ABSTRACT Introduction: Burnout results from chronic exposure to work-related stress and it is characterized by a reduction in professional efficacy, feelings of lack of energy/exhaustion, and negativity related to work activities. It has a higher incidence in professions with significant interpersonal contact and among caregivers, making doctors a vulnerable population. The Maslach Burnout Inventory questionnaire is considered the gold standard for measuring this disease. In 2014, quinquennial prevention was described, aiming to prevent harm to patients through strategies that reduce Burnout in doctors. Clinical Case: The case describes a 29-year-old woman, a physician in her final year of Residency in General and Family Medicine, who sought an urgent consultation due to feelings of physical and mental exhaustion, hopelessness, irritability, initial and middle insomnia, for the last three months, and hyperphagia, two months ago. She has requested a sick leave from work because “I can't stand working anymore. I need to sleep for a week”. She identified excessive workload at the Clinic, stemming from the demands of her medical residency, as the main cause. She feels unsupported by her colleagues and Training Supervisor and feels pressured to manage the medical agenda without adequate preparation. She reports occasional errors in prescriptions, leading her to feel the need to repeatedly review records and decisions she has made. She denies any appointment with her designated Work physician ever since she started her internship. Upon physical examination, she appeared slaughtered, with a depressed mood, tearful, restless, and with fleeting eye contact. Applying the Maslach Burnout Inventory: Section A- 34 points- high level; Section B- 28 points- high level; Section C- 25 points- high level. A work leave from work was issued, laboratory studies were requested, and fluoxetine 20 mg and trazodone 50 mg were initiated, along with psychotherapy. So far, the patient has been re-evaluated in three consultations, with organic causes ruled out, and in the last re-evaluation, her scores were: Section A- 20 points- moderate level; Section B- 5 points- low level; Section C- 39 points- moderate level. She reports a decrease in medical errors. She maintained the prescribed medication and psychotherapy. She declined to join a Balint group. A new re-evaluation was scheduled in six months. Discussion/Conclusion: This is a case of a General and Family Medicine Resident Physician, diagnosed with Burnout, who has managed to substantially improve her quality of life and job satisfaction, as well as her personal life, following the implementation of both pharmacological and non-pharmacological measures, along with workplace adjustments and the setting of boundaries. She has successfully reduced her perception of making medical errors, thereby improving the quality of healthcare provided to the patients. The long journey of recovery from Burnout makes the monitoring of this illness imperative not only by the patients Family Doctor and Psychologist, but also by the Occupational physician, targeting the improvement of the quality of life of the healthcare professionals in their occupational activity. This clinical case’s purpose is to address and raise awareness among professionals to the prevention of Burnout, particularly in Residents, promoting quinquennial prevention. It is important to note that only professionals who are fulfilled in their biopsychosocial sphere can provide quality care and significantly reduce medical errors.

RESUMO Introdução: O Burnout resulta da exposição crónica ao stress laboral e caracteriza-se por redução da eficácia a nível profissional, sentimentos de falta de energia/exaustão e negatividade relacionados com a atividade laboral. Tem maior incidência em profissões de elevado contacto com pessoas e em prestadores de cuidados, tornando os médicos uma população vulnerável. O questionário Maslach Burnout Inventory é considerado gold standard para a medição desta patologia. Em 2014 foi descrita a prevenção quinquenária, que pretende evitar o dano para o paciente, atuando no médico através de estratégias que visem a diminuição do Burnout. Caso Clínico: Descreve-se uma mulher de 29 anos, médica, no último ano da especialização em Medicina Geral e Familiar, que recorreu a consulta aberta por sensação de exaustão física e mental, sentimentos de desesperança, irritabilidade, insónia inicial e intermédia, com três meses de evolução e hiperfagia há dois meses. Solicitou certificado de incapacidade temporária para o trabalho, porque “já não aguento mais trabalhar. Preciso de dormir uma semana”. Aponta como principal etiologia o trabalho excessivo no Centro de Saúde, decorrente da exigência do internato médico. Sente-se pouco apoiada pelos colegas de equipa e orientador de formação e considera-se pressionada a gerir a agenda médica sem ter preparação para tal. Relata erros pontuais na prescrição médica, pelo que sente necessidade de rever várias vezes os registos efetuados e as atitudes tomadas. Nega ter sido convocada para qualquer consulta de Medicina do Trabalho desde que ingressou na especialidade. Ao exame objetivo, apresentava-se cabisbaixa, com humor deprimido, chorosa, inquieta e com contacto ocular fugaz. Aplicando o questionário atrás mencionado: Secção A - 34 pontos - nível elevado; Secção B - 28 pontos - nível elevado; Secção C - 25 pontos - nível elevado. Foi emitido o certificado de incapacidade temporária para o trabalho, solicitado estudo analítico e iniciada fluoxetina 20mg e trazodona 50mg, bem como psicoterapia. Até à data, a doente foi reavaliada em três consultas, foi excluída patologia orgânica e na última reavaliação apresentava os seguintes valores: Secção A- 20 pontos- nível moderado; Secção B- 5 pontos- nível baixo; Secção C- 39 pontos- nível moderado. Refere diminuição dos erros médicos. Manteve a medicação instituída, bem como a psicoterapia. Recusou o grupo Balint. Foi programada nova reavaliação em seis meses. Discussão/Conclusão: Trata-se de uma doente, Médica Interna em Medicina Geral e Familiar com o diagnóstico de Burnout, que conseguiu melhorar substancialmente a sua qualidade de vida e satisfação no trabalho e vida pessoal, após a implementação de medidas farmacológicas e não farmacológicas e também após alterações a nível laboral e imposição de limites. Conseguiu diminuir a perceção de erro médico, melhorando assim os cuidados de saúde prestados aos utentes. O longo percurso de recuperação desta doença torna fulcral o acompanhamento destes utentes pela equipa de Medicina do Trabalho, e não só pelo Médico de Família e Psicólogo, visando melhorar a qualidade de vida e saúde dos profissionais no âmbito da sua atividade laboral. Com este caso clínico pretende-se abordar e sensibilizar os profissionais para a prevenção do Burnout, em particular nos médicos internos, fomentando a prevenção quinquenária. De ressalvar que apenas profissionais realizados na sua esfera biopsicossocial conseguem proporcionar cuidados de qualidade e reduzir de forma importante o erro médico.

