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INFLUENCE OF PHYSICAL ACTIVITY ON MILITARY POLICE OFFICERS’ BURNOUT

INFLUÊNCIA DA ATIVIDADE FÍSICA NO BURNOUT EM POLICIAIS MILITARES

ABSTRACT

The literature points out that cops are among professionals vulnerable to the burnout syndrome, but there are only few studies that investigate this syndrome and associate it with a coping strategy. The hypothesis of this article is that physical exercise may correlate significantly with burnout, working as a protective element. From this perspective, the present study assessed physical activity levels and the perception of burnout syndrome dimensions in a sample of military police officers in the city of Belo Horizonte. Three instruments were employed for data collection, each one with a specific objective: the Maslach Burnout Inventory (MBI-HSS), the International Physical Activity Questionnaire (IPAQ), and a sociodemographic questionnaire. Results showed a prevalence of 64% for the burnout syndrome, especially among those individuals classified with low physical education level and those who perform operational roles. It is concluded that variables referring to socio-affective aspects influence the perception of this syndrome, just as sedentarism; by means of the variables that presented statistical significance, it was possible to determine the profile of a sedentary cop vulnerable to burnout, with the finding that physical activity levels associate with burnout indicators.

Keywords:
Physical activity; Burnout syndrome; Military Police Officers

RESUMO

A literatura aponta que os policiais estão entre os profissionais vulneráveis à síndrome de burnout, porem há poucos estudos que investigam esta síndrome e a associam a uma estratégia de enfrentamento. A hipótese deste artigo é de que o exercício físico pode ter associação significativa em relação ao burnout funcionando como elemento de proteção. Partindo deste ponto, o presente estudo avaliou os níveis de atividade física e a percepção das dimensões da síndrome de burnout em uma amostra de policiais militares na cidade de Belo Horizonte. Foram utilizados três instrumentos para coleta de dados, cada qual com um objetivo específico: o Inventário de burnout de Maslach (MBI-HSS), o Questionário Internacional de Atividade Física (IPAQ) e um questionário sociodemografico. Os resultados mostraram uma prevalência da síndrome de burnout de 64%, principalmente entre os classificados com baixo nível de atividade física e os que executam a atividade de trabalho operacional. Conclui-se que variáveis que se referem a aspectos sócio-afetivos influenciam a percepção desta síndrome assim como o sedentarismo, tendo sido, através das variáveis que apresentaram significância estatística, traçado um perfil do policial sedentário e vulneral ao burnout e constatado que os níveis de atividade física apresentam associação com os indicadores de burnout.

Palavras-chave:
Atividade física; Síndrome de burnout; Policial militar

Introduction

Among several diseases that affect workers, mental ones are ever-increasingly prevalent. According to data from the World Health Organization11 Organização Mundial de Saúde. Obesity: Preventing and managing the global epidemic. Geneva: WHO; 1998.,22 Organização Mundial de Saúde. World Health Report 2001: Mental health: new conception, new hope. Geneva: WHO; 2001., minor mental disorders, such as anxious, depressive and somatoform symptoms affect around 30% of occupied workers, and it is estimated that, by 2020, occupational stress will be the second most common cause of work leave22 Organização Mundial de Saúde. World Health Report 2001: Mental health: new conception, new hope. Geneva: WHO; 2001.. In this context, military police officers stand out because, due to the characteristics of their jobs, they are more vulnerable to mental disorders that may be aggravated or caused by work, with highlight to occupational stress and the burnout syndrome33 Costa M, Accioly Júnior H, Oliveira J, Maia E. Estresse: diagnóstico dos policiais militares em uma cidade brasileira. Rev Panam Salud Publica 2007;21(4):217-222.

4 Pessanha J. Um fardo peculiar de agentes da segurança publica. Serviço Social & Realidade 2009;18(2):279-305.

5 Rocha DF, Ferreira Neto JL. A síndrome de Burnout e os níveis de atividade física em policiais militares ambientais de Alagoas, Brasil. Revista Brasileira de Qualidade de Vida 2014;6(1):27-37.
-66 Souza ER, Minayo MCS, Silva JG, Pires TO. Fatores associados ao sofrimento psíquico de policiais militares da cidade do Rio de Janeiro, Brasil. Cadernos de Saúde Pública 2012;28(7):1297-1311. Doi:10.1590/s0102-311x2012000700008
https://doi.org/10.1590/s0102-311x201200...
.

