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NDT Advance Access originally published online on April 18, 2007
Nephrology Dialysis Transplantation 2007 22(8):2283-2290; doi:10.1093/ndt/gfm111
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Burnout in health care providers of dialysis service in Northern Italy—a multicentre study

Catherine Klersy1, Aliria Callegari1, Valentina Martinelli2, Valerio Vizzardi3, Carlo Navino4, Fabio Malberti5, Renzo Tarchini6, Giovanni Montagna7, Carlo Guastoni8, Roberto Bellazzi9, Teresa Rampino10, Salvatore David11, Cristiana Barbieri12, A. Dal Canton10, Pierluigi Politi2 and for the Working Group On Burnout And Dialysis*

1Service of Biometry and Clinical Epidemiology, IRCCS Fondazione Policlinico San Matteo, 2Section of Psychiatry, DSSAeP, University of Pavia, 3Division of Nephrology and Dialysis, Spedali Civili, Brescia, 4Division of Nephrology and Dialysis, Azienda Ospedaliera Maggiore della Carita', Novara, 5Division of Nephrology and Dialysis, Istituti Ospitalieri, Cremona, 6Division of Nephrology and Dialysis, Azienda Ospedaliera ‘Carlo Poma’, Mantova, 7Division of Nephrology and Dialysis, IRCCS Fondazione Maugeri, Pavia, 8Division of Nephrology and Dialysis, Azienda Ospedaliera ‘Ospedali Civili’, Legnano, 9Division of Nephrology and Dialysis, Azienda Ospedaliera of Pavia, Lomellina Center, 10Unit of Nephrology Dialysis Transplantation, University and IRCCS Fondazione Policlinico San Matteo, Pavia, 11Division of Nephrology and Dialysis, Azienda Ospedaliera, Parma and 12Division of Nephrology and Dialysis, Azienda Ospedaliera of Pavia, Oltrepo Center, Italy

Correspondence and offprint requests to: Catherine Klersy, Servizio di Biometria ed Epidemiologia Clinica, IRCCS Policlinico san Matteo, 27100 Pavia. Email: klersy{at}smatteo.pv.it



  Abstract

Background. Few data are available regarding the prevalence of burnout among dialysis health care workers. Aims of the present study were to assess and compare burnout levels in a sample of nurses and physicians working in dialysis units, and to investigate their relationships with quality of life, in a cross-sectional observational study.

Methods. A total of 344 workers from 10 dialysis centres in Northern Italy completed a battery of questionnaires including the Maslach Burnout Inventory, the MOS-36 Item Short Form Health Survey [SF36: physical (PCS) and mental (MCS) component scores] and the 30-item General Health Questionnaire (GHQ30). Data on social and demographic characteristics and working conditions were also collected. General Estimating Equations models were used for the analysis.

Results. Overall, burnout scores were lower than the Italian normative sample, with no significant differences between physicians and nurses. However, 30% of nurses had high emotional exhaustion vs 18% of physicians (adjusted OR 2.38, P = 0.003). Emotional exhaustion was also predicted by number of worked hours and months worked in dialysis in the previous 2 years. Depersonalisation was predicted by male gender and bad relationship with coworkers. Having no children and having a permanent hospital position predicted low personal accomplishment. PCS was lower in nurses (50.0 vs 53.3, P < 0.001), while no significant difference was found for MCS and GHQ30. Lower PCS was associated with emotional exhaustion (P = 0.007) and GHQ30 > 5 with depersonalization (P = 0.032).

Conclusions. Although burnout is not a general problem in dialysis health care providers, a subgroup of them may be identified, who would benefit from supportive measures to prevent this condition. Nurses appeared more burned-out in the emotional exhaustion scale than physicians.

Keywords: burnout; dialysis service; nurses; physicians; quality of life

*IRCCS Fondazione Policlinico San Matteo of Pavia: V. Sepe; E. Pez; IRCCS Fondazione Maugeri of Pavia: E. Efficace; M. Masciullo; Azienda Ospedaliera of Pavia,; Oltrepo Center: A. Milanesi; Azienda Ospedaliera of Pavia, Lomellina Center: D. Tira; Istituti Ospitalieri of Cremona: A. Tomasoni; Azienda Ospedaliera of Parma: C. Buzio; R. Fanfoni; Spedali Civili of Brescia: G. Cancarini; M. Appiani; Azienda Ospedaliera ‘Carlo Poma’ of Mantova: M. Peafrini; Azienda Ospedaliera ‘Ospedali Civili’ Legnano: S. Pala; Ospedale Maggiore of Novara: L. Pistoia; Department of Psychology; University of Pavia: P.G. Argentero; B. Dell’Olivo.

Received for publication: 11.11.06
Accepted in revised form: 8. 2.07


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