ABSTRACT Introduction: the postgraduate educational climate (CE) in the hospital environment can determine the way in which resident physicians (MRs) adapt to their new stage, during which professional burnout syndrome (PAS) is highly likely to occur at some point. Objective: to determine the relationship between the educational climate and professional burnout in physicians in the medical residency programs of the National Hospital 2023-2024. Methodology: cross-sectional observational study of a sample of MR convenience of both sexes from all medical specialties of the National Hospital between November 2023 and January 2024, MR with external rotation and/or vacations were excluded. Sample calculation; 136 MR. An online form from Google was sent to the MR email requesting voluntary participation. The SAP was measured with the standard Maslach Burnout Inventory (MBI) method with subscales; emotional exhaustion (EA), depersonalization (DESP), personal fulfillment (PR), with PAS with high scores of AE, DESP and low RP. The EC was assessed with the measure of the hospital postgraduate educational environment (PHEEM) with subscales; perception of role autonomy (PAR), perception of teaching (PE), perception of social support (PSS), the higher the score, the better the EC. Demographic and academic variables, MBI and PHEEM scores were collected, and the SAP was considered dependent, as the main result was the predictive relationship of the PHEEM on the SAP. Data were compared with χ², t-test or Mann-Whitney U, ANOVA and linear regression (p-significant value =<0.05). Results: of 233 participants, the mean age was 28.75 (±2.20), 63.94 % (149) women, the general prevalence of PAS; 70.38 % (164/233), PAS in men 75 % (63/84) and women 67.78 % (101/149) p=0.0014, the first 2 years with the highest frequency of PAS; 65 (85.52 %), 59 (86.76 %) respectively p=0.0009, 63 (90 %) p=0.0071 surgical specialties. The subscales of the MBI, the AE; 79.82 % (186) with an average of 35.39 (± 11.61) points. The CE of MRs with SAP; 107.9 (19.6) dots and without PAS; 136.3 (12.1) dots 95 % CI 18.1-25.0 p= 0.0001. The PHEEM predicted the AE with R2=0.619, B= -0.18 (±0.009) p=0.001, and the DESP; R2= 0.385, B= -0.001(0.004) p=0.009, PSS being a significant predictor with inverse correlation in both. Conclusion: there is an inverse relationship between the educational climate and burnout syndrome in the population studied, with a high prevalence of burnout in male residents of surgical specialties, with the social support of the hospital educational environment being a significant predictor for the development of burnout syndrome.

RESUMEN Introducción: el clima educacional (CE) de posgrado en el ambiente hospitalario puede determinar la manera en como los médicos residentes (MR) se adaptan a su nueva etapa, durante el cual el sindrome agotamiento profesional (SAP) es altamente probable de producirse en algún momento. Objetivo: determinar la relación entre el clima educacional y el agotamiento profesional en médicos de los programas de residencias médicas del Hospital Nacional 2023-2024. Metodología: estudio observacional transversal de una muestra por conveniencia de MR de ambos sexos de todas las especialidades médicas del Hospital Nacional entre noviembre 2023 y enero 2024, se excluyeron MR con rotación externa y/o vacaciones. Calculo muestral; 136 MR. Se envío un formulario en línea de Google al correo electrónico del MR solicitando la participación voluntaria. El SAP fue medido con el método estándar Maslach Burnout Inventory (MBI) con subescalas; agotamiento emocional (AE), despersonalización (DESP), realización personal (RP), existiendo SAP con puntuaciones altas de AE, DESP y bajas de RP. El CE fue valorado con la medida del entorno educativo de posgrado hospitalario (PHEEM) con subescalas; percepción autonomía de roles (PAR), percepción enseñanza (PE), percepción soporte social (PSS), a mayor puntaje mejor CE. Se recopiló variables demográficos, académicos, puntajes del MBI y PHEEM, el SAP fue considerado dependiente, como resultado principal la relación predictiva del PHEEM sobre el SAP. Se compararon datos con χ², prueba t o U de Mann-Whitney, ANOVA y regresión lineal (p-valor significativo =<0,05). Resultados: de 233 participantes, la edad media fue de 28,75 (± 2,20), el 63,94 % (149) mujeres, la prevalencia general del SAP; 70,38 % (164/233), SAP en hombres 75 % (63/84) y mujeres 67,78 % (101/149) p=0,0014, los 2 primeros años con mayor frecuencia de SAP; 65 (85,52 %), 59 (86,76 %) repectivamente p=0,0009, de especialidades quirúrgicas 63 (90 %) p=0,0071. Las subescalas del MBI el AE;79,82 % (186) con un promedio de 35,39 (± 11,61) puntos. El PHEEM de los MR con SAP; 107,9(( 19,6) puntos y sin SAP; 136,3(( 12,1) puntos IC 95 % 18,1-25,0 p= 0,0001. El PHEEM predijo el AE con R2=0,619, PPS; B= -0,18 (±0,009) p=0,001, y la DESP; R2= 0,385, PPS; B= -0,001 (±0,004) p=0,009 siendo PSS predictor significativo con correlación inversa en ambas. Conclusión: existe relación inversa entre el clima educativo y el sindrome de agotamiento profesional en la población estudiada, con alta prevalencia de este en residentes hombres de especialidades quirúrgicas, siendo el soporte social del ambiente educativo hospitalario un predictor significativo para el desarrollo del sindrome de agotamiento profesional.