As a result of excessive exposure to risk, cops may develop acute and chronic symptoms of psychological suffering, occupational stress and, consequently, burnout. However, Maslach and Leiter77 Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry 2016;15(2):103-111. Doi:10.1002/wps.20311
https://doi.org/10.1002/wps.20311...
observed that “burnout is not only a personal problem, it is a workplace problem”. Moraes, Ferreira and Rocha88 Moraes LFR, Ferreira SAA, Rocha DB [Internet]. Trabalho e organização: influências na qualidade de vida e estresse na Polícia Militar do Estado de Minas Gerais [acesso em 26 set 2016]. Disponivel em: http://www.anpad.org.br/admin/pdf/enanpad2001-grt-359.pdf
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came to a similar conclusion when conducting a case study with a sample of 1,152 military police officers in Minas Gerais. These authors argue that a major source of dissatisfaction in Minas Gerais Military Police lies on aspects related to organizational structure. The way that factors translate in the job of a cop, be they linked to organizational structure or the precarization of labor, may bring harmful implications to this worker’s physical and psychological health, which may explain the high rates of absenteism99 Stein AC, Reis AMS. O absenteísmo por dispensa médica e os prejuízos para gestão. Rev Preleção [Internet], 2012.[acesso em 26 set 2016]. Disponível em: https://pm.es.gov.br/Media/PMES/Revista%20Prele%C3%A7%C3%A3o/Revista_Prelecao_Edicao_11.pdf#page=31
https://pm.es.gov.br/Media/PMES/Revista%...
reported in this category.

Guimarães et al.1010 Guimarães LA, Mayer VM, Bueno HPV, Minari MRT, Martins LF. Síndrome de Burnout e qualidade de vida de policiais militares e policiais civis. Revista Sul Americana de Psicologia2014;2(1):98-122. conducted a study with 240 military police officers and 234 civil police officers in the city of Campo Grande, state of Mato Grosso do Sul, Brazil, in order to verify the occurrence of the burnout syndrome and analyze these professionals’ Quality of Life. The sample as a whole presented 56% of burnout levels classified as “serious”, and excessive workload as to Quality of Life assessment. Results found indicated the vulnerability of this professional category to the burnout syndrome.

Additionally to structural characteristics that make cops a risk population for burnout, Souza and Patrocínio1111 Souza, EMCD, Patrocínio MCC. Fatores psicossociais na gênese de atos agressivos de policiais militares. In: Sampaio JR. et al. Qualidade de vida, saúde mental e psicologia social: estudos contemporâneos II. São Paulo: Casa do Psicólogo 1999:181-216 showed that they are seen by society as the second professional category that most deserves the worst adjectives. A survey conducted in Brazil, in 2010, by market research institute GFK1212 MCF Consultoria [Internet]. Profissões mais confiáveis no Brasil e no mundo [acesso em: em 26 set 2016]. https://guiadoestudante.abril.com.br/estudo/brasileiro-acredita-mais-em-professores-veja-lista-das-profissoes-mais-confiaveis/
https://guiadoestudante.abril.com.br/est...
, showed that the trust put in the military police is way below the global average. In said survey, the military police officer job came 15th in the Brazilian rank of profession trustworthiness, with 51% of population trust, while the global average was 75%. For cops, lack of intrinsic rewards (such as being recognized by society and/or the feeling of being doing something important and doing it well) is associated with feelings of inefficacy and reduced Professional efficiency33 Costa M, Accioly Júnior H, Oliveira J, Maia E. Estresse: diagnóstico dos policiais militares em uma cidade brasileira. Rev Panam Salud Publica 2007;21(4):217-222.. There are authors that approach burnout and occupational stress as one same construct1313 Melquíades DD, Leite MCA. O estresse ocupacional em equipes de saúde da família. REBES 2014;4(2):27-32., while others1414 Limongi-França AC, Rodrigues AL. Stress e trabalho: uma abordagem psicossomática. São Paulo: Atlas; 2012.,1515 Lipp MEN [Internet]. O percurso do stress: suas etapas. Centro psicológico de controle do stress [acesso em 9 jul 2016]. Disponível em: http://estresse.com.br
http://estresse.com.br...
understand burnout as a chronification of occupational stress. However, burnout is herein understood as the result of a long process of attempts to deal with stress. The relational perspective present in burnout is what differs it from occupational stress. Such a perspective is expressed by individuals through defensive attitudes when they reach the Depersonalization stage, which is a fundamental characteristic of burnout1616 Maslach C, Schaufeli WB, Leiter MP. Job Burnout. Annu Rev Psychol 2001;52(1):397-422. Doi:10.1146/annurev.psych.52.1.397
https://doi.org/10.1146/annurev.psych.52...
.

The term burnout was first used in 1953 by psychiatrists Schwartz and Will1717 Freudenberger HJ. Staff Burn-Out. Journal of Social Issues. Wiley; 1974;30(1):159-165. Doi:10.1111/j.1540-4560.1974.tb00706.x
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, and then again in the 1970s by physician and psychoanalyst Herbert Freudenberg1818 Maslach C, Marek T, editors. Washington, DC: Taylor & Franci; 1993., who, while treating his patients, observed that many presented a gradual process of exhaustion in mood, and/or demotivation. Such a process lasted approximately a year and was followed by physical and psychological symptoms that denoted a particular state of being “exhausted”. The expression “burnout” is also referred to as “depletion” and began to be used as a metaphor to explain the suffering of men in the workplace1919 Benevides-Pereira AMT. Burnout: quando o trabalho ameaça o bem-estar do trabalhador. 4. ed. São Paulo: Casa do Psicólogo, 2010..

