

It is noteworthy that due to the work

execution and excessive work, nurses are

more predisposed to present two of the three

phases of Burnout. They are emotional

exhaustion and depersonalization, due to their

work overload.12

It is agreed that emotional exhaustion

involves the physical exhaustion of the

worker, to perform activities in the work

environment. Depersonalization of the

professional may involve irritability and

cynicism with colleagues. Both cases were

reported in the present study. The lack of

interest in work, in turn, is characterized by

low professional achievement.

It is demonstrated in an international study

evaluated the presence of Burnout Syndrome

in nurses, who work in the neonatal intensive

care unit. And, that the majority presented

moderate and high levels of exhaustion and

low professional achievement.13

It is shown that because it is more

prevalent in employees who have more

contact with the individual, it is essential to

point out that Burnout Syndrome affects

several workers, such as health professionals,

teachers and social workers.4-5 It is important

to point out that teachers are listed as

possible professionals presenting Burnout due

to professional demands, work overload and

little time to perform leisure activities.14

Studies confirm this data, when they specify

the emotional exhaustion associated with the

excessive workload of the professional.15

It is prioritized that work overload is the

main factor that triggers the onset of Burnout

Syndrome. Because of this, and due to the

difficulty in the precise conclusion of its

diagnosis16, it is essential to carry out

research, which contributes to the greatest

knowledge about work sickness.16

DISCUSSION

The information and data collected must be current and Evidence-based to support the topic

Vitorino MF, Rodrigues MSD, Evangelista CB et al. Burnout syndrome: knowledge of neonatal…

English/Portuguese

J Nurs UFPE online., Recife, 12(9):2308-14, Sept., 2018 2312

ISSN: 19The information and data collected must be current and Evidence-based to support the topic

The information and data collected must be current and Evidence-based to support the topic

It is emphasized that among the labor

factors that influence the appearance of

Burnout Syndrome, overload and inadequate

working conditions stand out. In addition,

conflicting interpersonal relationships, lack of

professional expectation and salary

dissatisfaction predispose the emergence of

the dimensions of the syndrome.10

From this perspective, it is known that

Burnout Syndrome is a disease that comes

from depression and labor stress. Its symptom

is the physical and mental exhaustion in

professionals of multi-professional teams.17

In many cases, Burnout Syndrome is

confused with depression or stress. This is

because a Burnout professional lives better in

one environment than another; in depression

the symptoms appear in the course of life, in

their daily life, regardless of the environment

in which they are. Compared with stress, in

Burnout Syndrome the worker is accompanied

by an overload of work, while in stress the

professional presents their altered stimuli.18

It is identified that the worker’s health

instability has greater visibility due to factors

such as anxiety and stress, and can

progressively progress to the onset of Burnout

Syndrome. Some causes are absenteeism,

elevation of stress and occupational

accidents, which cause a decrease in their

labor productivity.19

It is shown that, faced with the

symptomatology, the individual affected by

the syndrome may present: sleep disturbance,

chronic fatigue, pain, distraction, impatience,

decreased self-esteem, irritability and

absenteeism.20 Besides these manifestations,

there may be a lack of interest in work,

isolation and conflicts with colleagues and

users, impairing the worker’s quality of life

and his income in the company.

About what was presented in the speeches,

we identify the magnitude of the effects that

Burnout Syndrome can cause to the worker. In

this way, strategies capable of combating or

reducing this disorder must be stimulated.

Therefore, attention to professionals should

be holistic, from the perspective of self-care,

to favor the treatment of the other with

excellence.

 

It was verified with this study that the

majority of the interviewees do not have the

understanding about the Burnout Syndrome,

becoming indispensable the propagation of

the subject in the scientific community. It is

therefore essential to update the

professionals who make up the neonatal

health team, due to the innumerable changes

that nursing has undergone over the years.

These renewals in the process of academic

formation are inevitable, due to the constant

search for a better quality of patient care.

It is known that research on what nursing

professionals who attend newborns know

about Burnout Syndrome is fundamental, to

consolidate arguments about the level of

information and potential harms to the

occupational health of these workers. Among

the few professionals who have al