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Sindromul de epuizare (burn-out) la medici


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Rezumat

Transformrile econRPLFHVRFLDOHLFXOWXUDOHGLQXOWLPDMXPtate de secol au adus cu sine presiuni


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)UHXQGEHUJHUDSXEOLFDWSULPDGHVFULHUHWLLQLILFDDFHVWXLVLQGURPGHFGHUHSVLKLFLSVLKRORJLF
n 1974. Q&KULVWLQD0DVODFKSURIHVRUGHSVLKRORJLHDLQWURGXVGHILQLLDLPDLWkU]LXXQ
LQVWUXPHQWSHQWUXPVXUDUHDEurn-out-XOXLFDUHHVWHFHOPDLIRORVLWDVW]L0DVODFK%XUQRXW
Inventory.

Sindromul de burn-out (sau de epuizare) DIHFWHD]DWkWFDOLWDWHDDFWXOXLPHGLFDO UHODLDPHGLF-


SDFLHQWUDWDFUHVFXWDHURULORUPHGLFDOHSOHFDUHDPHGLFLORUGLQVLVWHP FkWLFDOLWDWHDYLHLL
SURIHVLRQLWLORUDIHFWDL DEX]XOGHDOFRROLDOWHVXEVWDQWHDFFLGHQWHUXWLHUHSUREOHPHGHVQWDWH
FRQIOLFWHIDPLOLDOHLFKLDUWHQGLQHVXLFLGDUH 

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psihiatria. De acest sindrom s-DXRFXSDWLQLLDOSVLKRORJLLDSRLLPHGLFLGHPHGLFLQDPXQFLLPHGLFLGH
PHGLFLQVRFLDOGDULSVLKLDWUL

CursXOvQFHDUFVDERUGH]HSUREOHPDSindromului de epuizare (burn-out) la medici, vQFRQGLLLOH


VLWXDLHLJHQHUDWHGHQLYHOHOHGHVWUHVVWRWPDLULGLFDWHvQVLVWHPXOGHVQWDWHLVRFLHWDWHvQJHQHUDO
FXDFFHQWSHVLWXDLDPHGLFLORUGHIDPLOLHSunt abordaWHHSLGHPLRORJLDGLDJQRVWLFXOSUHYHQLUHDL
tratamentul sindromului de epuizare (burn-RXW ODPHGLFLFDUHDUHXQLPSDFWGHRVHELWDVXSUDFDOLWLL
DFWXOXLPHGLFDOGDULDFDOLWLLYLHLLFHORUDIHFWDL

Cuvinte cheie: sindrom de epuizare, burn-out, medici

2ELHFWLYHGHvQYDUH:

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- VUHFXQRDVFVHPQHOHGHDYHUWL]DUHLVGLDJQRVWLFKH]HVLQGURPXOGHHSXL]DUH EXUQ-out) n
UkQGXOSDFLHQLORULDOFROHJLORU
- V-LGLDJQRVWLFKH]HQLYHOXOGHHSXL]DUH burn-out) la care au ajuns n exercitarea profesiei, utiliznd
instrumentele prezentate;
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- FDPDQDJHULVILHFRQWLHQLGHLPSDFWXOLUHSHUFXUVLXQLOHDFHVWXLVLQGURPDVXSUDOXFUXOXLvQ
HFKLSDFDOLWLLDFWXOXLPHGLFDOGDULDFDOLWLLYLHLLFHORUDIHFWDLLVSRDWLQGLFDFHPVXULSRWIL
OXDWHvQFHHDFHSULYHWHRUJDQL]DUHDDFWLYLWLLLQVWLWXLHL

Introducere

Motto: Medice, cura te ipsum!


Luca, 4:23

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SHUVRQDOVXIHUL-DLvQGHSOLQLWYLVXOvQVFXPYLQHDVWD"$VWDvLGRUHDL"&HSRLIDFHDFXP"

 

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sau la graQLDFXSVLKLDWULD

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Burn-RXW % HVWHXQWHUPHQSVLKRORJLFLQWURGXVGH+HUEHUW)UHXGHQEHUJHUvQVHSUHVXSXQHF
pornind de la titlul unui roman de Graham Greene, "A Burnt-Out Case".