In their studies, Maslach and Jackson1616 Maslach C, Schaufeli WB, Leiter MP. Job Burnout. Annu Rev Psychol 2001;52(1):397-422. Doi:10.1146/annurev.psych.52.1.397
https://doi.org/10.1146/annurev.psych.52...
concluded that this syndrome is more evident in professionals who deal with people or in assistance-oriented professions, such as those of doctors, nurses, teachers and cops. To these authors, burnout results from prolonged exposure to occupational risks and lack of social support. In their studies, three aspects or dimensions that compose this syndrome were identified: Emotional exhaustion (EE), Depersonalization (DE) and Professional efficiency (PE).

Emotional exhaustion (EE) is characterized by lack or absence of energy and enthusiasm, as well as a feeling of depleted resources, that is, it manifests physically and emotionally with symptoms of effective fatigue about work and difficulties to deal with emotions1919 Benevides-Pereira AMT. Burnout: quando o trabalho ameaça o bem-estar do trabalhador. 4. ed. São Paulo: Casa do Psicólogo, 2010.. Depersonalization (DE) or Cynicism refers to the context in which the professional shows, through their attitudes, an emotional insensitivity towards others1919 Benevides-Pereira AMT. Burnout: quando o trabalho ameaça o bem-estar do trabalhador. 4. ed. São Paulo: Casa do Psicólogo, 2010.. Professional efficiency (PE) was originally called Personal accomplishment reduced1616 Maslach C, Schaufeli WB, Leiter MP. Job Burnout. Annu Rev Psychol 2001;52(1):397-422. Doi:10.1146/annurev.psych.52.1.397
https://doi.org/10.1146/annurev.psych.52...
. However, changes have been suggested to name this dimension in order to make this construct easier to understand in languages other than English, since this dimension assesses positive aspects that, in a clinical burnout case, are reduced2020 Shephard RJ. Physical Activity, Fitness, and Health: The Current Consensus. Quest 1995;47(3):288-303. Doi:10.1080/00336297.1995.10484158
https://doi.org/10.1080/00336297.1995.10...
. PE is defined as a worker’s inclination to make self-evaluations as to their performance at work. This dimension of burnout evidences a feeling of dissatisfaction with labor activities involving personal achievements and accomplishments concerning the job, as well as their performance while executing their professional activity1919 Benevides-Pereira AMT. Burnout: quando o trabalho ameaça o bem-estar do trabalhador. 4. ed. São Paulo: Casa do Psicólogo, 2010..

Researchers have been discussing the importance of physical exercise2121 Cardoso HF, Baptista MN, Sousa DFA, Júnior EG. Síndrome de burnout: Análise da literatura nacional entre 2006 e 2015. Revista Psicologia, Organizações e Trabalho 2017;17(2):121-128. Doi:10.17652/rpot/2017.2.12796
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,2222 Pirajá G, Sousa T, Fonseca S, Barbosa A, Nahas M. Auto avaliação positiva de estresse e prática de atividades físicas no lazer em estudantes universitários brasileiros. Rev Bras Ativ Fís Saúde 2013;18(6):740-779. Doi: 10.12820/rbafs.v.18n6p740
https://doi.org/10.12820/rbafs.v.18n6p74...
as a coping strategy that prevents several physical and/or psychological diseases and improves quality of life, whether independently or combined with other lifestyle characteristics. Nevertheless, there are few studies approaching the burnout syndrome from this perspective. There are not many researches, especially in Brazil, that investigate the relationship between physical exercise, as a coping strategy, and the burnout syndrome2323 Fernandes BLV. A atividade física no processo de envelhecimento. Revista Longeviver 2014;40:43-48.. It is known that exercising regularly contributes to lowering anxiety2424 Nascimento PMC, Vieira MC, Sperandei S, Serra SM. Atividade física supervisionada melhora a modulação autonómica de participantes de reabilitação cardíaca. Revista Portuguesa de Cardiologia 2016;35(1):19-24. Doi:10.1016/j.repc.2015.10.004
https://doi.org/10.1016/j.repc.2015.10.0...
, reducing depression symptoms2424 Nascimento PMC, Vieira MC, Sperandei S, Serra SM. Atividade física supervisionada melhora a modulação autonómica de participantes de reabilitação cardíaca. Revista Portuguesa de Cardiologia 2016;35(1):19-24. Doi:10.1016/j.repc.2015.10.004
https://doi.org/10.1016/j.repc.2015.10.0...
, improving cognitive functions2525 Noce F, Kouyomdjian C, Reis I, Santos R, Santos C, Tufik S, et al A routine flight mission effects upon decision making performance of military fighter pilots. Sleep Medicine 2009;10:S36. Doi:10.1016/s1389-9457(09)70134-0
https://doi.org/10.1016/s1389-9457(09)70...
, allowing a quicker cardiovascular recovery2626 Carvalho TD, Nóbrega AD, Lazzoli JK, Magni JRT, Rezende L, Drummond FA, et al. Posição oficial da SociedadeBrasileira de Medicina do Esporte: atividade física e saúde. Rev Bras Med Esporte 2000;2(4):79-81. Doi:10.1590/S1517-86922000000300002
https://doi.org/10.1590/S1517-8692200000...
and improving sleep quality2727 Shephard RJ, Balady GJ. Exercise as Cardiovascular Therapy. Circulation 1999;99(7):963-972. Doi:10.1161/01.CIR.99.7.963
https://doi.org/10.1161/01.CIR.99.7.963...
.