Abstract Introduction: Nursing staffing in adult intensive care has been at a ratio of two patients per nurse or one patient for one nurse. Currently, patients require complex and specialized care that provides safety and reduces Healthcare-Associated Infections. Objective: Evidencing the importance of equipping nursing personnel according to the severity of the patient compared to the nurse-patient ratio in order to reduce Healthcare-Associated Infections in patients in the adult intensive care unit. Methodology: This is a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, conducted from September 2021 to March 2022. The databases PubMed, ScienceDirect, Epistemonikos and CUIDEN were used, and the following terms were utilized, i.e., nursing personnel, patient severity, nurse-patient ratio, healthcare-associated infections, and the Boolean operators AND, OR, and WITH. The sample consisted of 8 studies that were assessed using the Critical Reading Cards (FLC 3.0) and graded according to the National Institute for Health and Care Excellence. Results: Staffing according to patient severity compared to the nurse-patient indicator reduced healthcare-associated infections, mortality, sepsis occurrence, and medication errors. The impact on patients and nursing personnel showed improved quality of care and reduced burnout and work stress, which benefited the patient. Conclusion: It is important to provide nursing personnel according to the severity of the patient and with personnel having an academic level of at least a bachelor's degree in order to improve the quality of care and reduce healthcare-associated infections.

Abstrato Introdução: A equipe de enfermagem na terapia intensiva de adultos tem estado em uma proporção de dois pacientes para um enfermeiro ou um paciente para um enfermeiro. Atualmente, os pacientes que chegam exigem cuidados complexos e especializados que ofereçam segurança e reduzam as infecções associadas à assistência à saúde. Objetivo: Demonstrar a importância do dimensionamento do pessoal de enfermagem de acordo com a gravidade do paciente em comparação com o indicador enfermeiro-paciente, para reduzir as infecções associadas à assistência à saúde em pacientes adultos internados em unidades de terapia intensiva. Metodologia: Revisão sistemática com base nas diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analyses, realizada entre setembro de 2021 e março de 2022, mediante os bancos de dados PubMed, ScienceDirect, Epistemonikos e CUIDEN, e usando os seguintes termos: pessoal de enfermagem, gravidade do paciente, relação enfermeiro-paciente, infecções associadas à assistência à saúde, operadores AND, OR, WITH. A amostra consistiu em 8 estudos, avaliados usando os programas Critical Reading Card e classificados de acordo com o Instituto Nacional de Excelência em Saúde e Cuidados. Resultados: O dimensionamento de profissionais de acordo com a gravidade do paciente, em comparação com o indicador enfermeiro-paciente, reduziu as infecções associadas à assistência à saúde, mortalidade, ocorrência de sepse e erros de medicação. O impacto sobre os pacientes e o pessoal de enfermagem mostrou uma melhor qualidade de atendimento, redução do esgotamento e do estresse no trabalho, o que beneficiou o paciente. Conclusão: É importante fornecer pessoal de enfermagem de acordo com a gravidade do paciente e com pessoal com nível acadêmico de, no mínimo, bacharelado, a fim de melhorar a qualidade do atendimento e reduzir as infecções associadas à assistência à saúde.

Resumen Introducción: Dotar al personal de enfermería en la terapia intensiva adultos ha sido en proporción dos pacientes por enfermera o 1:1. Actualmente, los pacientes que ingresan requieren cuidados complejos y especializados que proporcionen seguridad y disminución de infecciones asociadas a la atención en salud. Objetivo: Evidenciar la importancia de dotar al personal de enfermería según gravedad del paciente comparado con indicador enfermera-paciente para disminuir infecciones asociadas a la atención en salud en pacientes de la unidad de terapia intensiva adultos. Metodología: Revisión sistemática, basada en la declaración Preferred Reporting Items for Sistematyc Reviews and Meta-analyses, realizada en septiembre 2021 a marzo 2022, se utilizaron las bases de datos PubMed, ScienceDirect, Epistemonikos y CUIDEN, empleando términos: personal de enfermería, gravedad del paciente, relación enfermero-paciente, infecciones asociadas a la atención a la salud, operadores boléanos AND, OR, WITH. La muestra fue de 8 estudios, evaluados mediante los programas de Fichas de Lectura Crítica y gradados según el National Institute for Health and Care Excellence. Resultados: Dotar de personal según gravedad del paciente comparado con indicador enfermera-paciente disminuyó infecciones asociadas a la atención en salud, mortalidad, aparición de sepsis y errores en la medicación. Las repercusiones en pacientes y personal de enfermería mostraron mejor calidad de la atención, disminución de agotamiento y estrés laboral lo que benefició al paciente. Conclusión: Es importante dotar al personal de enfermería según gravedad del paciente, con personal de nivel académico licenciatura para mejorar la calidad de atención y disminuir las infecciones asociadas a la atención en salud.

Abstract Research that goals to recognize and evaluate the behaviors of Syndrome of teachers from the Industrial Engineering department of a Higher Education Institution. The problem was identified that there were no prior evaluations to identify opportunities for improvement in mental health and the work environment of the teaching staff. A questionnaire based on Maslach, et. al; (1986) and Seisdedos, (1997), which is designed with 22 items, for the Burnout syndrome variable, which measures 3 sub variables: emotional exhaustion (9 items), depersonalization (5 items) and personal fulfillment (8 items), which They respond to a six-point Likert-type scale. The study was quantitative of a descriptive cross-sectional type (Hernández, et. al; 2010). For application to a sample of n=31 teachers. It was found that the subscale with the lowest value is: Personal fulfillment (37.35) and the behaviors with the highest priority to address are: I deal very well with the problems that my students present to me = 4.03 (Maslach, et. al; 1986), I can easily understand what my students think = 4.23 (Maslach, et. al; 1986) and I find myself with a lot of vitality = 4.55 (Maslach, et. al; 1986). The institution will carry out an analysis of the behaviors and causes to prevent and a proposal for the improvement of the studied indices.