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DSDUHODLQGLYL]LLFDUHOXFUHD]FXRDPHQLLvQFDUHSHUVRDQDDIHFWDWGHYLQHFLQLFIDGHYDORDUHD
RFXSDLHLVDOHLVHvQGRLHWHvQOHJWXUFXFDSDFLWDWHDSURSULHGHDSHUIRUPD 0DVODFK (2).

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GHGXUDWFXPDQLIHVWULQHJDWLYHvQSODQSVLKRORJLFSVLKRIL]LRORJLFLFRPSRUWDPHQWDO(Greenberg,
1998).

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SURIHVLRQDOLQWHQVLSUHOXQJLW(ODSDUHDWXQFLFkQGWHVLPLGHSLWLLQFDSDELOVvQGHSOLQHWL
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componente:

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Depersonalizarea - SURSULDSHUVRDQGHYLQHQHLPSRUWDQWLDUSDFLHQLLVXQWY]XLGLQFHvQFHPDL
SXLQvQLQGLYLGXDOLWDWHDORUGHYHQLQGSXULVLPSOXRELHFWHDOHUXWLQHLSURIHVLRQDOH
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Classification of Diseases and Related Health Problems) ca "Problems related to life-management
difficulty" (Z73.0) sau ([KDXVWLRQGLVRUGHU (F43.8)(2),(5).

Epidemiologie

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vQJULMLULSDOLDWLYH VXQWDIHFWDLvQWU-RDQXPLWPVXU    

Impact

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PHGLFDOHFUHWHPHGLFLLSOHDFGLQVLVWHP FkWLFDOLWDWHDYLHLLSURIHVLRQLWLORUDIHFWDL DEX]XOGH
DOFRROLDOWHVXEVWDQHDFFLGHQWHUXWLHUHSUREOHPHGHVQWDWHFRQIOLFWHIDPLOLDOHLFKLDUWHQGLQH
suicidare).

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Website: www.edmed.ro
! E-mail: contact@edmed.ro
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care se impun n tratamentul B.

Etiopatogeneza

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FHVLPXOWDQOHWLHPYHQLWXULOHOHVROLFLWPWRWPDLPXOWELURFUDLHOHOLPLWPLQGHSHQGHQDOH
SXQHPODvQGRLDOMXGHFDWDSURIHVLRQDOL le extindem programul de lucru" (8).

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fi un sHPQGHLQFDSDFLWDWHGHDIDFHIDVWUHVVXOXL

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PDQDJHPHQWXOFDELQHWXOXLQIDFXOWDWHVHvQYDSUDFWLFDUHDPHGLFLQHLQXLPDQDJHPHQWXODIDFHULL
care este un FDELQHWGHPHGLFLQGHIDPLOLH$FHDVWGLQXUPDFWLYLWDWHDUWUHEXLGHOHJDWFWUHXQ
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VHSULFHSVGHOHJHVDUFLQL  

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H[SULPDHPSDWLH&RQVHFLQHOHLQFOXGVFGHUHDFDSDFLWLLGHFRQFHQWUDUHDFFidente rutiere,
SUREOHPHGHVQWDWHFRQIOLFWHIDPLOLDOHLFKLDUWHQGLQHVXLFLGDUH        

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depersonalizare, seQ]DLDGHJROLFLXQHLQWHULRDULGHSUHVLH  QILJXUDSUH]HQWPXQJUDILF
LQWHUHVDQWFDUHvQILHD]SURFHVXOGH%    

Figura 1: Procesul de burn-out Figura 2: 5HIDFHUHDUH]LVWHQHLODVWUHVV


GXSDrosescu P., Sindromul Burn-Out  GXSDrosescu P., Sindromul Burn-Out)

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vQHOHJHUHDSURSULLORUHPRLLDGHVHDHOLPLQDWHGLQSUDFWLFDPHGLFDO  

Efectele negative ale B. VHPDQLIHVWvQWRDWHDVSHFWHOHYLHLL- LQFOXVLYDVXSUDYLHLLSULYDWHIDPLOLDOH


LVRFLDOH%SRDWHGHDVHPHQHDVGHWHUPLQHVFKLPEULSHWHUPHQOXQJvQRUJDQLVPIFkQGX-te
YXOQHUDELOODDIHFLXQLFXPVXQWUFHDODLJULSD6WUHVVXOFURQLFFRQWULEXLHODFUHWHUHDWHQVLXQLL
DUWHULDOHODSUREOHPHFDUGLDFHLODVOELUHDVLVWHPXOXLLPXQ 5).