Thus, bearing in mind the physiological28,29 and psychological2929 Gonzaga AL. A validação do Maslach Burnout inventory em língua portuguesa: Um estudo exploratório. [Dissertação em Administração de empresa]. São Paulo: Centro Universitário Álvares Penteado; 2003. benefits derived from exercising to stress, the question raised herein refers to whether these benefits could be applied to military police officers concerning the burnout syndrome, in its three dimensions.

Thus, the objective of this study was to assess the perception of physical activity levels and indicators of the burnout syndrome in military police officers in the city of Belo Horizonte. The relevance of this research lies on deepening the comprehension around the relationship between Physical activity and the burnout syndrome, seeking to analyze this relationship in an occupational context.

Methods

Participants

This study had the participation of 195 military police officers, both males and females, ranked as soldiers, corporals and sergeants, composing a non-probabilistic sample by convenience, out of a population of 230 cops. The study did not include officership ranks because, in the collection period, sampling access was allowed only to teams composed of enlisted officers, who, on the occasion, were taking a basic police training course held in Belo Horizonte, Minas Gerais.

The research intended to include as many participants as possible, so the inclusion criterion was to be an active military police officer and join the research freely by signing a free and informed consent form.

Instruments

The present study employed the following self-applied instruments:

Sociodemographic and situational data questionnaire: This instrument aimed to assess some institutional and quality of life aspects regarding the military police officers, as well as collect additional pieces of information, such as: sex, age, education, service time, activity field, and affectivity.

Maslach Burnout Inventory (MBI), version for Human Services: This questionnaire was validated in Brazil by means of several studies3030 Matsudo S, Araújo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, et al. Questionário Internacional De Atividade Física (IPAQ): Estudo de validade e reprodutibilidade no Brasil. Rev Bras Ativ Fis Saúde 2001;6(2):5-18. Doi: 10.12820/rbafs.v.6n2p5-18
https://doi.org/10.12820/rbafs.v.6n2p5-1...
,1111 Souza, EMCD, Patrocínio MCC. Fatores psicossociais na gênese de atos agressivos de policiais militares. In: Sampaio JR. et al. Qualidade de vida, saúde mental e psicologia social: estudos contemporâneos II. São Paulo: Casa do Psicólogo 1999:181-216. The inventory contains 22 questions, with nine being linked to Emotional exhaustion (EE), five to Depersonalization (DE) and eight to Professional efficiency (PE). Each item indicates the frequency of answers on a Likert scale ranging from zero to six points; the scale for the DE and PE constructs is positive, while for PE it is negative or inversion scoring.

International Physical Activity Questionnaire (IPAQ): It is a free and public questionnaire proposed by the World Health Organization and validated in Brazil3232 Mccullagh P, Nelder JA. Generalized Linear Models. London: Chapman and Hall; 1989. to determine people’s physical activity levels in their many aspects. The study participants had their data tabulated and classified according to orientations by the IPAQ itself, which divides and names categories as sedentary, insufficiently active, active and very active. “Active” and “very active” individuals were counted as a single group, classified as “Active”, and so were categories “Insufficiently active A” and “Insufficiently active B”, which were classified simply as “Insufficiently active”.

Procedures

After formal authorization from the institution, the responsible parties were contacted to be informed about the research objectives, relevance and methodological procedures. The sample was split into groups, with 20 to 30 participants each. The instruments were applied in the same order for each group and always in the morning. This study complied with all norms set forth by the Brazilian National Health Council (Resolution 466-2012) with respect to research involving humans. It was submitted for the approval of the Research Ethics Committee of the Federal University of Minas Gerais, which approved the conduction of the research under protocol No 619.728.

All study volunteers and participants were informed about the research objectives, relevance and methodological procedures, and signed a free and informed consent form.