Resumen Investigación con el objetivo de identificar y valorar los comportamientos del Síndrome en docentes de Ingeniería Industrial (departamento) de una Institución de Enseñanza Superior. Se identificó el problema de que no existían evaluaciones previas para identificar oportunidades de mejora en la salud mental y el ambiente laboral de la plantilla docente. Se aplicó un cuestionario basado en Maslach, et. al; (1986) y Seisdedos, (1997) que está diseñado con 22 ítems, para la variable síndrome de Burnout, que mide 3 subvariables: agotamiento emocional (9 ítems), despersonalización (5 ítems) y Realización personal (8 ítems), los cuales responden a una escala tipo Likert de seis puntos. El estudio fue cuantitativo de tipo descriptivo transversal (Hernández, et. al; 2010). Para la aplicación a una muestra de n=31 docentes. Se encontró que la subescala con menor valor es: Realización personal (37.35) y los comportamientos con más prioridad a atender son: Me enfrento muy bien con los problemas que me presentan mis alumnos = 4.03 (Maslach, et. al; 1986), Puedo entender con facilidad lo que piensan mis alumnos = 4.23 (Maslach, et. al; 1986) y Me encuentro con mucha vitalidad = 4.55 (Maslach, et. al; 1986). La institución realizará un análisis de los comportamientos y causas para prevenir y una propuesta para la mejora de los índices estudiados.

RESUMEN El contexto de pandemia ha evidenciado dificultades en la salud física y mental, donde han emergido emociones como la angustia, ansiedad, miedo e irritabilidad. A partir de este escenario, se considera importante analizar la experiencia de padres y madres desde la perspectiva del burnout parental, ya que se han evidenciado cambios abruptos en la dinámica familiar que representaron un importante y vertiginoso desafío de adaptación. Debido a que se carece de estudios con aproximaciones cualitativas que describan las experiencias en este ámbito, el objetivo del estudio es describir la experiencia de padres y madres desde la perspectiva del burnout parental en contexto de pandemia por COVID-19 en la región del Biobío, Chile. Se utiliza una metodología cualitativa, orientada desde un diseño fenomenológico. Los participantes fueron tres madres y tres padres chilenos, entre 20 y 50 años. Se utiliza la entrevista semi-estructurada para recolectar la información y el análisis de contenido temático para la construcción de categorías. Los resultados muestran que los padres y madres perciben un agotamiento asociado a un desajuste entre las demandas relacionadas con la crianza de los hijos, incluidas las expectativas de sí mismos y sus responsabilidades, y la disponibilidad de recursos para satisfacer esas demandas y expectativas. Se concluye una experiencia parental basada en sentimientos desadaptativos como el agobio y adaptativos como la cercanía parental, además de un carácter mayoritariamente íntimo en las actividades familiares, sociales y de ocio.

ABSTRACT The context of the pandemic has evidenced difficulties in physical and mental health, where emotions such as anguish, anxiety, fear, and irritability have emerged. Based on this scenario, it is considered important to analyze the experience of fathers and mothers from the perspective of parental burnout, since abrupt changes in family dynamics have been evidenced, which represented an important and dizzying adaptation challenge. Due to the lack of studies with qualitative approaches that describe the experiences in this area, the aim of the study is to describe the experience of fathers and mothers from the perspective of parental burnout in the context of the COVID-19 pandemic in the Biobío Region, Chile. A qualitative methodology is used, oriented from a phenomenological design. The participants were three Chilean mothers and three fathers, between 20 and 50 years old. The semi-structured interview is used to collect the information and the thematic content analysis for the construction of categories. The results show that fathers and mothers perceive exhaustion associated with a mismatch between the demands related to raising children, including expectations of themselves and their responsibilities, and the availability of resources to meet those demands and expectations. A parental experience based on maladaptive feelings such as overwhelm and adaptive feelings such as parental closeness is concluded, as well as a most intimate character in family, social, and leisure activities.

Abstract: This study had the general objective of verifying the relationship between burnout syndrome, social skills, coping strategies, and socio-occupational variables in a sample of 166 elementary school teachers from 13 public schools of Minas Gerais, Brazil, aged between 23 and 65 years, 73 % of whom were female. The Burnout Syndrome Inventory (ISB), the Social Skills Inventory 2 (IHS-2), the Coping Strategies Inventory (IEC), and a socio-occupational questionnaire developed especially for this research were used. A negative correlation was obtained between burnout and repertoire of social skills (r = -.273 and p < .001). The coping strategies that positively correlated with social skills were seeking social support, problem solving, and positive reappraisal. Furthermore, there was a positive correlation between coping and professional fulfillment, indicating that teachers who adopted coping strategies were more likely to feel professionally satisfied. The burnout predictor variables were age, marital status, family provision, number of children, length of service, ongoing health care and social resourcefulness. The implications of these results were discussed concerning protective actions for the mental health of teachers and the importance of socio-emotional development in schools.

Resumen: Este estudio tuvo como objetivo general verificar la relación entre el síndrome de burnout, las habilidades sociales, el afrontamiento y las variables sociolaborales en una muestra de 166 profesores de educación básica de 13 escuelas públicas del interior de Minas Gerais, Brasil, con edades entre 23 y 65 años, el 73 % de los cuales son mujeres. Se utilizó el Inventario de Síndrome de Burnout (ISB), el Inventario de Habilidades Sociales 2 (IHS-2), el Inventario de Estrategias de Afrontamiento (IEC) y un cuestionario sociolaboral desarrollado especialmente para esta investigación. Se obtuvo una correlación negativa entre el burnout y el repertorio de habilidades sociales (r = -.273 y p = .001). Las estrategias de afrontamiento que se correlacionaron positivamente con las habilidades sociales fueron: búsqueda de apoyo social, resolución de problemas y reevaluación positiva. Además, hubo una correlación positiva entre el afrontamiento y la realización profesional, lo que indica que los profesores que adoptaron estrategias de afrontamiento tenían más probabilidades de sentirse realizados profesionalmente. Las variables predictoras del agotamiento fueron la edad, el estado civil, la provisión familiar, el número de hijos, el tiempo de servicio, la atención médica continua y la desenvoltura social. Se discuten las implicaciones de estos resultados respecto de las acciones protectoras para la salud mental de los docentes y la relevancia del desarrollo socioemocional en las escuelas.