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(13)

Diagnostic

Diagnosticul, dar mai ales auto-diagnosticul sindromului de B. este dificil pentru un medic
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Sindromul de BGHVFULVFD([KDXVWLRQGLVRUGHU () OHJDWGHDFWLYLWDWHDSURIHVLRQDODUH


XUPWRDUHOHcriterii de diagnostic:
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DIDFHIDVWUHVVXOXLLULWDELOLWDWHVDXLQVWDELOLWDWHHPRLRQDOWHQGLQGHL]RODUH
- simptome fiziologice - WXOEXUULGHVRPQGXUHULPXVFXODUHDPHHOLSDOSLWDLLFHIDOHHRERVHDO
- DFHDVWVLPSWRPDWRORJLHWUHEXLHVVHPDQLIHVWH]LOQLFWLPSGHGRXVSWPkQLLVFDX]H]H
DIHFWDUHDVHPQLILFDWLYDFDSDFLWLLGHPXQF
- trebuie excluse alte diagnostice psihiatrice (depresia PDMRUWXOEXUULOHFRJQLWLYH), abuzul de
VXEVWDQH GHLDFHVWDSRDWHILRPDQLIHVWDUHD% , sau alte diagnostice medicale (ex. hipotiroidie,
hipogonadism, infecii sistemice, etc.) (2).

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profesionaO %QXDSDUHvQYDFDQH vQGHRVHELvQSURIHVLLOHFDUHDXFDRELHFWvQJULMLUHDDOWRU
RDPHQLLGLVWLQFLDIDGHGHSUHVLDSVLKRWLFPDMRUFDUHDIHFWHD]WRDWHDVSHFWHOHYLHLLLQXDUH
RUHODLHFDX]DOGLUHFWFXstressul profesional.

n 1996 &KULVWLQD0DVODFKDLQWURGXVXQLQVWUXPHQWSHQWUXPVXUDUHD%FDUHHVWHFHOPDLIRORVLW
DVW]L0DVODFK%XUQRXW,QYHQWRU\

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! E-mail: contact@edmed.ro
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Tabelul 1: Maslach Burnout Inventory abreviat (adaptat)

&kWGHIUHFYHQWFRUHVSXQGXUPWRDUHOHDILUPDLLFXIHOXOvQFDUHYVLPLLOXFUkQGFDPHGLF"

Zilnic De cteva ori 2GDWSH De cteva 2GDWSH De cteva 1LFLRGDW


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mai rar
5HXHVFVDERUGH]HILFLHQW
SUREOHPHOHSDFLHQLORUPHL
6LPWFvLWUDWH]SHXQLLSDFLHQL
GHSDUFDUILQLWHRELHFWH
0VLPWVHFWXLWHPRLRQDOGLQ
cauza muncii mele
0VLPWRERVLWFkQGPWUH]HVF
GLPLQHDDFXSHUVSHFWLYDXQHLQRL
]LOHGHPXQF
$PGHYHQLWPDLUH]HUYDWIDGH
oameni de cnd am acest job
6LPWFLQIOXHQH]SR]LWLYYLHLOH
altora prin munca mea
Lucrul cu oamenii constituie un
DGHYUDWFKLQSHQWUXPLQH
1XSUHDvPLSDVGHFHHDFHVH
vQWkPSOFXXQLLSDFLHQL
0VLPWEXFXURVGXSFHOXFUH]
ndeaproape cu paFLHQLLPHL

0DUFDLFX;FVXDFRUHVSXQ]WRDUHVLWXDLHLGYV(un singur X pe un rnd).

5VSXQVXULOHVXQWLQWHUSUHWDWHFRQIRUP7DEHOXOXL 1RWDLUVSXQVXULOHGXSFXPXUPHD]

Tabelul 2: Maslach Burnout Inventory abreviat (adaptat). Completarea UVSXQVXULOor

Zilnic De cteva ori 2GDWSH De cteva 2GDWSH De cteva 1LFLRGDW


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mai rar
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SUREOHPHOHSDFLHQLORUPHL
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GHSDUFDUILQLWHRELHFWH
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cauza muncii mele
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GLPLQHDDFXSHUVSHFWLYDXQHLQRL
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$PGHYHQLWPDLUH]HUYDWIDGH 6 5 4 3 2 1 0
oameni de cnd am acest job
6LPWFLQIOXHQH]SR]LWLYYLHLOH 0 1 2 3 4 5 6
altora prin munca mea
Lucrul cu oamenii constituie un 6 5 4 3 2 1 0
DGHYUDWFKLQSHQWUXPLQH
1XSUHDvPLSDVGHFHHDFHVH 6 5 4 3 2 1 0
vQWkPSOFXXQLLSDFLHQL
0VLPWEXFXURVGXSFHOXFUH] 0 1 2 3 4 5 6
vQGHDSURDSHFXSDFLHQLLPHL