Data Analysis

Statistical analyses, to describe categorical variables, used absolute and relative frequencies, while measures of central tendency, dispersion and position were used for describing quantitative variables.

To select significant variables to explain burnout indicators (EE - Emotional exhaustion; DP - Depersonalization; PE - Professional efficiency), the Stepwise method was employed3333 Wedderburn RWM. Quasi-Likelihood functions, generalized linear models, and the gauss-newton method. Biometrika 1974;61(3):439-447. Doi:10.2307/2334725
https://doi.org/10.2307/2334725...
. The Stepwise is one of the most popular methods for selection of variables in Regression Analysis context, being a mix of the Backward and the Forward methods. For the Forward method (criterion for inputting variables in the multivariate regression analysis), univariate analyses were used, adopting a significance level of 25%. For correlation analysis, Spearman’s test was applied3333 Wedderburn RWM. Quasi-Likelihood functions, generalized linear models, and the gauss-newton method. Biometrika 1974;61(3):439-447. Doi:10.2307/2334725
https://doi.org/10.2307/2334725...
.

The selected variables entered the Multiple Poisson Regression3434 Cameron AC, Windmeijer FAG. R-Squared Measures for Count Data Regression Models with Applications to Health-Care Utilization. Journal of Business & Economic Statistics 1996;14(2):209-220. Doi:10.2307/1392433
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, with the Backward method being applied at this stage, which is the procedure of removing, one by one, variables with the highest p-value; this procedure was repeated until only significant variables were left in the model. For the Backward method, a 5% significance level was adopted. Because over- or under-dispersion are very common in Poisson model, the Quasi-likelihood method3535 Agresti A, Kateri M. Categorical data analysis. Heidelberg: Springer; 2011. was used for estimating the model, thus allowing the estimation of robust variances for these phenomena. To verify the quality of Poisson regression models, adjusted R2 was calculated3636 Jesus GM, Jesus ÉF. Nível de atividade física e barreiras percebidas para a prática de atividades físicas entre policiais militares. Rev Bras Ciênc Esporte 2011;34(2): 433-448. Doi:10.1590/s0101-32892012000200013
https://doi.org/10.1590/s0101-3289201200...
.

To verify sociodemographic variables related to physical activity level, the Cochran-Armitage test for trend was employed3737 Diagnóstico Nacional do Esporte [internet]. Ministério do Esporte, Diesporte, Caderno I [acesso em 12 ago 2016]. Disponível em: http://www.esporte.gov.br/diesporte/diesporte_grafica.pdf
http://www.esporte.gov.br/diesporte/dies...
. The software used for the analysis was R, version 3.0.3.

Results

A total of 92% of the individuals were males, 29% were single, 66% were married and 61% had kids. About education, 3% had completed elementary school, 50% had completed high school, 25% had a college degree, and 23% had not completed higher education. As for functional role, 74% of the individuals performed operational ones, while 26% held administrative positions. Concerning shifts, 66% worked during the day, 27% at night, and 7% alternated between both shifts, with 81% of the individuals working on a fixed schedule, and 19% on a rotating schedule.

With respect to situational characteristics, 38% were concerned or sad about something, 89% had an affective relationship and 24% had some problem in said relationship, 22% faced some type of problem with relatives, 18% were going through financial instability, 31% of the individuals had someone in their families suffering from depression, 13% had a disease, 17% took medication regularly, 28% reported having experienced a traumatic situation (occurrences with gun shots and/or physically injuring themselves or others). About the emotional perception of those who had experienced a traumatic situation, 24% claimed they were getting over it, 31% suffered a little, 28% suffered moderately, and 17% still suffered a lot.

Besides, 77% of the participants claimed to exercise regularly, 93% were used to engage in leisure activities, and 93% had a belief or religion, 53% out of whom were practicing believers.

As for military rank, the sample was composed of enlisted officers: 27% of soldiers, 29% of corporals, and 44% of sergeants.

Figure 1 shows that the physical inactivity prevalence (sedentary + insufficiently active) among the cops participating in this study was 58%, and the percentage of police officers considered as “Active” was 42%.

Figure 1
Physical activity levels of military police officers participating in the study, classified according to the IPAQ

Figure 2 shows that Administrative functional roles (internal service) have a higher prevalence of physical inactivity (sedentary + insufficiently active) than Operational ones (external service) do.

Figure 2
Physical activity levels according to the military police officers’ functional roles

However, Figure 3 shows that operational functional roles have a higher number of sedentary individuals.

Figure 3
Detailing of physical activity levels according to the military police officers’ roles

Table 1 displays a comparison between physical activity levels and independent variables that presented statistical significance (p=value < 0.05). Thus, it can be pointed out that this is the profile of those who tend to exercise more: individuals without children (p-value = 0.028); those who do not take medication (p-value = 0.049); and individuals who engage in leisure activities (p-value = 0.034). Another piece of data is that 77% of the cops claimed to exercise regularly (p-value = 0.01), 12% out of whom were classified as “sedentary”, 25% as “insufficiently active” and 42% as “active”.