Resumo: Este estudo teve como objetivo geral verificar a relação entre síndrome de burnout, habilidades sociais, coping e variáveis sócio-ocupacionais em uma amostra de 166 professores do ensino fundamental de 13 escolas públicas do interior de Minas Gerais, Brasil, com idades entre 23 e 65 anos, sendo 73 % do sexo feminino. Foram utilizados o Inventário da Síndrome de Burnout (ISB), o Inventário de Habilidades Sociais 2 (IHS-2), o Inventário de Estratégias de Coping (IEC) e um questionário sócio-ocupacional desenvolvido especialmente para esta pesquisa. Obteve-se correlação negativa entre o burnout e o repertório de habilidades sociais (r = -0,273 e p < 0,01). As estratégias de coping que se correlacionaram positivamente com as habilidades sociais foram: busca de suporte social, resolução de problemas e reavaliação positiva. Ademais, houve correlação positiva entre coping e realização profissional, indicando que professores que adotaram estratégias de enfrentamento apresentaram maior tendência a sentirem-se realizados profissionalmente. As variáveis preditoras do burnout foram idade, estado civil, provimento familiar, número de filhos, tempo de serviço, tratamento contínuo de saúde e desenvoltura social. Discutiu-se a implicação desses resultados no tocante às ações protetivas de saúde mental docente e quanto à relevância do desenvolvimento socioemocional nas escolas.

Abstract Introduction: Nursing, as a science and discipline, faces the challenge of missed care and omissions that affect the safety and quality of care. Objective: to analyze the scientific evidence related to missed care in nursing, highlighting its impact on safety and quality of care. Methodology: A systematic review of articles was conducted between 2018 and 2023, with a descriptive design, following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) flowchart. The study was conducted between September and December 2023, collecting articles related to lost care in nursing from open-access indexed journals in the following repositories: Scielo, Redalyc, PubMed, Wos, Scopus, and CINAHL. Selection and exclusion criteria were applied, and original qualitative and quantitative articles were chosen with a maximum validity of 6 years. The review focused on literature in English, Spanish, and Portuguese. Ethical standards were rigorously respected, guaranteeing confidentiality and treating sensitive information ethically. Results: 7 articles were included, which revealed disparities in lost care between public and private hospitals, highlighting the gap in resources, in addition to emphasizing the relationship between lost care and professional burnout, omissions in primary nursing care such as handwashing, along with the importance of planning care through the nursing process, to ensure compliance and recording of this care. Conclusion s: Strategies such as humanizing care, developing plans for resource scarcity, and maintaining an adequate nurse-patient relationship are essential to address the issue of lost care.

Resumen Introducción: la enfermería, como ciencia y disciplina, se enfrenta al desafío de los cuidados perdidos y omisiones que afectan la seguridad y calidad de la atención. Objetivo: analizar las evidencias científicas relacionadas con los cuidados perdidos en enfermería, destacando su impacto en la seguridad y calidad asistencial. Metodología: se realizó una revisión sistemática de artículos entre 2018-2023, con diseño descriptivo, siguiendo el flujograma Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). El estudio se llevó a cabo entre septiembre y diciembre de 2023, recopilando artículos de revistas indexadas de acceso abierto en; Scielo, Redalyc, PubMed, Wos, Scopus y CINAHL, relacionados con los cuidados perdidos en enfermería. Se aplicaron criterios de selección y exclusión, eligiendo artículos originales cualitativos y cuantitativos con una vigencia máxima de 6 años. La revisión se centró en literatura en inglés, español y portugués. Se respetaron rigurosamente las normas éticas, garantizando la confidencialidad y tratando éticamente la información sensible. Resultados: se incluyeron 7 artículos, los que revelaron disparidades en el cuidado perdido entre hospitales públicos y privados, resaltando la brecha en recursos, además de enfatizar en la relación entre el cuidado perdido y el agotamiento profesional, omisiones en cuidados básicos de enfermería como el lavado de manos, junto con la importancia de planificar el cuidado mediante el proceso de enfermería, a fin de garantizar su complimiento y registro de este cuidado. Conclusiones: estrategias como la humanización de la atención, desarrollo de planes ante escasez de recursos y mantener una adecuada relación enfermero-paciente, son esenciales para enfrentar los inconvenientes que representan los cuidados perdidos.

INTRODUCTION: Ethical tensions are routinely encountered by occupational therapists and students in fieldwork and may impact patient care and team morale, and lead to practitioner burnout. Ethics education is a means to reduce ethical tensions in fieldwork. Despite this, however, limited research exists regarding ethical tensions and ethics education amongst students in the South African context. METHODS: The study was conducted to explore South African occupational therapy students' reflections on ethical tensions experienced in fieldwork practice. A qualitative, descriptive design was used to review thirty-five ethics reflective journals by fourth-year occupational therapy students at a university in South Africa. Students identified ethical tensions, reflected on these using Sokol's decision-making framework and Kolb's Cycle of Experiential Learning, and incorporated their learning into practice. Data were analysed thematically. Trustworthiness was ensured through triangulation of researchers, multiple data sources, and an audit trail. FINDINGS: Three central themes emerged: (1) Ethics from the perspective of the student, (2) Ethical tensions experienced during fieldwork, and (3) How students navigated ethical tensions. CONCLUSION: This study provides an insight into the ethical tensions and reflections of fourth-year occupational therapy students during fieldwork. Findings inform healthcare educators and clinicians regarding students' perceptions about ethics education and the tensions experienced during fieldwork. IMPLICATIONS FOR PRACTICE • Students experienced ethical tensions during fieldwork and navigated these ethical tensions by following institutional procedures, acquiring knowledge through research, drawing from the "well" of experience, and reflective practice. • The study offers a narrative for encountering and resolving ethical tension during fieldwork. • The main distinction between the two classifications persists when reviewing the support given to the participant who has been empowered to resolve the ethical tension whilst receiving consultation from their site clinician and the institution. Findings inform healthcare educators and clinicians regarding students' perceptions about ethics education and the tensions experienced during fieldwork.