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Interpretare:

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B.).
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Cele trei HOHPHQWHFRORUDWHvQYHUGHFRUHVSXQGPSOLQLULLSURIHVLRQDOH$GXQDLVFRUXULOHDIHUHQWH
UVSXQVXULORUUHVSHFWLYHSHQWUXDRELQHVFRUXOWRWDO6FRUXULvQDOWHLQGLFRPSOLQLUHSURIHVLRQDOPDL
VFD]XW LFDXUPDUHPDLPXOW% 
Un scor de 0 -15 indicXQQLYHOVF]XWGH%
Un scor de 16 - LQGLFXQQLYHOPHGLXGH%
Un scor de 31 - LQGLFXQQLYHOvQDOWGH%

La chestionarul de mai sus s-DDGXJDWvQFXQXOFDUHFXDQWLILFVDWLVIDFLDvQOHJWXUFXVLWXDLDGH


a fi medic (Tabelul 3) (16).

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Zilnic De cteva 2GDWSH De cteva 2GDWSH De cteva 1LFLRGDW


ori pe VSWPkQ RULSHOXQ OXQVDX ori pe an
VSWPkQ mai rar

0JkGHVFVUHQXQODPHGLFLQ
SHQWUXRDOWFDULHU
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Regret decizia pe care am luat-o
de a deveni medic

MarcaLFX;FVXDFRUHVSXQ]WRDUHVLWXDLHLGYV

Interpretare:

6FRUXULvQDOWHLQGLFRVDWLVIDFLHPDLPDUHGHDILPHGLF.

Zilnic De cteva 2GDWSH De cteva 2GDWSH De cteva 1LFLRGDW


ori pe VSWPkQ RULSHOXQ OXQVDX ori pe an
VSWPkQ mai rar

0JkGHVFVUHQXQODPHGLFLQ 0 1 2 3 4 5 6
SHQWUXRDOWFDULHU
0JkQGHVFODVDWLVIDFLDSHFDUH 6 5 4 3 2 1 0
RRELQGLQDILPHGLF
Regret decizia pe care am luat-o 0 1 2 3 4 5 6
de a deveni medic

QDIDUGHDFHVWHDH[LVWLDOWHLQVWUXPHQWHGLVSRQLELOHFDUHDMXWODVWDELOLUHDGLDJQRVWLFXOXLGH%
: Burnout Self-Check (Tabelul 4) (17) sau testul elaborat de Clinica Gezeiten Haus Klinik (GHK)
din Bonn (13).

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Tabelul 4: Burnout Self-Check

Intrebare Deloc Rar Uneori Adesea Foarte des


1 9VLPLLHSXL]DWLJROLWGHHQHUJLHIL]LFVDXHPRLRQDO"
2 *VLLFVXQWHLvQFOLQDWFWUHJkQGLUHQHJDWLYIDGH
munca dvs.?

3 9LVHSDUHFVXQWHLPDLH[LJHQLVDXPDLSXLQDPDELOLFX
RDPHQLLGHFkWDUPHULWDDFHWLD"

4 9LVHvQWkPSOVILLFXXXULQLULWDWGHSUREOHPHPLFLVDX
GHFWUHFRODERUDWRULVDXHFKLS"

5 9VLPLLQHvQHOHVVDXQHDSUHFLDWGHFWUHFRlaboratorii
dvs.?