Table 1
Physical activity levels and independent variables that presented statistical significance (p < 0.05)

Table 2 displays results for burnout levels, including general burnout. In this classification, burnout characterizes any individual who had at least one indicator classified as “Serious”. A total of 64% of the cops participating in the study presented at least one indicator classified as “Serious”, and 26% presented a general burnout index classified as “Moderate”, that is, they did not present any “Serious” classification, but presented at least one “Moderate” classification”. Moreover, 10% of the sample was classified as “Light”, that is, they reached this classification for the three assessed indicators; in the individualized analysis of indicators, depersonalization reached the highest index - 49%.

Table 2
Burnout indexes found in the sample

Figure 4 displays a comparison between burnout indicators and functional roles. For this analysis, the individuals were split into two groups, according to their roles (Operational and Administrative) so that the analysis of each group could be run separately. It is worth highlighting that the Operational functional role had a higher percentage of individuals with indexes within the “Serious” classification for burnout indicators on the Depersonalization (DE) and Professional efficiency (PE) subscales, with DE at 53% and PE at 32%, while for the Administrative functional role, the DE subscale stood at 35%, and the PE subscale, at 16%.

Figure 4
Burnout indicators (EE, DE, PE) by functional role

Analyzing the correlation between age and burnout levels, the age variable presented statistical significance (p < 0.05) in relation to EE (r = -0.167; p=0.019) and DE (r = -0.144; p=0.045), through a negative correlation; and positive as to the correlation with the PE subscale (r = -0.154; p=0.031), indicating that the levels of these indicators improve with age.

Figure 5 shows the prevalence of burnout indicators by physical activity level. Thus, it is possible to observe that the physical activity level classified as “Active” has a smaller percentage of individuals with burnout indicators classified as “Light” - 21% for EE, 8.2% for DE, and 19.5% for PE.

Figure 5
Burnout indicators (EE, DE, PE) by physical activity level

Table 3 displays a comparison between the independent variables that presented statistical significance (p < 0.05) and burnout indicators (EE, DE and PE) in the Multivariate Regression Analysis, while Table 4 shows the variables that were then subjected to the Multiple Poisson Regression.

Table 3
Independent variables with statistical significance (p < 0.05) and burnout indicators (EE, DE and PE) in the Multivariate Regression Analysis
Table 4
Poisson model with robust variance for burnout indicators

Discussion

Analyzing sociodemographic variables, it was possible to verify that the number of male military participants was higher than that of female ones. It is important to highlight that women represent 10% of Minas Gerais Military Police’s personnel.

About physical activity, this study showed a predominance of sedentary and insufficiently active cops, and that the police officers who have children tend to be more sedentary, corroborating with a study conducted with military police officers in the city of Florianópolis, state of Santa Catarina, Brazil3838 Ferreira DKS, Bonfim C, Augusto LGS. Condições de trabalho e morbidade referida de policiais militares, Recife-PE, Brasil. Saúde e Sociedade 2012;21(4):989-1000. Doi:10.1590/s0104-12902012000400016
https://doi.org/10.1590/s0104-1290201200...
. Said study found that professionals with kids engaged less in physical and leisure activities. The prevalence of physical inactivity found was 58%; this calculation includes percentages for sedentary and insufficiently active individuals. This index was higher than the national percentage, which stood at 54%, for the same age group as that of the studied sample3939 Calheiros DDS, Cavalcante Neto JL, Calheiros DDS. A qualidade de vida e os níveis de atividade física de policiais militares de Alagoas, Brasil. Revista Brasileira de Qualidade de Vida 2013;21;5(3):59-71. Doi:10.3895/s2175-08582013000300007, although these indexes are lower than those found in similar studies conducted in Brazil with military police officers, such as those developed in the states of Pernambuco, 73%, and Alagoas, 70%4141 Leiter MP. Burnout as a developmental process: Consideration of models. In: Schaufeli WB, Maslach C, Marek T editors. Series in applied psychology: Social issues and questions. Professional burnout: Recent developments in theory and research. Philadelphia: Taylor & Francis; 1993, p. 237-250.. It is also possible to infer that the association between Depersonalization (DE) and lower physical activity levels is influenced by functional role, since said indicator showed statistical association with the operational functional role and the “Insufficiently active” physical activity level.

By investigating physical activity levels, it was also possible to define a profile for sedentary cops. Thus, those who do not frequently engage in leisure activities, have kids, take medication, and/or have operational functional roles are vulnerable to the burnout syndrome as a consequence of sedentarism. Considering the vulnerability profile for sedentarism and the burnout syndrome, educative actions aimed at encouraging a healthier lifestyle may contribute to improving these professionals’ physical and psychological health. Proposals for promotion of a healthier lifestyle and better physical fitness must act simultaneously at intra-personal, inter-personal and organizational levels, taking into account theories for behavioral changes in order to achieve long-lasting results, which may be possible through institutional programs that support engagement in sports and physical activity.