Abstract The study was proposed due to the perception of the scarcity of studies on the correlation between burnout, coping and social support. Thus, the present study aimed to verify the prevalence of academic burnout and its correlations with coping strategies and social support in students of health courses. The sample consisted of 173 participants, ages between 18 and 30 years (M = 23.71; SD = 7.04). For data collection we used: Sociodemographic questionnaire, Maslach Burnout Inventory for students (MBI-SS), Brief COPE (coping inventory) and Social Support Satisfaction Scale for higher education students (SSSS). The results revealed correlations between the dimensions of emotional exhaustion and cynicism, with family support satisfaction [F (3. 201752) = 9184.986, p < .001; r2 = .12] and F (3.168) = 8.473, p < .001; r2 = .131]. Referring to the correlations between coping strategies with the other study variables, the sample most frequently used emotion-focused coping in the strategies of Self-blaming (r = .290, p<.001); Substance Use (r = .241, p<.01); Instrumental Support (r = .206, p<.01) and Positive Reinterpretation (r =.197, p<.01).

Resumen El estudio fue propuesto debido a la percepción de la escasez de estudios sobre la correlación entre burnout, afrontamiento y apoyo social. Así, el presente estudio tuvo como objetivo verificar la prevalencia de burnout académico y sus posibles correlaciones con estrategias de afrontamiento y apoyo social en estudiantes de cursos de salud. La muestra estuvo constituida por 173 participantes, con edades comprendidas entre 18 y 30 años (M = 23,71; DE = 7,04). Para la recogida de datos se utilizaron: Cuestionario sociodemográfico, Inventario de Burnout de Maslach para estudiantes (MBI-SS), COPE breve (inventario de afrontamiento) y Escala de satisfacción con el apoyo social para estudiantes de enseñanza superior (SSSS). Los resultados revelaron correlaciones entre las dimensiones de agotamiento emocional y cinismo, con la satisfacción de apoyo familiar [F (3. 201752) = 9184,986, p < .001; r2 = .12] y F (3.168) = 8,473, p < .001; r2 = .131]. En cuanto a las correlaciones entre las estrategias de afrontamiento con el resto de las variables del estudio, la muestra utilizó con mayor frecuencia el afrontamiento centrado en la emoción en las estrategias de Autoculpabilización (r = .290, p< .001); Consumo de Sustancias (r = .241, p< .01); Apoyo Instrumental (r = .206, p< .01) y Reinterpretación Positiva (r = .197, p< .01).

Abstract In an increasingly dynamic and complex world, the professional figure of teachers who show commitment to their work acquires fundamental importance in quality education. In this sense, this research aims to analyze burnout syndrome as a predictor of work commitment in teachers of private universities in the city of Chiclayo, Peru, in a context of mitigation of the COVID-19 pandemic. This is an empirical study of cross-sectional predictive design. The final sample included 100 undergraduate teachers, of both sexes, whose ages ranged from 35 to 60 years (M=46.63; SD=9.90). The instruments applied were the Burnout Syndrome Scale version for teachers and the Utrecht Work Engagement Scale, virtualized in Google Forms. The data collected were subjected to simple regression analysis, also reporting effect size indices and statistical power, to ensure greater scope and precision in the results. Low levels of burnout syndrome and high levels of work engagement were reported; moreover, burnout syndrome negatively and significantly predicted work engagement and its dimensions of vigor and dedication; not so for absorption. Therefore, the reported findings suggest that burnout syndrome can predict work engagement and its factors, except for absorption, in teachers of private universities in Chiclayo. The limitations and practical implications of the study are discussed.

Resumen En un mundo cada vez más dinámico y complejo, la figura profesional docente que muestra compromiso con su quehacer adquiere fundamental importancia en una educación de calidad. En ese sentido, esta investigación tiene como objetivo analizar el síndrome del quemado como predictor del compromiso laboral en docentes de universidades privadas de la ciudad de Chiclayo, Perú, en un contexto de mitigación de la pandemia por COVID- 19. Se trata de un estudio empírico de diseño predictivo transversal. La muestra final incluyó 100 docentes de pregrado, de ambos sexos, cuyas edades oscilaban entre los 35 y 60 años (M=46.63; DE=9.90). Los instrumentos aplicados fueron la Escala de Síndrome de Burnout versión para docentes y la Escala Utrecht de Engagement Laboral, virtualizados en Google Forms. Los datos recopilados se sometieron a análisis de regresión simple, reportando también índices de tamaño de efecto y potencia estadística, para garantizar un mayor alcance y precisión en los resultados. Se reportaron niveles bajos de síndrome del quemado y altos de compromiso laboral, además, el síndrome del quemado predijo de manera negativa y significativa el compromiso laboral y sus dimensiones de vigor y dedicación; no así para absorción. Por tanto, lo reportado sugiere que el síndrome del quemado puede predecir al compromiso laboral y sus factores, salvo la absorción, en docentes de universidades privadas de Chiclayo. Se discuten las limitaciones e implicancias prácticas del estudio.

Resumen El objetivo de este estudio es analizar el impacto del miedo al Covid-19, estrés laboral, agotamiento y cinismo en la intención de abandono en trabajadores de los sectores industrial, comercial y de servicios, en la frontera mexicana. Se utilizó como método una investigación cuantitativa no experimental, con una muestra por conveniencia de 328 empleados. Las relaciones entre constructos se probaron utilizando modelos de mínimos cuadrados parciales (PLS). Los resultados indican que el miedo al Covid-19, el estrés laboral, el agotamiento y el cinismo afectan positivamente a la intención de abandono. Los hallazgos son relevantes al señalar que el modelo explica de forma débil al estrés (0.134), de forma moderada al cinismo (0.446) y a la intención de abandono (0.396) y de forma entre moderada y sustancial al agotamiento (0.561). Esta investigación es original al contribuir al conocimiento de la salud ocupacional, al considerar nuevos factores que influyen en la intención de abandono laboral, durante eventos como la pandemia Covid-19. Se tiene la limitante de que la recolección de datos se realizó a través de una encuesta en línea, existe un posible sesgo de selección debido al muestreo no probabilístico.