6 6LPLLFQXDYHLFXFLQHVYRUELL"

7 6LPLLFUHDOL]DLPDLSXLQHOXFUXULGHFkWDUWUHEXL"
8 6LPLLFVXQWHLVXSXLXQXLQLYHOQHSOFXWGHSUHVLXQH
SHQWUXDUHXL"

9 6LPLLFQXSXWHLRELQHFHHDFH GRULLGHODVOXMEDGYV"
10 6LPLLFQXYDIODLvQRUJDQL]DLDSRWULYLWVDXvQSURIHVLD
SRWULYLW"

11 QFHSHLVGHYHQLLIUXVWUDWvQOHJWXUDFXDVSHFWHDOH
muncii dvs.?

12 6LPLLFSROLWLFDRUJDQL]DLRQDOVDXELURFUDLDDIHFWHD]
FDSDFLWDWHDGYVGHDYvQGHSOLQLFRUHVSXQ]WRUVDUFLQLOH
de serviciu?
13 6LPLLFVXQWPDLPXOWHOXFUXULGHIFXWGHFkWDLILFDSDELO
vQPRGSUDFWLFVIDFHL"

14 6LPLLFQXDYHLWLPSXOQHFHVDUSHQWUXDUHDOL]DPXOWH
dintre lucrurLOHFDUHWUHEXLHIFXWHSHQWUXDIDFHRPXQFGH
calitate?
15 6LPLLFQXDYHLWLPSVSODQLILFDLDWkWFkWDLGRULV
faceti?

0 0 0 0 0

,QVWUXFLXQL/DILHFDUHvQWUHEDUHUVSXQGHLPDUFkQGXQ;vQFRORDQDFRUHVSXQ]WRDUH3XQHLFkWH
un singur X pe fiecare rnd.

Scorul:
5VSXQV Numar Pondere Total
Deloc 0 0 0
Rar 0 1 0
Uneori 0 2 0
Adesea 0 3 0
Foarte des 0 4 0
0 0

>=
0 )UVHPQHGHEXUQRXW
6HPQHXRDUHGHEXUQ-out, n afara cazului n care unii factori sunt n mod
5 particular severi
)LLDWHQL- DLSXWHDILvQSHULFROGHEXUQ-RXWPDLDOHVGDFXQHOHVFRUXULVXQW
18 ridicate
35 6XQWHLH[SXLXQXLULVFVHYHUGHEXUQ-out - OXDLLPHGLDWPVXUL
45 6XQWHLH[SXLXQXLULVFIRDUWHVHYHUGHEXUQ-out - OXDLXUJHQWPVXUL
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Chestionarul Gezeiten Haus Klinik (GHK) Bonn

$YHLLPSUesia c VXQWHLVXSUDVROLFLWDW"
6XQWHLPDLLULWDELOFDvQXUPFXDQ"
9GLVSODFHPXQFDSHFDUHRIDFHL"
6XQWHLFRQWLQXXVXUPHQDW"
9VLPLLSUHDRERVLWSHQWUXDFWLYLWLUHFUHDWLYH"
QUHJLVWUDLvQXOWLPDYUHPHvQPRGUHSHWDWVLPSWRPHIL]LFH ?
9UHWUDJHLGLQFHvQFHPDLPXOWGLQFHUFXOGHSULHWHQL"
5HFXUJHLGLQFHvQFHPDLGHVODDOFRRO"
$YHLYUHRVSHUDQFSXWHLVFKLPEDFHYD"
$YHLSODQXULQRL"
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$YHLWLPSSHQWUXSDUWHQHUSDUWHQHU"
9vQFKLGHLFHOXODUXOSHQWUX DILGRDUFXSDUWHQHUXOVDXSHQWUXRDOWRFXSDLHLQWHUHVDQW"
9VLPLLJROSHGLQXQWUX"
$YHLVWULGHDQJRDVSHFDUHQXOHDYHDLvQDLQWH"
Vi se pare totul lipsit de sens ?
6XQWHLSHUPDQHQWvQSUL]"
$YHLLPSUHVLDFSDUWHQHUXOVDXSULHWHQLL YHYLW"
/XDLVHGDWLYHVDXSDVWLOHGHGRUPLW"
9LVHSDUHFSDX]HOHVXQWWLPSSLHUGXW"

,QWHUSUHWDUH'DFDLUVSXQVODPDLPXOWGHvQWUHEULFX'$SUREDELOFVXIHULLGHVLQGURPXOGH
%/XDLPVXUL

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Tratamentul preveQWLYLFXUDWLYDOHSXL]ULLJHQHUDWHGHVWUHVVQXHVWHXQOXFUXVLPSOXLQXVHSRDWH
IDFHUHFXUJkQGODPHGLFDPHQWHFLODRDERUGDUHPDLFRPSOH[SULQVFKLPEDUHDVWLOXOXLGHYLD
DSHODUHDODFRQVLOLHUHSVLKRORJLFWHKQLFLGHJHVWLRQDUHDVWUHVVXOXLVau participarea la grupuri de
suport. (YLGHQWvQDLQWHGHDOXDRULFHPVXUHVWHQHFHVDUVWDELOLUHDGLDJQRVWLFXOXLFRUHFW