The Operational functional role presented a higher percentage of individuals with indexes within the “Serious” classification - DE with 53% and PE with 32%. Cops who perform operational roles tend to seek defensive strategies to deal with occurrences, which leads to a more distant treatment in relation to other people, decreasing their motivation to continue the job they are assigned4242 Freitas, AR, Carneseca EC, Paiva CE, Paiva BSR. Impacto de um programa de atividade física sobre a ansiedade, depressão, estresse ocupacional e síndrome de Burnout dos profissionais de enfermagem no trabalho. Rev Lat Am Enfermagem 2014;22(2):332-336. Doi:10.1590/0104-1169.3307.2420
https://doi.org/10.1590/0104-1169.3307.2...
. A research with military police officers in the south of Minas Gerais88 Moraes LFR, Ferreira SAA, Rocha DB [Internet]. Trabalho e organização: influências na qualidade de vida e estresse na Polícia Militar do Estado de Minas Gerais [acesso em 26 set 2016]. Disponivel em: http://www.anpad.org.br/admin/pdf/enanpad2001-grt-359.pdf
http://www.anpad.org.br/admin/pdf/enanpa...
found that operational activities are linked to higher stress indexes compared to administrative positions, because operational jobs make professionals more exposed to the risks inherent of their activity, thus directly impacting their stress and burnout levels4141 Leiter MP. Burnout as a developmental process: Consideration of models. In: Schaufeli WB, Maslach C, Marek T editors. Series in applied psychology: Social issues and questions. Professional burnout: Recent developments in theory and research. Philadelphia: Taylor & Francis; 1993, p. 237-250..

Similar EE (29%) and PE (28%) indexes can be explained by the fact that EE takes place in parallel with PE perception and is a direct consequence of labor stressors, especially lack of social support and opportunities for professional development4242 Freitas, AR, Carneseca EC, Paiva CE, Paiva BSR. Impacto de um programa de atividade física sobre a ansiedade, depressão, estresse ocupacional e síndrome de Burnout dos profissionais de enfermagem no trabalho. Rev Lat Am Enfermagem 2014;22(2):332-336. Doi:10.1590/0104-1169.3307.2420
https://doi.org/10.1590/0104-1169.3307.2...
.

The analysis of the Emotional exhaustion indicator provided values lower than those reported in the literature4343 Harizanova SN, Tarnovska TH. Professional burnout syndrome among correctional facility officers. Folia Med 2013;55(2);73-79. Doi:10.2478/folmed-2013-0020,1010 Guimarães LA, Mayer VM, Bueno HPV, Minari MRT, Martins LF. Síndrome de Burnout e qualidade de vida de policiais militares e policiais civis. Revista Sul Americana de Psicologia2014;2(1):98-122.. To Guimarães et al.1010 Guimarães LA, Mayer VM, Bueno HPV, Minari MRT, Martins LF. Síndrome de Burnout e qualidade de vida de policiais militares e policiais civis. Revista Sul Americana de Psicologia2014;2(1):98-122., EE is primarily a response to the demands of stressors that workers deal with, such as overwork, interpersonal contacts, role conflicts and high expectation levels about oneself and the organization. In line with these authors, data found in the present study may be related to prolonged permanence of these stressors in the work environment, probably resulting from the structural-organizational sphere and that expose workers to a constant state of chronic stress and burnout, in addition to the association of other situational elements, such as studying, which ends up taking one’s time for rest.

Another point that draws attention is that, in the analysis of burnout indicators in association with physical activity levels, individuals classified as physically “Active” presented higher percentages in the EE indicator classified as “Serious”. This led us to investigate these individuals isolatedly in order to understand which characteristics could be making them more vulnerable to Emotional exhaustion, since they were deemed “Active” as to physical activity level and, therefore, should be reaping the benefits of physical exercise against stressor elements4444 Haines III VY, Harvey S, Durand P, Marchand A. Core self-evaluations, work-family conflict, and Burnout. J. Marriage Fam 2013;75(3):778-793. Doi:10.1111/jomf.12026
https://doi.org/10.1111/jomf.12026...
.