Abstract The objective of this study is to analyze the impact of fear of Covid-19, job stress, burnout and cynicism on the intention to quit in workers in the industrial, commercial and service sectors in the Mexican border. A non-experimental quantitative research method was used, with a convenience sample of 328 employees. Relationships between constructs were tested using partial least squares (PLS) models. The results indicate that fear of Covid-19, job stress, burnout and cynicism positively affect quit intention. The findings are relevant in that the model weakly explains stress (0.134), moderately explains cynicism (0.446) and intention to quit (0.396), and moderately to substantially explains burnout (0.561). This research is original in contributing to the knowledge of occupational health by considering new factors that influence quitting intention during events such as the Covid-19 pandemic. It is limited by the fact that the data collection was done through an online survey, there is a possible selection bias due to non-probabilistic sampling.

Abstract The objective of this research was to analyze the impact of teleworking on the work stress of university teachers due to the covid-19 pandemic, it also sought to establish the relationship between work exhaustion and work stress. A quantitative, descriptive and correlational methodology was used. The research design was non-experimental in a cross-sectional way, since data was only collected during the confinement period, in the months of August and September 2021. The study population was the teachers of the Universidad Autónoma del Estado de México. The results reveal that teleworking due to the covid-19 pandemic caused a mild level of job stress and a medium level of job burnout in a majority of university professors. The main symptoms associated with work stress that teachers manifested were gastrointestinal discomfort and headaches. In addition, female teachers presented higher levels of stress, compared to men. However, according to the results job stress correlates significantly, positively and highly with job burnout.

Resumo O objetivo desta investigação foi analisar o impacto do teletrabalho no stress laboral dos docentes universitários devido à pandemia de covid-19, procurou também estabelecer a relação entre o esgotamento laboral e o stress laboral. Foi utilizada uma metodologia quantitativa, descritiva e correlacional. O desenho da pesquisa foi não experimental de forma transversal, pois os dados foram coletados apenas durante o período de confinamento, nos meses de agosto e setembro de 2021. A população do estudo foram os professores da Universidad Autónoma del Estado de México. Os resultados revelam que o teletrabalho devido à pandemia de covid-19 provocou um nível ligeiro de stress laboral e um nível médio de burnout laboral na maioria dos docentes universitários. Os principais sintomas associados ao estresse laboral que os professores manifestaram foram desconforto gastrointestinal e dores de cabeça. Além disso, as professoras apresentaram maiores níveis de estresse, em comparação aos homens. No entanto, de acordo com os resultados, o estresse no trabalho se correlaciona significativamente, positivamente e altamente com o esgotamento profissional.

Resumen La presente investigación tuvo como objetivo analizar el impacto del teletrabajo en el estrés laboral de los docentes universitarios por la pandemia del covid-19, así como establecer la relación entre agotamiento laboral y estrés laboral. Para ello, se utilizó una metodología cuantitativa, de tipo descriptiva y correlacional. El diseño de investigación fue no experimental de forma transversal debido a que solo se recolectaron datos durante el periodo de confinamiento, en los meses de agosto y septiembre de 2021. La población de estudio fueron los docentes de la Universidad Autónoma del Estado de México. Los resultados revelan que el teletrabajo a causa de la pandemia del covid-19 provocó en una proporción mayoritaria de docentes universitarios un nivel leve de estrés laboral y un nivel medio de agotamiento laboral. Los principales síntomas asociados al estrés laboral que manifestaron los docentes fueron molestias gastrointestinales y dolores de cabeza. Además, las mujeres docentes presentaron mayores niveles de estrés, en comparación con los hombres. En definitiva, según los resultados, el estrés laboral se correlaciona de forma significativa, positiva y alta con el agotamiento laboral.

Abstract One of the measures taken by governments to preserve people's health during the Covid 19 pandemic was physical distancing. In this context, universities went from face-to-face classes to online classes, which caused an uncertain outlook for students. students. The objective of this research was to identify the proportion of students who presented burnout syndrome during online classes taught during the pandemic in a population of university students from various areas of knowledge at a public university located in Tabasco, Mexico. The research was quantitative, descriptive, with a non-experimental cross-sectional design; For data collection, a questionnaire prepared in Google Forms was applied to 268 students who responded voluntarily. For the validity of the instrument, an exploratory factorial analysis was applied and for reliability the Cronbach's Alpha coefficient was used, which reported α = 0.950. The results indicated that more than half of the students presented low personal fulfillment, exhaustion and depersonalization. It is concluded that these data represent an alert in the population studied, so it is necessary to carry out actions aimed at reducing burnout in students and carry out other investigations on the return of face-to-face classes to determine the presence of burnout in this context.

Resumo Uma das medidas tomadas pelos governos para preservar a saúde das pessoas durante a pandemia da Covid 19 foi o distanciamento físico. O objetivo desta pesquisa foi identificar a proporção de alunos que apresentaram a síndrome de burnout durante as aulas online ministradas durante a pandemia em uma população de universitários de diversas áreas do conhecimento de uma universidade pública localizada em Tabasco, México. A pesquisa foi quantitativa, descritiva, com delineamento transversal não experimental; Para coleta de dados, foi aplicado um questionário elaborado no Google Forms a 268 alunos que responderam voluntariamente. Para a validade do instrumento foi aplicada a análise fatorial exploratória e para a confiabilidade foi utilizado o coeficiente Alpha de Cronbach, que reportou α = 0,950. Os resultados indicaram que mais da metade dos alunos apresentou baixa realização pessoal, exaustão e despersonalização. Conclui-se que esses dados representam um alerta na população estudada, por isso é necessário realizar ações que visem diminuir o burnout nos alunos e realizar outras investigações sobre o retorno das aulas presenciais para determinar a presença de burnout em este contexto.