6WUHVVXOFDX]HD]DQ[LHWDWHLQVRPQLHRVWLOLWDWHRERVHDOFURQLFUHWUDJHUHSLHUGHUHDPRWLYDLHL
$GHVHDRDPHQLLVWUHVVDLDOHJVVHUHWUDJQFD]XOPHGLFLORUPXOLVHUHIXJLD]vQPXQFDORUvQ
VWXGLXLHYLWYLDDVRFLDOQVDFHDVWL]RODUHOHDJUDYHD]VWDUHDQFRQVHFLQHVWHQHFHVDU
stimularea FXOWLYULLLQWHUHVXOXLVRFLDO, care este un factor important n evitarea sau combaterea
stressului. &XFkWRDPHQLLVHVLPWPDLFRQHFWDLODFHLODOLFXDWkWVLPWPDLPXOWFDXFRQWULEXLDORU
vQVRFLHWDWHFVXQWVSULMLQLLDXVHQWLPHQWXOGHDSDUWHQHQLVXQWPDLSXLQYXOQHUDELOLvQIDD

VROLFLWULORU$VWIHOGHVFULVLQWHUHVXOVRFLDOHVWHFHYDPDLPXOWGHFkWJULMDRIHULWGHPHGLFXOGHIDPLOLH
SDFLHQLORUVL(OLPSOLFLWLPSXOSHWUHFXWvPSUHXQFXIDPLOLDVDLFXSULHWHQLLGLQ afara domeniului
PHGLFDOIDSWFDUHRIHUSHUVSHFWLYHQRLDVXSUDSUREOHPHORU   (19), (20).

2DOWPRGDOLWDWHGHDFUHWHUH]LVWHQDODVWUHVVFRQVWvQvQJULMLUHDSURSULHLVWULGHVQWDWH prin
DOLPHQWDLHFRUHFWFXOWLYDUHDXQRUKREE\-XULLH[HUFLLXIL]LF DFWLYLWDWHDIL]LFPRGHUDWFUHHD]R
stare de bine). &KHLDHVWHVJVLLRDFWLYLWDWHFDUHY IDFHSOFHUHLVIDFHLGLQHDRSULRULWDWH
8QLLDUSXWHDVSXQHFQXDXWLPSSHQWUXDVWDGDUGHIDSWQXHVWHDGHYUDW3URJUDPDL-YRUDGH
PLFDUHvQDFHODLFDLHWvQFDUHIDFHLSURJUDPULOHSHQWUXDFWLYLWLOHSURIHVLRQDOH(20).

2DWUHLDDERUGDUHDVWUHVVXOXLRFXSDLRQDOvQPHGLFLQSRDWHILGHWLSKRPHRSDWLFcui pe cui se
scoate. (GXFDLDPHGLFDOFRQWLQX, cu cultivarea n profunzime a unui domeniu medical, sau
YDORUL]DUHDUHODLHLSHUVRQDOHPHGLF-pacient3DFLHQLLQRWULSRWILLQWHUORFXWRULIRDUWHLQWHUHVDQL
GDFvQFHUFPVOHDFRUGPDWHQLHFDXQRUILLQHXPDQHIUVQHOLPLWPODWUDWDPHQWXO
DIHFLXQLORUGHFDUHVXIHU

8QDGLQWUHPHWRGHOHSURSXVHSHQWUXDFRQWUDFDUDVHQWLPHQWXOGHSLHUGHUHDFRQWUROXOXLi a scopului
vQYLDHVWHGH]YROWDUHDFRQWLHQHLVDXDamintirii de sineFDOLWDWHDGHDILSHGHSOLQSUH]HQWLDWHQW
vQILHFDUHPRPHQWDODFWLYLWDLORU]LOQLFH6-DVXJHUDWFDQWUHQDUHDLQWHQVLYDDWHQLHLFRQWLHQHL
LDELOLWLORUvQFRPXQLFDUH aUSXWHDFUHWHVHQ]DLDGHELQHDPHGLFXOXLLDUSXWHDSURPRYD
VFKLPEULSR]LWLYHvQFDSDFLWDWHDPHGLFXOXLGHDUHODLRQDFXSDFLHQLLVLUH]XOWkQGvQFUHWHUHD
HPSDWLHLLRSUDFWLFFHQWUDWSHQHYRLOHSDFLHQWXOXL  

