Burnout is related to executive dysfunction in primary healthcare professionals working in rural areas
*Correspondence: Dr. Irene Cano-López. Universidad Internacional de Valencia. Calle Pintor Sorolla, 21. E-46002 Valencia.
E-mail: irene.cano@campusviu.es
Introduction: Healthcare professionals are especially vulnerable to burnout, which implies a hypothalamus-pituitary-adrenal dysregulation that could impact the integrity of brain structures needed for cognitive processing. However, a scarce number of studies have analyzed the relationship between burnout and executive functions in this population, and possible modulator factors have not been clarified. This study aims to characterize the burnout level of primary healthcare professionals working in rural areas, and to analyze its relationship with executive functioning, considering the possible modulating role of optimism.
Subjects and methods: In this cross-sectional study, 32 primary healthcare professionals were recruited from the Carcastillo Health Center (Spain) and underwent an assessment in which burnout was assessed using the Maslach Burnout Inventory - Human Services Survey. Optimism and executive functions were also evaluated.
Results: 43.8%, 59.4%, and 56.3% of participants experienced high levels of burnout via emotional exhaustion, depersonalization, and personal accomplishment. The path analysis showed that emotional exhaustion was associated with poorer Trail Making Test scores (ß = -0.37, SE = 0.17, p = 0.024, Cohen's f2 = 0.15), but optimism was not a significant moderator of this relationship (p = 0.24). The proposed model yielded excellent fit (CFI = 1.00, RMSEA = 0.0001, SRMR = 0.0001, and ?2(3) = 6.07, p = 0.11).
Conclusions: These results suggest that burnout in healthcare professionals could have a detrimental effect on the efficiency of health systems. This has relevant implications, especially for professionals characterized by both work pressure and high cognitive demands, and highlights a need to implement occupation-specific approaches for prevention.
Sujetos y métodos En este estudio transversal, 32 profesionales de atención primaria fueron reclutados en el centro de salud de Carcastillo (España) y sometidos a una evaluación en la que se valoró el burnout mediante el Maslach Burnout Inventory-Human Services Survey, y el optimismo y las funciones ejecutivas.
Resultados El 43,8, el 59,4 y el 56,3% de los participantes experimentaron alto burnout a través del agotamiento emocional, la despersonalización y la desrealización personal. El path analysis mostró que el agotamiento emocional se asoció con peores puntuaciones en el Trail Making Test (beta = –0,37, SE –error estándar– = 0,17, p = 0,024, f2 de Cohen = 0,15), pero el optimismo no fue un moderador significativo (p = 0,24). El modelo mostró un ajuste excelente (índice de ajuste comparativo = 1, error cuadrático medio de aproximación = 0,0001, residuo cuadrático medio estandarizado = 0,0001, y chi cuadrado(3) = 6,07, p = 0,11).
Conclusiones Estos resultados sugieren que el burnout en profesionales sanitarios podría tener un efecto perjudicial sobre la eficiencia del sistema sanitario. Esto tiene implicaciones relevantes, especialmente para profesionales caracterizados tanto por la presión laboral como por las altas demandas cognitivas, y pone de manifiesto la necesidad de implementar enfoques específicos para su prevención.