Resumen Una de las medidas adoptadas por los gobiernos para preservar la salud de las personas durante la pandemia por covid-19 fue la implementación del distanciamiento físico. Esto obligó a las universidades a transitar de las clases presenciales a las clases en línea, lo que generó un panorama incierto para los estudiantes. Por ende, el propósito de esta investigación fue identificar la proporción de estudiantes que experimentaron el síndrome de burnout durante las clases en línea impartidas durante la pandemia. Para ello, el estudio se enfocó en una población de estudiantes universitarios de diversas áreas del conocimiento en una universidad pública ubicada en Tabasco, México. La investigación se llevó a cabo mediante un enfoque cuantitativo y descriptivo, con un diseño no experimental de tipo transversal. Para recopilar datos, se utilizó un cuestionario elaborado en Google Forms, que fue administrado de manera voluntaria a 268 estudiantes. Asimismo, se aplicó un análisis factorial exploratorio para validar el instrumento, y la confiabilidad se evaluó mediante el coeficiente alfa de Cronbach que arrojó un valor de α = 0.950. Los hallazgos indicaron que los porcentajes más altos de burnout se identificaron en las dimensiones de agotamiento y despersonalización. Esto se atribuyó a las dificultades para prestar atención durante las clases en línea, el agotamiento causado por las demandas académicas, el estrés asociado con las tareas, la falta de sueño debido al trabajo escolar y las dificultades en la comunicación con los profesores cuando surgían dudas sobre las clases. En general, los resultados señalaron que más de la mitad de los estudiantes presentaron baja realización personal, agotamiento y despersonalización. Por tanto, se concluye que estos datos representan una alerta en la población estudiada, y subrayan la necesidad de implementar medidas dirigidas a reducir el burnout en los estudiantes. Además, se sugiere realizar investigaciones adicionales al regreso de las clases presenciales para evaluar la presencia del burnout en ese contexto.

RESUMEN Introducción: el síndrome de Burnout surge como respuesta a estresores crónicos emocionales e interpersonales en el trabajo y se relaciona con consecuencias negativas a nivel personal y organizacional. Objetivo: describir el síndrome de Burnout en Especialistas del Servicio de Medicina Interna del Hospital Provincial Universitario “Arnaldo Milián Castro”. Métodos: se realizó un estudio descriptivo, transversal en el período de julio de 2022 a enero de 2023; de una población de 26 médicos fueron seleccionados, por muestreo no probabilístico e intencional, 23, 12 Especialistas en Medicina Interna, seis en Endocrinología y cinco en Reumatología. Se empleó la Encuesta de Maslach Burnout Inventory y se calcularon las prevalencias expresadas en por cientos. Resultados: la prevalencia del agotamiento emocional bajo fue del 43,5%, alto en edades entre 46 y 65 años (del 66,7 al 100%), en solteros (75%) y en Especialistas en Medicina Interna (58,3%); bajo con seis y hasta 15 años de servicio (50%). Prevaleció la despersonalización baja en 69,6% doctores; en todos los grupos de edades, en los dos sexos, en los casados, en todas las especialidades y en los que realizaban guardia. La realización personal fue alta en 56,5% y en menores de 55 años (del 55 al 75%) y baja en los demás (del 66 al 100%); alta en hombres (66,7%), casados (63,2%) y en Especialistas en Medicina Interna (58,3%) y en Reumatología (100%). Conclusiones: hay variabilidad de respuesta de los médicos en dependencia de sus características y de las dimensiones del síndrome de Burnout, de forma general menos de la mitad de los profesionales tuvieron agotamiento emocional y despersonalización altos y realización personal baja.

ABSTRACT Introduction: Burnout syndrome arises as a response to chronic emotional and interpersonal stressors at work and is related to negative consequences at a personal and organizational level. Objective: to describe Burnout syndrome in Specialists of the Internal Medicine Service of the “Arnaldo Milián Castro” Provincial University Hospital. Methods: a descriptive, cross-sectional study was carried out in the period from July 2022 to January 2023; From a population of 26 doctors, 23 were selected by non-probabilistic and intentional sampling, 12 Specialists in Internal Medicine, six in Endocrinology and five in Rheumatology. The Maslach Burnout Inventory Survey was used and prevalences expressed in percentages were calculated. Results: the prevalence of low emotional exhaustion was 43.5%, high in ages between 46 and 65 years (from 66.7 to 100%), in singles (75%) and in Internal Medicine Specialists (58. 3%); low with six and up to 15 years of service (50%). Low depersonalization prevailed in 69.6% doctors; in all age groups, in both sexes, in those who were married, in all specialties and in those who were on duty. Personal fulfillment was high in 56.5% and in those under 55 years of age (from 55 to 75%) and low in others (from 66 to 100%); high in men (66.7%), married (63.2%) and in Specialists in Internal Medicine (58.3%) and in Rheumatology (100%). Conclusions: there is variability in the response of doctors depending on their characteristics and the dimensions of Burnout syndrome; in general, less than half of the professionals had high emotional exhaustion and depersonalization and low personal accomplishment.

Resumen La pandemia del COVID-19 ha presentado desafíos sin precedentes para la educación superior y, en consecuencia, para los docentes universitarios, subrayando la imperativa necesidad de abordar el síndrome de burnout en docentes universitarios, así como desarrollar estrategias específicas para enfrentar los desafíos que plantea la pandemia del COVID-19, requiriendo investigaciones empíricas al respecto. El objetivo de la presente investigación es cuantificar el estado de manifestación y prevalencia del síndrome del desgate profesional en docentes de universidades públicas españolas durante la era pospandemia COVID-19. Se desarrolló bajo una metodología cuantitativa, con un diseño no experimental y enfoque descriptivo de corte transversal, aplicándose un muestreo no probabilístico por conveniencia. Los resultados obtenidos evidencian un alto desgaste profesional docente con un 76%, con un agotamiento emocional alto del 72%, un alto grado de despersonalización del 81%, y un bajo grado de realización personal del 78%.

Abstract The COVID-19 pandemic has posed unprecedented challenges for higher education and, consequently, for university educators. This situation has underscored the critical need to address the burnout syndrome among university teachers and to develop specific strategies to face the challenges posed by the COVID-19 pandemic, requiring empirical researches in this regard. The goal of this research is to quantify the state of manifestation and prevalence of professional burnout syndrome among teachers at Spanish public universities during the post-COVID-19 pandemic era. It was developed under a quantitative methodology, with a non-experimental design and cross-sectional descriptive approach, applying non-probabilistic convenience sampling. The results reveal a high rate of professional burnout among educators with 76%, with a high level of emotional exhaustion of 72%, a high degree of depersonalization of 81%, and a low level of personal accomplishment of 78%.