"A evita B. este la fel cu a meUJHFXELFLFOHWDDPEHOHQHFHVLWPHQLQHUHDHFKLOLEUXOXLLDGDSWDUHDOD


SDUWLFXODULWLOHWHUHQXOXL 20).
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(VWHQHFHVDUVQHLPXQL]PFRQWUD%vQYkQGVQHHFKLOLEUPYLDDLVVSXQHPXQHRUL18
VROLFLWULORU tot mai mari din societatea contemporan$FHUHDMXWRUDXUPDXQFXUVRULSXUL
simplu DOXDRYDFDQIDFSRVLELOUHFXSHUDUHDvQVWRWXOvQFHSHFXUHFXQRDWHUHDLvQFHUFDUHDGH
a schimba ceva (21), (22).

Medicul afectat de sindromul de B. poate apela la un psihoterapeut, care l poate ajuta:


- 6vQHOHDJELQHFDUDFWHULVWLFLOHPXQFLLVDOHVDXLVJVHDVFFHOHPDLEXQHVROXLLSHQWUXD-i
FUHWHVWLPDGHVLQH
- 6-LUHHYDOXH]HFUHGLQHOHJUHLWHOHJDWHGHVWUHVVRULLGHODORFXOGHPXQF
- 6-LIRORVHDVFSXWHUHDGHFRQWUROSHFDUHRDUHIDGHVWUHVVRUL
- 6vQFHUFHV-LLDSDX]HYDFDQHVFXUWHFDUHSRWILPDLHILFLHQWHvQIDDVWUHVVXOXLGHFkWRYDFDQ
OXQJ
- 6SUDFWLFHMRFXOGHUROSHQWUXDSXWHDOXFUDSHRVLWXDLHFRQFUHWGHVWUHVVSURIHVLRQDO
- 6vQFHUFHVIDFVSRUWLVHOLPLQHRELFHLXULOHGLVWUXFWLYH
- 6vQHOHDJLPSRUWDQDDFWLYLWLORUUHFUHDWLYH
- 6vQFHDSLXQSURJUDPSVLKRORJLFDXWRDGPLQLVWUDW UHOD[DUHSURJUHVLYUHVSLUDLHFRQWURODW
PHGLWDLHDXWRVXJHVWLHDXWRKLSQR]   

n Romnia, ca LvQDOWHULH[LVW*UXSXULOH%iOLQWFDUHDXFDVFRSIRUPDUHDSVLKRORJLFFRQWLQXD
SDUWLFLSDQLORUSHQWUXDvPEXQWLFDOLWDWHDUHODLHLGLQWUHPHGLFLSDFLHQWLSHFHDGLQWUH
SURIHVLRQLWLLPHGLFDOL  

Michael Blint (1896-1970), psihanalisWHQJOH]GHRULJLQHPDJKLDUDSXVED]HOHXQHLPLFULFDUH


XUPUHWHXPDQL]DUHDUHODLHLPHGLF-SDFLHQW*UXSXO%iOLQWHVWHXQJUXSVSHFLILFDOFWXLWGLQ-13
SHUVRDQHSURIHVLRQLWLFDUHVHRFXSGHEROQDYL vQVSHFLDOPHGLFLJHQHUDOLWLGDULPHGLFLGe alte
VSHFLDOLWLSVLKRORJLHWF LFDUHVHUHXQHVFSHULRGLFVXE

conducerea a unuia sau a doi lideri. 6HDERUGHD]UHVSHFWkQGRGLVFLSOLQDGLVFXLLORUDQXPLWH