Analyzing the profile of these professionals, a higher percentage of students was found (attending postgraduate or undergraduate courses). In this study, the “Higher education” variable showed significantly statistical correlation (p=0.038) with the Emotional exhaustion dimension. Benvides-Pereira2020 Shephard RJ. Physical Activity, Fitness, and Health: The Current Consensus. Quest 1995;47(3):288-303. Doi:10.1080/00336297.1995.10484158
https://doi.org/10.1080/00336297.1995.10...
argues that the higher the educational level, the higher the stress and burnout levels. A research conducted in Bulgaria4545 Rossetti MO, Ehlers DM, Guntert IB, Leme IF, Rabelo ISA, Tosi SM, et al. O inventário de sintomas de stress para adultos de lipp (ISSL) em servidores da polícia federal de São Paulo. Revista Brasileira de Terapias Cognitivas 2008;4(2):108-120. Doi:10.5935/1808-5687.20080018
https://doi.org/10.5935/1808-5687.200800...
found that cops with higher educational levels were more likely to develop the burnout syndrome.

Most variables that associated statistically with the EE indicator refer to aspects involving the individual’s socio-affective life or family context, for instance: “Something saddening”, “Recent trauma”, and “Relationship problems”. This shows the importance of these variables in influencing the perception of this indicator. In a study conducted by Haines et al.4646 Noce F, Kouyoumdjian C, Santos CS, Rzezak P, Tufik S, Mello MT. A influência dos turnos de trabalho na tomada de decisão dos militares controladores do tráfego aéreo. Revista Conexão SIPAER 2012;3(3):28-29. to assess the influence of family context on the development of the burnout syndrome in American cops, it has been found that work can be a cause of conflicts in the family environment, and that cops are among the professionals with the highest divorce rates.

Age is the factor that has been most related to burnout1010 Guimarães LA, Mayer VM, Bueno HPV, Minari MRT, Martins LF. Síndrome de Burnout e qualidade de vida de policiais militares e policiais civis. Revista Sul Americana de Psicologia2014;2(1):98-122.. Older people tend to have coping strategies (set of behaviors that an individual presents faced with a situation they want to change) improved with professional experience, which allows them to manage better the demands of their jobs compared to resources used by younger professionals. A study carried out with a sample of 250 federal traffic police officers reported that professionals with longer service time showed lower stress levels4747 Briones Mella D, Boutin APK. Burnout and coping strategies in male staff from national police in Valparaíso, Chile. Iran J Public Health 2013;42(9):950-959.. The data obtained in the present study also reveal that service time and age influence the perception of the EE and PE indicators.

“Shift work” (p-value = 0.008) was also a variable with statistical significance related to the burnout syndrome. This type of work requires a series of physiological and psychological adaptations. There are consequences to health because shift work affects the individual’s internal clock and circadian rhythms4848 Pichón R. O processo grupal. 8. ed. São Paulo: Martins Fontes; 2009.. When someone works by shift, there is a progressive change that demands constant adaptation to changes in schedule (the “shift”) and in the individual’s biological clock2727 Shephard RJ, Balady GJ. Exercise as Cardiovascular Therapy. Circulation 1999;99(7):963-972. Doi:10.1161/01.CIR.99.7.963
https://doi.org/10.1161/01.CIR.99.7.963...
.

Furthermore, the PE indicator is affected by elements concerning the professional’s personal sphere and that are linked to socio-affective matters, such as relationship problems or recent traumatic experiences; this result corroborates with the findings of another study conducted in Chile49, which verified a negative and statistically significant relationship between Professional efficiency and the “Relationship problems” variable.

The methodology used in this study is cross-sectional, which limits results, bearing in mind that the biggest disadvantage of this type of design is the impossibility of establishing causal relations, for not proving the existence of a temporal sequence between exposure to a factor and subsequent development of a certain effect. However, despite existing limitations, it is possible to deem this study as a pioneer one, since it revealed relevant data about the occupational profile of these professionals, which may provide a basis to actions inside the institution, as well as further researches.

Conclusion

It is concluded that there is burnout and sedentarism prevalence in the studied institution. Most cops presented general burnout indicators classified in the “Serious” category and, with respect to physical activity level, were also classified as sedentary. Affective aspects were proven to influence their relationship with work, and conflicts within the family context are associated with risk of developing this syndrome.

Cops with operational roles are more likely to have the syndrome compared to professionals with administrative positions because, in operational activities, the risk of exposure to the aggravations of the profession is higher.

It is worth considering the importance of creating strategies for the promotion of a healthier lifestyle and educational actions aimed at raising the awareness of professionals about the benefits of regular physical exercise. As a suggestion, a Program for Occupational Stress and Burnout Management, as well as operative groups, could be created, as proposed by Pichón50, and leisure activities could be promoted so as to allow the emotional discharge of tension build up by labor activity.

The present study is expected to contribute to the adoption of health promotion strategies in the organizational context of military professionals, providing guidance to areas that need interventive actions, thus helping improve working conditions, satisfaction and quality of life, consequently decreasing the risks of triggering psychological disorders that may evolve to burnout.

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Publication Dates

  • Publication in this collection
    20 Dec 2019
  • Date of issue
    2019

History

  • Received
    24 Apr 2018
  • Reviewed
    14 Aug 2018
  • Accepted
    06 Sept 2018
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