Association between burnout syndrome, harmful use of alcohol and smoking in nursing in the ICU of a university hospital

Fernandes, Larissa Santi; Nitsche, Maria José Trevizani; Godoy, Ilda de

doi:10.1590/1413-81232018231.05612015

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Free Themes • Ciênc. saúde colet. 23 (1) • Jan 2018 • https://doi.org/10.1590/1413-81232018231.05612015 copy

Association between burnout syndrome, harmful use of alcohol and smoking in nursing in the ICU of a university hospital

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The article aims to determine the presence of burnout syndrome among professionals in the field of Nursing in the Intensive Care Unit in a university hospital and a possible association with consumption of alcohol and tobacco. Participants were 160 nursing professionals from 04 intensive care unit of a university hospital in the period from March 2013 to February 2014. We used a structured questionnaire, plus the smoking history, Maslach Burnout Inventory, Alcohol Use Disorders Identification Test, Fagerström Dependence Questionnaire and the measurement of carbon monoxide. We used Fisher's chi-square or Fisher exact test. Syndrome was found in 34 professionals, most of them female, married and young adults. 18 professionals reported being smokers. 6,4% of Nursing Assistants, 50% Practical Nurses and Nurses 71,4% drank moderate; 5,4% Nursing Assistant and 14,3% Nurses scored default risk drinking and only 01 Practical Nurses had possible alcohol dependence. There was a positive association of the syndrome with smoking in 01 ICU. Final considerations: Hospital Intensive Care services need assistance from the managers of services for the purpose of caring for the health of their caregivers.

Key words
Burnout; Intensive Care Nursing; Alcoholism; Smoking

Work places/MBI issues	Adult ICU	Coronary ICU	Neonatal ICU	Pediatric ICU	p-value
Emotional Exhaustion ^* * Anova followed by Tukey.	29.08±8.83 a	19.31±10.73 b	20.94±14.24 b	14.75±14.69 b	<0.0001
Personal Accomplishment ^* * Anova followed by Tukey.	27.68±10.63 a	35.85±8.56 b	33.04±10.65 b	36.06±7.55 b	0.0011
Depersonalization ^ Gama. Means followed by the same letters do not differ statistically from each other.	10.38±7.29 a	3.92±4.33 b	3.52±5.44 bc	5.63±7.74 ac	0.0015

Categorized variables		Emotional Exhaustion						p-value
		High		Medium		Low
		n	%	N	%	n	%
Work period						0,0139^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.		0,0139^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	6 hours	9 ac	29	6 a	19	16 bc	52
	12/36 hours	56 b	48.7	30 a	26.1	29 a	25,2
	> 12 hours	9 a	69.2	3 ab	23.1	1 b	7,7
		Depersonalization
		High		Medium		Low
		n	%	N	%	n	%	p - value
Gender						0,0030^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.		0,0030^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	Female	45 a	30	40 a	26.7	65 b	43,3
	Male	7 a	77.8	2 a	22.2	-	-
Work period						0,0163^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.		0,0163^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	6 hours	5 a	16.1	6 a	19.4	20 b	64,5
	12/36 hours	40 a	34.8	33 a	28.7	42 a	36,5
	> 12 hours	7 a	53.8	3 a	23.1	3 a	23,1
		*Burnout syndrome*
		Present			Absent
		n	%		n	%		p - value
Gender					0.0217^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.			0,0217^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	Female	29 a	19.2		122 b	80.8
	Male	5 a	55.6		4 a	44.4

Categorized variables		Adult ICU Personal accomplishment						p - value

		High		Medium		Low
		n	%	n	%	n	%
Tobacco use								0.0154^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	Smoker	1 a	12.5	5 a	62.5	2 a	25
	Passive Smoker	2 a	33.3	-	-	4 a	66.7
	Former Smoker	1 a	12.5	1 a	12.5	6 b	75
	Non-smoker	3 a	7.4	6 a	14.6	32 b	78
		Depersonalization
		High		Medium		Low
		n	%	N	%	n	%	p - value
Work period								0.0150^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	6 hours	3 a	30	1 a	10	6 a	60
	12/36 hours	31 b	62	13 a	26	6 a	12
	> 12 hours	3	100	-	-	-	-
Tobacco use								0.0147^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	Smoker	1 a	12.5	4 a	50	3 a	37.5
	Passive Smoker	2 a	33.3	3 a	50	1 a	16.7
	Former Smoker	5 a	62.5	2 a	25	1 a	12.5
	Non-smoker	29 b	70.7	5 a	12.2	7 a	17.1
		*Burnout syndrome*
		Present			Absent
		n	%		n	%		p - value
Tobacco use								0.0406^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	Smoker	-	-	8		100
	Passive Smoker	2 a	3	4 a		66.7
	Former Smoker	3 a	3	5 a		62.5
	Non-smoker	21 a	5	20 a		48.8
		Neonatal ICU Emotional exhaustion
		High		Medium		Low
		n	%	n	%	n	%	p - value
Physical activity								0.0191^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	Yes	3 a	15	4 a	20	13 b	65
	No	23 bc	48.9	9 a	19.2	15 ac	31.9
		Depersonalization
		High		Medium		Low
		n	%	n	%	n	%	p - value
Physical activity								0.0150^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	Yes	-	-	4 a	20	16 b	80
	No	11 a	23.4	14 ac	29.8	22 bc	46,8
		*Burnout syndrome*
		Present			Absent
		n	%		n	%		p - value
Work period								0.0122^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	6 hours	2 a	11,8		15 b	88.2
	12/36 hours	1 a	2.2		45 b	97.8
	> 12 hours	2 a	50		2 a	50