FD]XULGHUHODLHPHGLF-SDFLHQW WXOEXUULIXQFLRQDOHSVLKRVRPDWLFHFRPXQLFDUHDYHtilor proaste,
etc.) prin metoda Blint sau se recurge la 3VLKRGUDPDDQDOLWLF*UXSXULOHILLQGHWHURJHQHRIHU
SRVLELOLWDWHDDERUGULLPXOWLGLVFLSOLQDUHDVXELHFWXOXLGLQSXQFWGHYHGHUHPHGLFDOHFRQRPLFGLGDFWLF
ILORVRILF0HGLFXOQHFHVLWRIRUPDUH HPRLRQDOSURSULHHOvQYDVGHYLQWROHUDQWVQXMXGHFH
V-LDFFHSWHSURSULLOHOLPLWHVQXVHVXSUDVROLFLWHLVILHFDSDELOVSUHWLQGSDFLHQWXOXLV
vQGHSOLQHDVFDQXPLWHFRQGLLLSHQWUXFDVSRDWILDMXWDWQFDGUXOJUXSXULORU%iOLQWparticipantul
SDUFXUJHXQSURFHVWUHSWDWGHGH]YROWDUHVXIOHWHDVFGHYHQLQGPDLFRQVHFYHQWPDLUEGWRUPDL
vQJGXLWRU  

n acest mod se poate contracara sindromul de B. sub toate cele trei aspecte ale sale, de epuizare
HPRLRQDOGHGHSHUVRQDOL]DUHLGHVHQWLPHQWVF]XWGHvPSOLQLUHSURIHVLRQDO

QOXSWDFRQWUD%PDLVXQWGLVSRQLELOHPHWRGHFDUHLQGHmanagementul cabinetului medical.


'LQWUHDFHVWHDVHSRWHQXPHUDGRWDUHDFXWHKQLFLQIRUPDWLFLRUJDQL]DUHDFDELQHWXOXL
completarea echipHLFXSHUVRQDOPHGLXLDX[LOLDUVXILFLHQWGHOHJDUHDGHVDUFLQLLQWURGXFHUHDGH
SDX]HvQIXQFLHGHVSHFLILFXODFWLYLWLLXQVLVWHPHILFLHQWGHSURJUDPULSHQWUXFRQVXOWDLLFX
SURJUDPDUHDXQXLQXPUPD[LPGHSDFLHQL]LSOXVRPDUMSHQWUXXUJHQHVtabilirea de obiective
realiste (25).

)LLQGPHGLFLGHIDPLOLHGHFLPHGLFLFDUHVHRFXSvQPDUHPVXUFXPHGLFLQDSUHYHQWLYSHQWUX
SDFLHQLLQRWULDUWUHEXLVILPFDSDELOLQRLvQLQHVQHIHULPGHSHULFROXOLQVWDOULLVLQGURPXOXLGH%
VDXGDFDFest lucru deja s-DSURGXVVDYHPODvQGHPkQPLMORDFHOHSRWULYLWHGHDQHYLQGHFD

Bibliografie

1. Physicians giving up medicine, MomMd - Connecting women in medicine, 2011 MomMd LLC [accesat la
14.11.2011]. Disponibil la http://www.mommd.com/givingup.shtml.
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Health Publications; 2011.
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among 14 surgical specialties, comparing academic and private practice settings. Johns Hopkins Medical
Institutions Annals of surgery 2011; 254(4):558-68.

*!
Website: www.edmed.ro
! E-mail: contact@edmed.ro
!
!

7. RadX2$PSORDUHDVLQGURPXOXLGHEXUQRXWODPHGLFLLFDUHOXFUHD]vQGRPHQLXOvQJULMLULORUSDOLDWLYHDFRUGDWH
EROQDYLORUGHFDQFHUVXQWHLSUHJWLLVIDFID">DFFHVDWOD@'LVSRQLELOOD
http://www.paliatia.eu/uploads/2011/PALvol4no1Jan2011en.pdf.
8. Pho K. Primary care doctors face burnout, and how that affects health reform. MedpageToday, 2011.
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transition from communism to capitalism. Oxford Journals, Family Practice, 2008;28(4):437 443.
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14. Teacher Burnout - The reDOLW\RIWKHSUREOHPDGDSWDUHGXS&R\RWH&6ORZ/HDGHUVKLS+HURLF
Management [accesat la 14.11.2011]. Disponibil la: https://sites.google.com/site/teacherburnoutandresources/
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PsihoCenter.ro
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physicians? The official journal of The College of FAmily Physicians of Canada 2008;54(2): 234 - 235.
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for burnout. Family Practice Management 2000;4:70.
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5HYLVWDGHPHGLFLQLSVLKRORJLHDHURQDXWLF  -21.

Linkuri utile

http://www.mindtools.com/pages/article/newTCS_08.htm
https://www.cpp.com/en/detailprod.aspx?pc=35
http://www.asociatiabalint.ro

"+!

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