Categorized variables		Alcohol Use Disorders Identification Test (AUDIT)								p-value
		Non-drinker		Moderate drinker		Risk drinking pattern		Possible alcohol dependence
		n	%	n	%	n	%	n	%
Marital Status										0.0002^ Qui-quadrado. Valores numéricos seguidos das mesmas letras não diferem estatisticamente entre si.
	Married	46 a	59.7	30 b	39	1 c	1.3	-	-
	Separated	13 a	68.4	5 b	26.3	1 b	5.3	-	-
	Single	13 a	20.6	39 b	62	10 a	15.9	1 c	1,6
Children										0.0318^* * Fisher
	Yes	48 a	55.1	33 b	38	6 c	6.9	-	-
Employment Relationship										0.0054^* * Fisher
	CLT	46 a	42.2	54 a	49.5	8 b	7.3	1 c	1
	Statutory	25 a	61	16 a	39	-	-	-	-
	Temporary	1 a	12.5	3 a	37.5	4 a	50	-	-
Education										0.0011^ Qui-quadrado. Valores numéricos seguidos das mesmas letras não diferem estatisticamente entre si.
	Secondary School	57 a	59.4	35 b	36.5	4 c	4.1	-	-
	Higher Education	10 a	30.3	20 b	60.6	2 a	6.1	1 a	3
	Specialist	6 a	21.4	17 b	60.7	5 a	17.9	-	-
Tobacco use										0.0259^* * Fisher
	Smoker	4 a	22.2	12 b	66.7	2 a	11.1	-	-
	Passive Smoker	6 a	35.3	10 b	58.8	1 a	5.9	-	-
	Former Smoker	5 a	38.4	4 b	30.8	4 a	30.8	-	-
	Non-smoker	58 a	51.8	48 a	42.8	5 b	4.4	1 b	1
		Measurement of carbon monoxide in th exhaled air (COex)
		Smoker				Non-Smoker
		n		%		n		%		p-value
Tobacco use										< 0,0001^ Qui-quadrado. Valores numéricos seguidos das mesmas letras não diferem estatisticamente entre si.
	Smoker	9 a		50		9 a		50
	Passive Smoker	1 a		5,9		16 b		94,1
	Former Smoker	1 a		7,7		12 b		92,3
	Non-smoker	8 a		7,1		104 b		92,9

Categorized variables		UTI Adulto Alcohol Use Disorders Identification Test (AUDIT)
		Non-drinker		Moderate drinker		Risk drinking pattern
		n	%	n	%	n	%			p-value
Employment Relationship										0.0186^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	CLT	14 a	31.8	25 b	56.8	5 c	11.4
	Statutory	3 a	23.1	10 b	76.9	-	-
Education										0.0055^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	Secondary School	15 a	42.9	18 a	51.4	2 b	5.7
	Higher Education	1 a	7.1	12 b	85.8	1 a	7.1
Tobacco use										0.0215^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	Smoker	2 a	25	5 a	62.5	1 a	12.5
	Passive Smoker	-	-	5	83.3	1	16.7
	Former Smoker	2 a	25	2 a	25	4 a	50
	Non-smoker	14 a	34.1	25 b	61	2 c	4.9
		Measurement of carbon monoxide in the exhaled air (COex)
		Smoker		Non-smoker
		n	%	n		%				p-value
Tobacco use										0.0011^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	Smoker	5 a	62,5	3 a		37.5
	Passive Smoker	-	-	6		100
	Former Smoker			8		100
	Non-smoker	2 a	4,9	39 b		95.1
Categorized variables		UTI Neonatal Alcohol Use Disorders Identification Test (AUDIT)
		Non-drinker		Moderate drinker		Risk drinking pattern		Possible alcohol dependence
		n	%	n	%	n	%	n	%	p-value
Marital Status										0.0019**
	Married	29 a	82.9	6 b	17.1	-	-	-	-
	Separated	11 a	84.6	2 b	15.4	-	-	-	-
	Single	4 a	21	12 b	63.2	2 a	10.5	1 a	5.3
Children										0.0021**
	Yes	33 b	84.6	5 a	12.8	1 a	2.6	-	-
	No	12 a	41.4	15 a	51.8	1 b	3.4	1 b	3.4
Employment Relationship										0.0092^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	CLT	25 a	59.5	15 a	35.7	1 b	2.4	1 b	2.4
	Statutory	20 a	87	3 b	13	-	-	-	-
	Temporary	-	-	1 a	50	1 a	50	-	-
Education										0.0045**
	Secondary School	37 b	82.2	7 a	15.6	1 a	2.2	-	-
University/course										0.0350^* * Fisher. Numerical values followed by the same letters do not differ statistically from each other.
	No	38 a	73.1	12 b	23.1	2 c	3.8	-	-

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[1] Collaborations

LS Fernandes contributed to the preparation of the initial project, data collection, analysis and interpretation, writing the final project, writing and reviewing the paper for publication. MJT Nitsche contributed to the preparation of the initial project, review of the final project, writing and review of the paper for publication. I Godoy contributed to the preparation of the initial project, data analysis and interpretation, writing the final project, writing and review of the paper for publication.